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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 multi-systems approach to the assessment of terminally ill patients which shall include the cardiovascular, renal, musculoskeletal, respiratory, and neurological systems.

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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 who have set of unique skills and expertise. Such an expertise is needed to provide an assessment and management of physical deconditioning, neuro muscular condition, respiratory complication and musculoskeletal conditions.

The terminally ill patients suffers from a long term condition which 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 multidisciplinary approach to care which promotes lung function, promotion of an early discharge from the intensive care unit and reduction of the incidence of ventilator associated pneumonia.

Physiotherapy Rehabilitation in the Intensive Care Unit (ICU) 

Physiotherapy is an effective clinical intervention which 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 minimise the functional decline while in the ventilation.

Physiotherapy and occupational therapy provided the mobility to  terminally ill patients.

Rehabilitation is set to effectively communicate with the patient, 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 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 recommends early assessment and management of physical morbidity delivered by the physiotherapists.

An early Physiotherapy and an Occupational Therapy of the ventilated patients is 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 implementation of mobilisation of plans and exercise prescription in conjunction with the other team members.

Such an early mobilisation can reduce the length of stay in the hospital, improve the quality of life, reduce expenses and can promote functional independence of the patient.

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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 level in the patients. An assessment of such a patient requires an indepth multisystem evaluation of respiratory, renal, cardiovascular, neurological, musculoskeletal system to make a physiotherapy intervention for the patient so that his health does not gets deteriorated.

Cardiovascular System

The assessment of cardiovascular system will include an assessment of the heart or pulse rate, rhythm of the heart, blood pressure levels, peripheral oedema and level of physical activities.

Physiotherapy assessment is based upon the cardiac trends that needs to be reviewed to analyse the correct heart status of the patient.

The Respiratory and ventilation system are also assessed along with cardiovascular assessment to recognize the signs and symptoms.

Musculoskeletal System 

A long bed rest in the hospital can decrease 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 musculoskeletal system includes an evaluation of patient’s skeletal muscle properties, neuromuscular control and functional strength.

Assessment of functional task includes bed mobility and out of bed mobility which improves the strength of the patient and assess the need for further testing and aids.

Neurological System 

The assessment of 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 defines the neurological condition of the patient. The unilateral fixed dilated pupil indicates the pressure on the oculomotor nerve and needs an immediate investigation.

Bilaterally fixed and dilated pupils shows a severe neurological impairment which is a sign of brain stem death and requires a CT or an MRI scan.

Respiratory System

The functioning of respiratory system can be assessed by the oxygenation and ventilation including the oxygen saturation and arterial blood gases.

Assessment of 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 rate of respiration, evaluation of the patient’s ability to clear secretion and quantity of sputum produced, abnormal beating of 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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