SAFEMOB: Difference between revisions
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*Medical history | *Medical history | ||
*Premorbid level of function (e.g. | *Premorbid level of function (e.g. mobility aids), activity and exercise response | ||
*Primary diagnosis | *Primary diagnosis | ||
*Medications | *Medications | ||
*Investigations, lab work (e.g. | *Investigations, lab work (e.g. Hgb, RBC, Blood sugar, ECG, fluid/electrolytes) | ||
*Risk factors and lifestyle conditions | *Risk factors and lifestyle conditions | ||
*Physician orders re specific restrictions on mobilization | *Physician orders re specific restrictions on mobilization | ||
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*Level of cooperation | *Level of cooperation | ||
*Ask patient what he/she currently feels about mobilization concerns and readiness. | *Ask patient what he/she currently feels about mobilization concerns and readiness. | ||
*Consider the impact of the illness or medical procedures & medications on the patient’s mobility (e.g. weakness from disuse, incision, trauma, pain, equipment needs, e.g. | *Consider the impact of the illness or medical procedures & medications on the patient’s mobility (e.g. weakness from disuse, incision, trauma, pain, equipment needs, e.g. walker) | ||
*Coordinate with team members the timing of treatment with medication, availability of equipment and of personnel to optimize effectiveness | *Coordinate with team members the timing of treatment with medication, availability of equipment and of personnel to optimize effectiveness | ||
Revision as of 20:00, 19 January 2014
Developed by the SAFEMOB Task Force:
Dr. Elizabeth Dean, Dr. Darlene Reid, Frank Chung, Simone Gruenig, Rosalyn Jones, Jocelyn Ross, Maylinda Urbina, Alison Hoens.
SAFE PRESCRIPTION OF MOBILIZING PATIENTS IN ACUTE CARE SETTINGS[edit | edit source]
What to Assess, What to Monitor, When not to Mobilize, and How to Mobilize and Progress
Purpose, Scope, & Disclaimer[edit | edit source]
The purpose of this document is to provide physical therapists with guidance on safe mobilization of the patient in acute care settings. This decision-making guide is evidence informed and where there is insufficient evidence, expert informed. It is not intended to replace the clinician’s clinical reasoning skills and interprofessional collaboration. Mobilization, for the purposes of this document, has been defined as “To work towards the functional task of locomotion”.
What to Assess[edit | edit source]
The Chart | The Patient, Family, and Team Member |
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When to Consider Not Mobilizing[1][2][3][4][5][6][edit | edit source]
Cardiovascular Status | Respiratory Status |
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Neurological Status | Other |
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- Please note: The cited values are not absolute criteria for withholding mobilization but are within the range of concern that could benefit from team discussion.
What to Consider During Mobilization[edit | edit source]
Subjective | Objective |
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How to Mobilize and Progress[7][edit | edit source]
Step 1: Prepare | Step 2: Safety First |
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Step 3: When to Quite While You are Still Ahead | Step 4: Monitor and Progress |
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Morris PE, Goad A, Thompson C, Taylor K, Harry B, Passmore L et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Critical Care Medicine,fckLR2008; 36:2238-43. Cite error: Invalid
<ref>
tag; name "Morris 2008" defined multiple times with different content - ↑ 2.0 2.1 Stiller, K. Safety issues that should be considered when mobilizing critically ill patients. Crit Care Clin 2007; 23, 35-53.
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 Schweickert WD, Pohlman MC, Pohlman NS Nigos C, Pawlik AJ, Esbrook CL et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: an RCT. Lancet. 2009; 373:1874-82.
- ↑ 4.0 4.1 ACSM Guidelines for Exercise Testing and Prescription. 8th edition. Lippincott Williams &amp; Wilkins. Philadelphia 2010 pp.209-10.
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 Timmerman, RA. A mobility protocol for critically ill adults. [DIMENS CRIT CARE NURS. 2007; 26(5):175-9.
- ↑ 6.0 6.1 Singh C, Fletcher R, Cunningham K, and Szlivka M. Mobilization with a Deep Vein Thrombosis. Clinical Practice Guideline (DRAFT in process). Fraser Health Authority. 2009.
- ↑ Reid WD, Chung F. Clinical management notes and case histories in cardiopulmonary physical therapy. New Jersey: Slack; 2004.