Sedation, Analgesia, Delirium, and Mobility in Critical Care: A Comprehensive Clinical Guideline

Evidence-based guideline for pain assessment, sedation management, delirium prevention and treatment, early mobility, and sleep promotion in the ICU — the PADIS/ABCDEF bundle approach.

5 articles Updated Mar 2026

Part 5: Special Populations & Quality Metrics

PADIS management in special populations including post-operative, neurological injury, substance withdrawal (alcohol/CIWA, opioid/COWS), ECMO and CRRT dosing adjustments, plus quality metrics, bundle compliance measurement, and implementation strategies.

Part 4: Early Mobility and Exercise & Sleep Promotion

Safety screening criteria for ICU mobilization, progressive mobility levels, ICU-acquired weakness diagnosis and prevention, barriers to early mobility, sleep disruption assessment and causes, non-pharmacologic and pharmacologic sleep interventions, and circadian rhythm management.

Part 3: Delirium Assessment, Prevention, and Management

Complete delirium assessment tools (CAM-ICU flowsheet, ICDSC scoring), delirium subtypes, modifiable and non-modifiable risk factors, evidence-based non-pharmacologic prevention bundles, and pharmacologic management including haloperidol, quetiapine, and dexmedetomidine dosing.

Part 2: Agitation and Sedation Assessment and Management

Comprehensive sedation assessment (RASS, SAS complete scoring tables), light sedation targets, sedative agent pharmacology and dosing (propofol, dexmedetomidine, midazolam, ketamine), propofol infusion syndrome, daily sedation interruption protocols, and nurse-driven sedation algorithms.

Part 1: ABCDEF Bundle Overview & Pain Assessment and Management

The ABCDEF bundle framework for ICU liberation, comprehensive pain assessment tools (BPS, CPOT, NRS) with complete scoring tables, and evidence-based analgesic management including opioid dosing, non-opioid adjuncts, and multimodal protocols.