Introduction to cinical set up for physiotherapy students

Introduction to cinical set up for physiotherapy students

• 1.
  INTRODUCTION TO CLINICAL SETUP
• 2.
  What is therole of the physiotherapist in ICU? • The physiotherapists’ role within ICU can be separated into two key areas— • respiratory • rehabilitation.
• 3.
  What is respiratoryphysiotherapy? • Every day our lungs produce 100mls of fluid called sputum. Sputum traps the dirt particles that we breathe in. This is normally coughed and cleared during the day to clean the lungs. • Patients on ICU may require mechanical ventilation to help their breathing. This is necessary to allow the body to heal— however, it stops patients from coughing and clearing the daily sputum load. This is made worse if the patient has pneumonia or a chest infection, as more sputum is produced. • Physiotherapists help patients to clear this excess sputum, reducing the chance of chest infections and treating infections when they occur.
• 4.
  How does thephysiotherapist do this? • Early activity such as getting into the chair, or walking. This encourages deep breaths and coughing. • Positioning patients to allow gravity to help the sputum to 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 which involves placing a small tube into the lungs to suck out the excess sputum.
• 5.
  What is rehabilitationphysiotherapy? • 　 Patients on ICU can become weak very quickly, losing up to 2% of muscle daily. They can also experience joint stiffness, muscle tightness and reduced fitness—this can lead to long term disability. • Physiotherapists’ play a vital role in maintaining and improving muscle strength and joint movement.
• 6.
  How will thephysiotherapist do this? • Stretches or splints for hands or feet to prevent muscle and joint stiffness. • Bed and chair bike—these bikes can passively move the legs to reduced joint stiffness and improve circulation, or they can be used actively to improve strength. • Electrical stimulation—electrodes to contract the muscle electronically, keeping it strong. • Improving the way you sit to stand—for example, by practising sitting on the edge of the bed (postural control). • Being tilted into standing—using a tilt table to strengthen muscles and bones. • Standing and walking practice
• 7.
  　 How willthe physiotherapist help with weaning? • If patient is on the ventilator for a long time, his/her respiratory muscles get weak. Weaning means reducing the ventilator’s support so that patients can breathe for themselves. • As physiotherapists play a vital role in regaining muscle strength, they work closely with the ICU team to make a ‘weaning plan’. • Will muscle wasting last forever? • 　 Some patients will return to normal—however others may develop long term weakness. It is difficult to predict how long it will take patient to get better.
• 8.
  SOME OF ABBREVIATIONSUSED TO DESCRIBE THERAPIES • • IFT- Interferential therapy • UST-Ultrasound therapy • SWD-Shortwave diathermy • CVT-Cervical traction • LBT-Lumbar traction • WXT-Wax therapy • MOT-Moist therapy • LAS-Laser therapy • CPM-Continuous passive movement • PD-Postural drainage • GAT-Gait training • PSN-Post natal exercise • MBZ-Mobilization exercise • CPT-Chest physiotherapy • SPN-Spinal exercise • PVF-Pelvic floor exercise • PFT-Pulmonary function test • ROM-Range of motion • Mm-Muscle power
• 9.
  BASIC PROTOCOLS OFPATIENT CARE • HAND HYGIENE 1. HAND RUB 2. HAND WASH • CAP - MASK - GLOVES • NO ORNAMENTS • NO CELL PHONES • APPRON • BIO MEDICAL WASTE DISPOSAL • PROFESSIONAL ETIQUETTE • ADDRESS PATIENT WITH SIR OR MADAM • INTRODUCE YOUR SELF BEFORE TOUCHING TO PATIENT • EXPLAIN THERAPY YOU ARE GOING TO APPLY ON PATIENT
• 10.
  BASIC PROTOCOLS OFPATIENT CARE • Refer consultant's notes of physiotherapy exercises • Check patients status and ability to co-operate with exercise or mobilization • Check patients peripheral lines and other attachments • Check for requirements of assistant • Check patients blood profile • Check patients Ortho notes if patient is having fracture • Check patients post -operative notes of surgeon for mobilization • Repositioning of patient in bed with supporting side rails after completion of exercise/ mobilization of patient
• 11.
  • AFTER MOBILISATIONOR PHYSIOTHERAPY EXERCISE - REPOSITIONING OF THE PATIENT IS MUST .
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  THANK YOU