3.15.5 - Anxiety, Psychological Trauma and the Difficult Patient in Intensive Care

Summary

Key Learning Points

1. 1. No one chooses to become an intensive care patient – adjusting well draws both on coping skills and on experienced, empathic staff to help vulnerable people.

2. 2. Anxiety is the norm, not the exception, in a busy, noisy ICU. Even high-standard ICU care can bring back memories of previous bad experiences, especially psychological traumas such as childhood abuse.

3. 3. Early identification of anxiety disorders (including trauma-generated) and multi-level interventions will reduce anxiety amongst patients, their carers and staff.

4. 4. Experienced ICU staff deal with a range of personality traits and diverse reactions to illness. Staff supporting one another is the most effective intervention.

5. 5. Up to 25 per cent of discharged ICU patients have post-traumatic stress disorder (PTSD) symptoms – there are subgroups more likely to get PTSD and minimising ICU benzodiazepine use has been shown to diminish it.