As in all situations in which patients are critically ill, family and friends are under stress and likely have many questions and concerns. Keep them informed and allow them to be at the bedside as much as possible. Caretakers should assume that even though sedated, the patient may be capable of hearing and understanding all conversations in the room and may experience pain. Keeping this in mind, all conversation at the bedside should be appropriate and all procedures should be performed with local anesthesia and pain medication.