Maj. William Pileggi has seen patients go to sleep in Allegheny County and wake up in Iraq. 

Pileggi is part of a team focused on helping healthcare professionals better understand and treat patients with PTSD who experience emergence delirium after surgery. 

In 2017, Pileggi took a mandatory training class for medical professionals to learn to defend themselves against violent patients. The training was great, he says, for patients who were alert and cognizant of their surroundings. What about the patients who wake up in a different world? 

Pileggi and his team — Michael Boland, David Julian and Amanda Beckstead — built on Project Golden Eagle, aimed at identifying pre-op patients with PTSD, and took it into the operating and recovery rooms by developing a hands-on safety training program for anesthesia and perioperative staff.

In addition to learning physical holds and engaging in simulations of emergence delirium episodes, staff learns to perform detailed assessments and ask patients questions to establish a sense of comfort should they become agitated post-op. They learn names of loved ones, pets, “anything to grab something familiar outside of Iraq or Vietnam — something to just give a patient a moment’s relief to try and concentrate on,” Pileggi says. 

Since 2018, there have been no reported injuries to VA patients or staff related to emergence delirium/agitation, and hospitals from around the country are reaching out to Pileggi and his team to learn more. 

“We’re thrilled,” says Pileggi. “We changed our culture, and our success has been phenomenal.”