Physiotherapy In ICULimp Physiotherapy, though not important, has to be given to prevent Deep Vein Thrombosis. A physiotherapist who is working in the ICU must have good knowledge about the different instruments (machines) used in the ICU like.
- ECG displayer.
- Saturation displayer.
- Pulse Oxygen meter BP. ox player ventilator has different modes.
Physiotherapy in ICUA patient who is critical, or with Respiratory failure is kept on volume control–here the ventilator is doing all the breathing. In such patient the physiotherapist has to be very careful. Depending upon the lobe which is congested, the patient is positioned. Before that Normal Saline is put through the intubated tube. The side which is congested is kept down and bagging is given with the help of an Ambu bag. Then the patient is turned so that the congested side is upward. Manipulation such as percussion and vibrations are given to mobilize the secretions. Since the patient is on volume control, the patient cannot be kept off the ventilator for a long time. Therefore suctioning has to be done very fast.
This procedure has to done has to be done twice or thrice. It should not be done more than 3 times as it makes the patient hypoxia. While weaning the patient, the patient is put on an SIMV mode in which the patients has to breath are synchronized with with the machine. The patient initiates the breath and is taken over by the machine, even if the patient does not take a breath. In pressure support, the patient has to initiate the breath and then the machine takes over. The physiotherapist has to keep a watch on the O2 saturation of the patient. If the saturation falls below 85%, then the patient should be quickly oxygenated and suctioning should be stopped.If the saturation is low before physiotherapy treatment, then it might be because of lot of secretion. Then proper PT and suctioning has to be done.
The saturation is checked usually after PT. The patient is given position in which he is kept till the next sessions of PT is carried out.This position is given to drain the secretions with the help of gravity. These position are called postural drainage positions. The physiotherapist should check the BP, pulse, Respiratory Rate and saturation of the patient before and after the treatment.