Physiotherapists Role in ICU
Original Editor - Your name will be added here if you created the original content for this page.
Top Contributors - Vidya Acharya, Rucha Gadgil, Kim Jackson, Jaison Kiran Dsouza, Admin, Adam Vallely Farrell and Karen Wilson
Introduction[edit | edit source]
Critical care is the specialised care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units (ICUs).
Critically ill patients frequently suffer long-term physical and psychological complications. They are on long term mechanical ventilation and as a result ,25% display significant muscle weakness, and approximately 90% of long-term ICU survivors will have ongoing muscle weakness. Prolonged stays in the intensive care unit are also associated with impaired quality of life, functional decline and increased morbidity, mortality, cost of care and length of hospital stay.[1]
Therefore, they require a multidisciplinary team in critical care who are uniquely qualified with skills and expertise to work with the assessment and management of respiratory complications, physical deconditioning, and neuromuscular and musculoskeletal conditions.
Physiotherapy treatment as part of a multi-disciplinary approach to care is integral in promoting lung function, reducing the incidence of ventilator-associated pneumonia, facilitating weaning and promoting safe and early discharge from the intensive care unit.
Physiotherapy rehabilitation in ICU[edit | edit source]
Physiotherapy is an important intervention that prevents and mitigates adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on conscious state, psychological status and physical strength of the patient. It incorporates any active and passive therapy that promotes movement and includes mobilisation. Early progressive physiotherapy, with a focus on mobility and walking whilst ventilated, is essential in minimising functional decline.
Physiotherapist works to maintain and improve respiration and cardiac functions and later on aid in rehabilitation.
How do physiotherapists do this?[edit | edit source]
Short term Goals:
- Early activity - Both passive and active to maintain integrity of musculoskeletal system
- Positioning patients: To allow gravity to help sputum drain from the lungs.
- Manual techniques such as shaking and vibrations: These are applied to the ribs to try to loosen and clear the sputum.
- Suction: By placing a small tube into the lungs to suck out the excess sputum.
- They play a vital role in weaning a patient off ventilation.
Long term:
- They plan an extensive rehabilitation programme to integrate and re-initiate the patient into society.
- They set goals in conjunction with the medical team to rehabilitate the patient.
Impact of Physiotherapy[edit | edit source]
Early intervention by physiotherapists in the ICU helps
- reduce the patient's stay in the ICU and overall hospital stay.
- prevent ICU related complications
- to improve function and quality of life in long term[2]
Studies have shown that Physiotherapy intervention in Critical care has helped reduce the mortality rate by 25%.[3]
Resources[edit | edit source]
Physical Therapy Intervention in ICU
Physiotherapy in Intensive Care Unit
References[edit | edit source]
- ↑ http://www.csp.org.uk/publications/physiotherapy-works-critical-care
- ↑ https://physiotherapy.ca/sites/default/files/valuePT/cpa_valuept_icu-en.pdf
- ↑ Tomasi CD, Figueiredo F, Constantino L, Grandi R, Topanotti MFL, Giombelli V, Dal-Pizzol F, Ritter C. Beneficial effect of respiratory physiotherapy in critically ill patients ventilated for more than 48 hours: A randomized controlled trial. Intensive Care Medicine. Conference 23rd Annual Congress of the European Society of Intensive Care Medicine, ESICM Barcelona Spain. Date of publication: September 2010.
