ABSTRACT
One of our primary goals as physician is to promote patient safety and comfort. With recent advancements in technology and modern intensive care, we are able to improve outcomes in critically ill patients who in the past had little hope of survival. Aggressive critical care often involves life support measures and invasive techniques that are frequently uncomfortable and=or frightening. Patients with normal mentation may be aware that their life is threatened and yet often have little ability or opportunity to communicate with others. The stress of systemic derangement and organ failure often results in mental status changes or encephalopathy. These factors in addition to unpleasant aspects of the intensive care unit (ICU) environment may contribute to disorientation, agitation, and delirium in many critically ill patients. The inability of such patients to comprehend or cope with their circumstances often results in unsafe conditions for both the patient and staff members should they become combative or severely agitated. Sedation helps to alleviate anxiety, facilitates mechanical ventilation, and helps to modulate excessive humoral and hemodynamic manifestations of the stress response (1-6). Inadequate pain control may also contribute to the patient’s distress or agitation and must be routinely assessed and treated as needed.
