Definition of ICU psychosis | |
Our
ICU psychosis Main Article provides a comprehensive look at the who, what, when and how of ICU psychosis
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b>ICU psychosis: A disorder in which patients in an intensive
care unit (ICU) or a similar hospital setting may experience anxiety,
become paranoid, hear voices, see things that are not there, become
severely disoriented in time and place, become very agitated, even
violent, etc. The condition has been formally defined as "acute brain
syndrome involving impaired intellectual functioning which occurs in
patients who are being treated within a critical care unit." ICU
psychosis is a form of delirium, or acute brain failure. Organic
factors including dehydration, hypoxia (low blood oxygen), heart
failure (inadequate cardiac output), infection and drugs can cause or
contribute to delirium.
The treatment of ICU psychosis depends on the cause(s). Family
members, familiar objects and calm words may help. Dehydration should
call for fluids. Heart failure needs treatment with digitalis.
Infections must be diagnosed and treated. Sedation with anti-
psychotics agents may help.
To prevent ICU psychosis, many critical care units now have
instituted visiting hours, they try to minimize shift changes in the
nursing staff caring for a patient, the lighting is coordinated with
the normal day-night cycle, etc. ICU psychosis usually goes away when
the patient leaves the ICU.
One patient in every 3 who spends more than 5 days in an ICU
experiences some form of psychotic reaction, according to current
estimates. As the number of intensive care units and the number of
people in them grow, ICU psychosis is perforce increasing as a
problem.
What causes ICU psychosis is not fully known. Something about the ICU
causes some people, who are already experiencing great debility,
stress and pain, to "lose their minds." Among the factors which are
believed to play into ICU psychosis are:
- Sensory deprivation (being put in a room often without
windows, away from family, friends and all that is familiar),
- Sensory overload (being tethered to noisy machines day and
night),
- Pain (which may not be adequately controlled in an ICU),
- Sleep deprivation,
- Disruption of the normal day-night rhythm, or simply
- The loss of control over their lives that patients often feel in
an ICU.
ICU psychosis often goes away with the coming of morning or sleep.
Although it may linger through the day, severe agitation usually
occurs only at night. (This phenomenon, called sundowning, is common
in nursing homes).
Here is an example of ICU psychosis definition - medical term
Once when we went to visit my father-in-law in an ICU, we found him
disoriented and very depressed. He couldn't hear or see well. It was
like being in a medically induced whiteout. His room was windowless.
He was unable to listen to a radio, watch television or talk on the
telephone. He had virtually no human contact other than brief visits
by medical staff because he was in isolation with an infection and
those people he did see were in mask and gown and all looked alike.
He felt cut off from human contact. He was sure he was going to die
(which he didn't). He had ICU psychosis.
It turned out that my father-in-law's customized hearing aid left
lying on the nightstand had disappeared. It had apparently fallen
into the waste basket and then been thrown out with the trash. To
safeguard his glasses, a well-meaning nurse had then suggested that
his glasses be taken home. Hence he could not hear or see much.
Restoration of his hearing aid and glasses largely relieved his ICU
psychosis.
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