Week 12.2 - Safe mobilisation of scutely ill patients Flashcards

1
Q

List the general considerations that must be made when mobilising an acutely ill patient

A

Cardiovascular
Respiratory
Heamatological and metaboli
Subjective

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2
Q

How does the cardiovascular consideration, Heart rate affect physio treatment

A

HR will increase when SOOB and mobilising. If it increases to much and signs of CV stress (SOB, chest pain, faint, clammy) - may need to pause
If it decreases or doesn’t Increase and there is CV stress - CEASE mobilisation

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3
Q

What do we have to consider about BP when mobilisation

A

What for signs of Orthostatic Intolerance
remember the effect of inotropes
If BP drops significantly during treatment - cease or modify mobilisation

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4
Q

Look at cardiac status. List potentially things that you should take care with or modify your treatment for

A
Recent AMI - within 2 days
Unstable Angina
Uncontrolled Arrythimia
Severe symptomatic sternoisis
Uncontrolled symptomatic heart failure
Acute PE or pulmonary infarction
Suspected/ known dissecting aneurysm
Acute infections
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5
Q

Should you be monitoring ECG’s when you are mobilisation a patient? Isn’t that the nurses job?

A
Yes you should be monitoring.  
Monitor for more than the occasional VEB
Runs of VT
Atrial fibrillation
New ST segment changes and symptoms
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6
Q

What are the levels of PAo2/ FiO@ ratio you should be thinking about for mobilisation

A

If > 300 - safe to mobilise
200-300 - marginal respiratory reserve , be careful
<200 - no reserve, hazardous to mobilise
monitor SpO2 during and after mobilisation aswell

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7
Q

Should a Chronic Hympercapnic person be mobilised

A

Yes! DOn’t need to worry about their PaCO2. Maybe still monitor if you can

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8
Q

What should you do if you go in and the patient has an acute rise in PaCo2?

A

THis is respiratory failure. This will liit mobilisation as it can alter the consciousness

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9
Q

Does Respiratory pattern affect treatment including mobilisation

A

can should seterioration of respiratory function. Don’t ignore this. Look at patient and respond to visual clues

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10
Q

Do Hb levels affect mobilisation?

A

No absolute value prevents. If there is an acute fall in Hb probably and acute or recent bleeding and you should delay mobilisation

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11
Q

Do Platelet counts affect mobiliation

A

if < 20000 potential increase in BP as a reult, therefore avoid mobilisation.
If there is an acute drop means there is active or recent bleeding so should delay mobilisation

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12
Q

Does WBC could affect mobiliation?

A

No, just note well that there may be an increase demand in O2 demand while fighting infection

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13
Q

What affect does fever have on physiotherpay treatment

A

You can still mobilise etc just remember that as the temperature increase so does the consumption of O2

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14
Q

How does blood glucose levels affect mobilisation

A

Check blood glucose levels in at risk patients before mobiliation. If too hypoglycemic it can cause unconsciousness
If too much not good for diabetes and may cause loss of consciousness too

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15
Q

What should you take into accoun on a neurological basis

A

Consciousness, muscle strength, neurological procedures, contraindications/ precautions to be aware of
Care if the have balance issues

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16
Q

What Orthopedic conditions is mobilisaion contraindicated for?

A

Pelvic and unstable spiral #

Check wB status for lower imb fractures

17
Q

SKin conditions can be contraindiations for mobilisation. Name them

A

Split skin grafts, burns and pressure wounds
Bandaging may be required
Clarify with plastics team if unsure

18
Q

How do DVT and PEs affect mobilisation

A

Depends on the hospital. Usually delay until anticoagulation reaches theraputic levels. Beware risk of bleeding

19
Q

What do you consider when an individual has a really low BMI

A

This results in bony prominances, avoid skin tears and avoid pressure areas, May be weakness and reduced exercis tolerance

20
Q

If a patient has High BMI, is there risk and what is the risk

A

Yes, They are a risk to both the patient and the staff
May need Bariatric equipment
Lifters/ hoists/ slide sheets

21
Q

What about attachements when mobilising someone?

A

Remember to take the relavevent ones, ask if ones can be take off suction, if you can reduce O2

22
Q

What should I do about the environment

A

Keep the environemnt uncluttered and free from safety hazards
remember monitoring, manual handing equipment
Make sure you stick to protocols a training in MH
Respect patient privacy and dignity at all times

23
Q

What information do I give the patient

A

Gain consent
Explain why and benefits of mobilisation
Include basic components of consent