Dr Pamela Page 💙

Critical care nurse and academic, passionate about person and family centred care.
2019 Churchill Fellow, ICUsteps trustee.

[Dr Pamela Page 💙 @PamPage16]

Please support this research to enhance family centred care in ICU - a global study @TantamKate @ZoeWilligen @ICUsteps @chodgsonANZICRC @RanaAwdish @DrSamuelBrown

[ICUsteps @ICUsteps]

Family involvement in ICU care activities - https://t.co/zmEaXKIdc2

[ICUsteps @ICUsteps]

Family involvement in ICU care activities - https://t.co/zmEaXKIdc2

[Prevention is the new cure @PreventionPodc]

“We have seen a trebling of presentations of anaphylaxis to emergency departments in 20 years”

@DrAdamFox presents examples of tragic and avoidable cases of young people dying from an allergic reaction, in similar circumstances highlighting the case for full ingredient lists on menus in restaurants.

He points to the @OwensLaw1 campaign which advocates for this to be passed into law.

@JimBethell | @BrineHealth | @BSACI_allerg | @NatashasLegacy | @AllergyUK1 | @AnaphylaxisUK

[Hopkins ICU Rehab @icurehab]

“ICU Rehabilitation is
so incredibly important”

“Our patients need it and deserve it”

Hear @DrDaleNeedham discuss
“Why Early #ICURehab Matters”

15th Johns Hopkins #ICURehab Conf

In-Person at Johns Hopkins
Nov 5-6, 2026
Register: https://t.co/B4YFfRLOcl

@APTAcvp, @AOTAInc, @ATSCritCare, @AcuteCareAPTA, @HopkinsAMP

[Nursing in Critical Care Journal @niccjournal]

Sustainability in ICU is not an “extra”.

It is a patient safety, governance, and quality-of-care issue.

The challenge isn’t staff motivation — it’s organisational design.

🔗 https://t.co/aOFptFRYu3

[Peter Nydahl @NydahlPeter]

Who Knows the Patient Best? An Epistemological Approach to Family-Centered Care for Unconscious Patients in the Adult Intensive Care Unit

Food for thought
https://t.co/z2LttLJsg9

[Nursing in Critical Care Journal @niccjournal]

Family-centred ICU care often forgets children.

Excluding children from bereavement doesn’t protect them — it may increase distress and confusion.

Children need honest, supported inclusion, not silence.

🔗 https://t.co/TWUS7RkN07

[Offcall @OffCallDotCom]

Dr. @RanaAwdish nearly died during residency, as a patient, inside her own hospital.

What she learned changed how she thinks about medicine, compassion, and what we ask physicians to suppress in order to survive.

New episode of How I Doctor is out now 🧵

Listen: https://t.co/SxVAHCmYXr

#HowIDoctor #MedTwitter #PhysicianBurnout #CompassionateCare

[Dr. Chacón-Lozsán F .'. @franciscojlk]

👵🏼Older adults already account for the majority of ICU days in many healthcare systems.

Yet modern critical care is still largely designed around:
⚙️ disease centered models
⚙️ organ centered endpoints
⚙️ short term survival metrics

rather than:
🧠 cognition
🚶 mobility
🏠 independence
👥 quality of recovery
❤️ what actually matters to older patients.

The document repeatedly emphasizes that:
• frailty
• baseline functional status
• cognition
• disability
• mobility
• social vulnerability
often predict outcomes better than age itself.

Notably, the guideline highlights principles that are often overlooked in traditional ICU culture: 📌 minimizing restraints
📌 reducing unnecessary catheters
📌 deprescribing anticholinergics
📌 hearing optimization
📌 mobility preservation
📌 occupational therapy integration
📌 delirium prevention strategies

This reflects an important evolution:

Modern critical care is no longer only about survival. It is increasingly about survivorship.

One particularly important concept is the Age Friendly Health System “4Ms” framework:
🧠 Mentation
💊 Medications
🚶 Mobility
❤️ What Matters Most

In practice, this means ICU decisions should not focus exclusively on:
• vasopressor dose
• ventilator settings
• creatinine trends

but also:
• whether the patient may walk again
• preserve cognition
• return home independently
• maintain social identity and autonomy

The delirium recommendations are also notable.

The guideline suggests:
⚠️ avoid prophylactic antipsychotics for delirium prevention in older ICU adults.

This is important because antipsychotics are often perceived as “low risk ICU routine medications,” while older adults are particularly vulnerable to:
• oversedation
• falls
• prolonged cognitive dysfunction
• inappropriate continuation after discharge

Another fascinating area: 🩸 permissive hypotension in older vasodilatory shock patients.

The panel ultimately made no formal recommendation regarding MAP 60-65 mmHg versus traditional targets >65 mmHg because evidence remains uncertain.

However, the discussion reflects a broader critical care transition:
⚖️ balancing organ perfusion against vasopressor burden and iatrogenic harm.

Perhaps the most clinically meaningful line in the entire document:

Older adults often prioritize maintaining independence over survival itself.

That single concept should fundamentally change: • goals of care discussions
• ICU communication
• rehabilitation planning
• discharge decisions
• outcome measurement in research

This guideline is less about “geriatric ICU protocols” and more about redefining what successful critical care truly means.

📖 Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU. Critical Care Medicine, 2026.
DOI: 10.1097/CCM.0000000000007085

[BACCN 💙 @BACCNUK]

BACCN are proud to offer financial support to members through grants for conference attendance, events, and research.

We have also made it easier than ever before with the launch of our new online grant application process.

Full details on our website: https://t.co/P47Ov7lCQf

[Alasdair MacLullich @A_MacLullich]

Delirium treatment should involve *brain care* AND *mind care*.

#delirium

[The UK Sepsis Trust @UKSepsisTrust]

In 2014, aged just 18, university student Emma Musson developed severe #sepsis after a perforated appendix.

Now, she’s sharing her story to encourage young survivors struggling after sepsis to seek support 🧡

Read Emma’s story: https://t.co/kSGdzeVN5K

[Peter Nydahl @NydahlPeter]

The Dutch Clinical Practice Guideline: Pain, analgesia/sedation, delirium, immobility and sleep disturbances; PADIS

https://t.co/0AZWcAGAFh

[Johns Hopkins Activity & Mobility Promotion (AMP) @HopkinsAMP]

Mobility outcomes do not improve from tools alone. They improve when mobility is operationalized as a coordinated #hospital system.

Increasing d/c home 🏠 and reducing #Falls #Delirium #VTE #PressureInjuries starts upstream with mobility.

#HospitalMobility

[BACCN 💙 @BACCNUK]

The University of Technology, Sydney are partnering with the James Lind Alliance (JLA) to identify the top research priorities about communication and swallowing difficulties after critical illness.

View further information here:
https://t.co/8zy4Mi4IAh

[Chartered Society of Physiotherapy (CSP) @thecsp]

'We must put AHP leadership at the table at every level.'

MPs highlighted the value of physiotherapy at the first-ever House of Commons debate on the contribution of allied health professionals.

Thank you @SoniaKumarMP @SWDevonRebecca @lukeakehurst

Read more: https://t.co/KonBfy1wbV

[ICU Steps Edinburgh @ICUSEdinburgh]

#ICUThoughtForToday: Doing your best looks different every day

[Peter Nydahl @NydahlPeter]

Standard of care for rehabilitation in critical illness

Excellent review by @chodgsonANZICRC and team
https://t.co/HuvDbcbjba

[ICUsteps @ICUsteps]

Help Shape the Future of Intensive Care Research - https://t.co/DnUtmwjvDf

[Alasdair MacLullich @A_MacLullich]

Clinical tip on #delirium: involve the multidisciplinary team, including physiotherapy, occupational therapy & pharmacy.