Interventions in the ICU

Question 1

Prevention of Secondary Complications
Promote weaning from ventilatory support by improving strength and endurance
Optimize oxygenation
Restoration of Function
Decrease length of stay in ICU and hospitalization
Improve interdisciplinary progression of mobility
Improve quality of life

Answer 1

Goals of PT in the ICU

Question 2

CommunicationPT must communicate with interdisciplinary team prior to initiating evaluation process and daily prior to intervention
Must coordinate care with nursing, respiratory therapy, medical tests/interventions, physicians assessments, occupational therapy, speech/language therapy, family, patient (activity tolerance)
Must communicate objectively in written documentation to demonstrate patient’s ability to participate and progress with PT interventions

Answer 2

Communication

Question 3

Arousal, attention, and cognition
Aerobic capacity/endurance/activity tolerance
Circulation
Integumentary integrity
Motor function
Muscle performance
Pain
Range of Motion
Ventilation and gas exchange

Answer 3

PT Tests and Measures in the ICU

Question 4

The readiness of the human system for activity

Answer 4

Arousal

Question 5

Selective awareness of the environment or responsiveness to a stimulus or task without being distracted by other stimuli

Answer 5

Attention

Question 6

Patient’s awareness of time, person, place, and situation

Answer 6

Orientation

Question 7

Defined as the process of knowing and includes both awareness and judgement (Mini-Mental exam, MoCA, any documentation of poor judgement during PT intervention)

Answer 7

Cognition

Question 8

Ventilator asynchrony
Increased O2 consumption
Inadvertent removal of devices, IV’s and catheters
PTSD

Answer 8

Risks of UNDER-Sedation

Question 9

Pneumonia/lung injury
Neuromuscular dysfunction (CIP) and (CIM)
Delirium

Answer 9

Risks of OVER-Sedation

Question 10

A disturbance of consciousness and cognition that develops over a short period of time (hours to days) and fluctuates over time

Answer 10

Delirium

Question 11

Assessment tool that systematically assesses and quantitatively measures stroke-related neurologic deficit
Can be performed by a physician, RN, or PT
Valid for predicting lesion size and can help determine stroke severity
Predicts patient outcomes

Answer 11

National Institutes of Health Stroke Scales (NIHSS)