Physiotherapy in the Intensive Care Unit Essay Sample, Ireland
The following essay sample work shall highlight the physiotherapy process for terminally ill patients, physiotherapy rehabilitation in the ICU, and a multi-systems approach to the assessment of terminally ill patients which shall include the cardiovascular, renal, musculoskeletal, respiratory, and neurological systems.
The patients who are critical and are suffering from any long-term physical and psychological complications require specialized care in the critical care unit. Such patients require comprehensive care and constant monitoring in the intensive care unit (ICUs) and high dependency unit (HDUs).
A very long stay in the intensive care unit shows an impaired quality of life, expensive cost of care, high mortality, and functional decline. Physiotherapy is usually designed for any critical care and is mostly safe and effective.
Physiotherapists are associated with the multidisciplinary team in critical care and have a set of unique skills and expertise. Such expertise is needed to provide an assessment and management of physical deconditioning, neuromuscular condition, respiratory complications, and musculoskeletal conditions.
The terminally ill patients suffer from a long-term condition that requires them to be treated on the mechanical ventilation which displays 25% muscle weakness and 90% of them who survives have ongoing muscle weaknesses.
Treatment under physiotherapy is a part of a multidisciplinary approach to care that promotes lung function, the promotion of an early discharge from the intensive care unit, and the reduction of the incidence of ventilator-associated pneumonia.
Physiotherapy Rehabilitation in the Intensive Care Unit (ICU)
Physiotherapy is an effective clinical intervention that can mitigate and prevent the adverse effects of mechanical ventilation and long bed rest during critical illness.
The rehabilitation delivered by the physiotherapist is meant for catering to the needs of patients according to their psychological status and physical strength. The physiotherapy session focuses on the walking and mobility of the patient to minimize the functional decline while in the ventilation.
Physiotherapy and occupational therapy provided mobility to terminally ill patients.
Rehabilitation is set to effectively communicate with the patient, the family of the patient, and the healthcare team is divided for the recovery of the patient from any critical illness.
Such rehabilitation goals must be achieved on the basis of regular assessment of the physical and non-physical consequences of the illness.
The National Institute for Health and Clinical Excellence, the European Respiratory Society, and the European Society of Intensive Care Medicine recommend early assessment and management of physical morbidity delivered by physiotherapists.
An early Physiotherapy and an Occupational Therapy for ventilated patients are considered safe in comparison to standard care during ventilator-free days. It improves the respiratory system, physical muscle strength, and functional independence.
Physiotherapists are responsible for the implementation of mobilization of plans and exercise prescriptions in conjunction with the other team members.
Such an early mobilization can reduce the length of stay in the hospital, improve the quality of life, reduce expenses, and can promote the functional independence of the patient.
Multi-Systems Approach to Assessment of Terminally Ill patients
The physiotherapy assessment of the terminally ill patient is done due to a lack of functional and physiological levels in the patients. An assessment of such a patient requires an in-depth multisystem evaluation of the respiratory, renal, cardiovascular, neurological, and musculoskeletal systems to make a physiotherapy intervention for the patient so that his health does not get deteriorated.
The assessment of the cardiovascular system will include an assessment of the heart or pulse rate, rhythm of the heart, blood pressure levels, peripheral edema, and level of physical activities.
A physiotherapy assessment is based upon the cardiac trends that need to be reviewed to analyze the correct heart status of the patient.
The Respiratory and ventilation systems are also assessed along with cardiovascular assessments to recognize the signs and symptoms.
Long bed rest in the hospital can decrease the skeletal muscle strength and endurance of the patients. A terminally ill patient will have long-term repercussions on his health even after getting discharged from the ICU.
Assessment of the musculoskeletal system includes an evaluation of the patient’s skeletal muscle properties, neuromuscular control, and functional strength.
Assessment of functional tasks includes bed mobility and out-of-bed mobility which improves the strength of the patient and assesses the need for further testing and aid.
The assessment of the neurological system includes the level of consciousness, muscle tone, size of pupils, and review of radiological imaging (CT and MRI scan).
Changes in the size and reactivity of the pupils define the neurological condition of the patient. The unilateral fixed dilated pupil indicates the pressure on the oculomotor nerve and needs immediate investigation.
Bilaterally fixed and dilated pupils show a severe neurological impairment which is a sign of brain stem death and requires a CT or an MRI scan.
The functioning of the respiratory system can be assessed by oxygenation and ventilation including oxygen saturation and arterial blood gases.
Assessment of the respiratory system involves an awareness of arterial blood gas analysis, review of chest radiological investigations, and percussion.
The initial assessment process includes observing the breathing pattern of the patient, oxygen saturation level, measuring the rate of respiration, evaluation of the patient’s ability to clear secretion and quantity of sputum produced, the abnormal beating of the heart, and sounds of the lungs.
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The above-written essay sample has highlighted physiotherapy in the intensive care unit.
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