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ICU ABCDEF Bundle Delirium Prevention — FRCA Final MCQ

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ModerateIntensive Care MedicineICU ABCDEF Bundle Delirium PreventionFRCA Final

A 75-year-old woman (ASA III) has been in ICU for 14 days with abdominal sepsis. She is being weaned from ventilation. Assessment with the ICU Liberation ABCDEF bundle includes which specific delirium prevention strategy?

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Correct answer: B — Early mobilisation and non-pharmacological delirium prevention

The ABCDEF bundle (Assess/prevent/manage pain, Both SATs and SBTs, Choice of analgesia and sedation, Delirium assessment/prevention/management, Early mobility and exercise, Family engagement) is the evidence-based framework for ICU liberation. The 'D' component emphasises non-pharmacological delirium prevention: early mobilisation, sleep promotion (minimising nocturnal interruptions, earplugs, eye masks), cognitive stimulation, re-orientation, minimising benzodiazepines, and family involvement. Routine antipsychotic prophylaxis is not recommended (MIND-USA trial showed no benefit of haloperidol or ziprasidone for delirium prevention).

Reference: ICS – 2023 – ABCDEF bundle guidelines; Girard TD – 2018 – MIND-USA trial