COVID-19:- ROLE OF PHYSIOTHERAPY IN ICU

COVID-19 

ROLE OF PHYSIOTHERAPY IN ICU

COVID-19:

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment.  

Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

Symptoms:

Day 1: In the starting day of the symptom, the patient suffers from fever along with fatigue, muscle pain, and a dry cough. Few of them may experience nausea and diarrhoea a few days before the arousal of symptoms.

Day 5: Patients may suffer from breathing problem especially if they are elderly or have some pre-existing health condition.

Day 7: According to the Wuhan University study, these are the symptoms of the patient that lead the patient to be admitted in the hospital.

Day 8: On the 8th day, patients (15%, according to the Chinese CDC) develop acute respiratory distress syndrome (ARDS), a condition where the fluid fills up in the lungs and this is mostly fatal. This usually happens in severe cases.

Day 10: The progression of the disease leads to worsening of the symptom and at this point the patient is shifted to ICU. Patients with milder symptoms probably have more abdominal pain and loss of appetite.

Role of Physiotherapist in ICU….

Prolonged immobilization in an Intensive Care Unit (ICU) puts patients at risk for complications  such as deconditioning, ICU-related weakness, myopathy and neuropathy, respiratory infections, and contractures.

•  Physiotherapy treatment in the ICU is focused on early mobilization of critically ill patients and respiratory management of patients who are ventilator dependent. Early intervention by a physiotherapist leads to improvements in quality of care.

• The ICU is a dynamic inter-professional environment where physiotherapists assess, treat and manage respiratory conditions and mobility issues and rehabilitate critically ill patients. 

• The most common use of physiotherapy in the ICU is to improve the function of critically ill patients, including those receiving mechanical ventilation. 

Physiotherapists assess and manage neurological, musculoskeletal and cardiorespiratory complications of critically ill patients. 

The physiotherapist is involved in specific patient positioning, suctioning, mobilization,including ambulation, strengthening and balance exercises, passive range of motion exercises and airway clearance techniques. 

Early mobility in the ICU by a physiotherapist is safe, reduces length of stay (LOS) and improves quality of life (QOL).

Physiotherapy in the ICU also aids in service integration through collaboration with multiple providers and plays an essential role in the continuum of care when transitioning patients from the ICU.

Physiotherapists can contribute in the rehabilitation phase to assist recovered COVID-19 cases return to full function.

Rehabilitation in the recovery phase is going to be a key responsibility of physiotherapists in collaboration with the multidisciplinary team, including occupational therapists, speech and language therapists, dieticians and psychologists.