An algorithm to distinguish the need for sedative, anxiolytic, and analgesic agents

This article discusses the use of an algorithm developed by nurses at the University of Minnesota Hospital and Clinic in Minneapolis, that can be used to distinguish the need for sedative, anxiolytic, and analgesic agents for patients in the medical intensive care unit (MICU). Many problems associated with patient sedation and analgesia exist within the critical care environment. These problems include undersedating patients with neuromuscular blockade; rapidly tapering or abruptly discontinuing high-dosage sedation, which often results in withdrawal symptoms; over-use of high-dosage continuous intravenous infusions of short-acting benzodiazepines and analgesics; failure to recognize delirium; and resistance to modifying drug regimens when patient outcomes are not satisfactory.