Physiotherapy Management for CCU / ICU Patients
A physiotherapist is part of the multidisciplinary team in most intensive care units / Critical Care Units in India . Physiotherapists are primary contact practitioners and use a comprehensive multisystem assessment that includes the respiratory, cardiovascular, neurological, and musculoskeletal systems to formulate individualized treatment plans. The traditional focus of treatment has been the respiratory management of both intubated and spontaneously breathing patients. However, the emerging evidence of the longstanding physical impairment suffered by survivors of intensive care has resulted in physiotherapists re-evaluating treatment priorities to include exercise rehabilitation as a part of standard clinical practice.
What patients stay in ICU/CUU ?
Someone who Critically I'll patient like - Cardio & respiratory I'll patient, Head injuries, uncontrolled Infections, Stroke, Craniotomy, Bypass Surgery, Pneumonia, Pulmonary TB , Chronic kidney Disease, etc.
Adverse effects of CCU/ ICU stay Patient :
•Physical Inactivity leading to muscular atrophy and generalized weakness
•Diaphragmatic weakness due to prolonged mechanical ventilation
•Hypotension
•Low blood oxygen level
•Pressure ulcers
•compromised cardiac and respiratory function
•deep vein thrombosis(DVT)
•infections
Physiotherapy Goals for Managing CCU/ICU patient
•To maintain cough secretion & blood oxygen level.
• Early Mobilization & Activity
• To maintain Cardiorespiratory Function
•Positioning patients: To allow gravity to help sputum drain from the lungs & Reduce Pressure Ulcers.
• To prevent DVT.
• To set management goals in conjunction with the medical, Nurses team to rehabilitate the patient.
Effects of Physiotherapy management in CCU/ICU
Physiotherapy Management Plan & Prescription for CCU /ICU patient :
According to the Patient condition , Examination a qualified Physical Therapist Set Their Treatment Plan.
Some Common Physiotherapy Plan are :
• Active and Passive ROM exercise. (Improve circulation , prevent DVT , Proprioception activation).
•Chest Physiotherapy -includes (shaking, vibration ,Percussion, suctions ,etc) chest Physiotherapy improves secretion, increase Spo2.
• Positioning : changing patient position in every two hours after. ( It's helps to Reduce pressure Ulcer & improve secretion.)
• mobilization : according to the Patient condition a therapist set patient mobilization plan like ( wheel chair activity,Out from the bed activities ,etc)
• High sitting with leg Dangling : Improve Spo2,Heart Rates, Head & neck control.
Note : For CCU/ICU patients Per day twice Physiotherapy session is effective than once per day Physiotherapy session.
