One patient thought the blood pressure cuff was a tentacle

One of the risks facing patients in critical care is a condition known as ICU (Intensive Care Unit) delirium.

However, a good night’s sleep can help with the condition, which affects half of patients in intensive care, according to Doctor George Gardiner.

The consultant at Belfast Health & Social Care Trust has studied the condition, and says its seriousness is often underestimated.

“In an intensive care unit, there’s no night. There’s always somebody working around you, you’re connected to lots of monitors with flashing lights, there’s constant noise.

“You’ve often got a tube in your throat, you’re attached to various machines.

“The best way

I can describe the conditions of intensive care is, if you did that to somebody anywhere other than a hospital, you’d be arrested and accused of war crimes. It’s the sort of experience you would expect if you were training for the SAS.”

For the delirious patient, the experience can be terrifyingly real.

“We put an inflatable band round patients’ calves to stop them getting blood clots, it’s sort of like a blood pressure device. I had one patient who thought the band on his leg was an octopus that was trying to drag him underwater and drown him.

“The external stimulus is being interpreted incorrectly by the disordered brain. You can imagine how distressing that would be.”

ICU delirium takes two forms, according to Dr Gardiner – hypoactive and agitated.

The first is where the patient looks outwardly normal but is facing turmoil on the inside.

“The second is where you don’t know where you are, or what’s going on. You may have delusions or think you’re being attacked, you start hitting out at staff, and become a danger. There’s no magic bullet cure for ICU delirium, although there are things that can help.

“Trying to keep night and day as normal as possible is one way of doing it. We try to keep the clocks in the view of patients so they know what time of day it is.

“Getting people up, mobilising them and getting them sitting out of bed, even while they’re still attached to their ventilator or their kidney dialysis machine makes a difference.

“Sedatives and keeping patients in a constant twilight state isn’t helpful.

“We’re trying to think of the intensive care unit as a gym, not as somewhere you go to rest.

“Then there’s simple awareness of this condition. We often have relatives who are baffled their family member is suddenly accusing doctors and nurses of being Nazis who are trying to kill them.

“I’d like patients’ relatives to keep in mind that this sort of delirium affects up to 60% of patients, and is much more common than people expect.”