Through the creation of an interdisciplinary curriculum, an institution can effectively train health care providers in a new resuscitation team role: the family support provider.

based on unit bed location. The primary endpoint was the incidence of delirium during ICU admission. Secondary endpoints included time to onset of delirium and ICU and hospital length of stay (LOS). Results: Twenty-two patients received quetiapine and forty-nine patients did not. The incidence of delirium was 45.5% (10/22) in the quetiapine group and 77.6% (38/49) in the control group (p = 0.013). The mean time to onset of delirium was longer, (1.4 days [SD ± 1.5] vs. 2.5 [SD ± 1.5]; p = 0.059), in the quetiapine group. There was no significant difference in ICU or hospital LOS. Conclusions: For critically ill, trauma/ surgical patients identified as high-risk for delirium, prophylactic administration of low-dose quetiapine significantly decreased the incidence of ICU delirium. 594Learning Objectives: Two randomized, placebo-controlled studies found melatonin and ramelteon prophylaxis in elderly patients were associated with lower risk for the development of delirium. Few studies have specifically studied melatonin in the intensive care unit (ICU). The purpose of this study was to evaluate the incidence of ICU delirium in patients who received supplemental melatonin prophylaxis compared to patients who did not receive melatonin. Methods: Data were retrospectively collected on adult patients who received melatonin ≥48 hours in the ICU. Patients with delirium prior to melatonin administration or persistent or severe neurologic deficits were excluded. The primary outcome was incidence of ICU delirium, defined by positive Confusion Assessment Method for the Intensive Care Unit or documentation of delirium. Secondary outcomes included a comparison of risk factors associated with delirium, use of newlyprescribed antipsychotics, use of restraints, ICU and hospital lengths of stay, and duration of mechanical ventilation. Results: Eighty-eight patients were included. Both groups were well matched with the exception of ICU type. The incidence of delirium was not statistically different among patients that received melatonin in the ICU compared to no melatonin (15.9% vs 34%, respectively; p=0.084). After adjusting for potential risk factors, patients who received melatonin were at lower odds of developing delirium (odds ratio 0.22; 95% confidence interval 0.05-0.82). No additional risk factors were identified. Use of newly-prescribed antipsychotics and restraints were not different between groups. Patients in the melatonin cohort had a longer duration of mechanical ventilation (16 days vs 4 days; p=0.014), longer ICU length of stay (19 days vs 10 days; p=0.003), and longer hospital length of stay (30 days vs 14 days; p=0.003). Conclusions: The incidence of delirium was not different between groups. After adjusting for potential risk factors, patients in the melatonin cohort were at significantly lower odds for the development of delirium.

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