Physiotherapy management of MRSA pneumonia sepsis in the ICU- the evolution of a multimodal intervention program

A growing body of evidence supports the benefits of early mobilization in the ICU setting. The data highlights the impact on decreasing ICU as well as overall hospital length of stay. Some standard progressions include movement from tilting in the bed, to chair-bed position, to edge of bed then standing from the bed. Severe critical illness polyneuropathy delays the ability for standard weight bearing, as can the sequelae of acute kidney injury.

Profound weakness limits not only weaning from ventilation but also patient autonomy to direct self-management.  It is important to create a greater range of options for mobilization and goal setting. Tilt table or stretcher chairs with a tilt table option provide safe alternatives for early weight bearing and antigravity positions. They also enable offloading of the diaphragm for effective diaphragm muscle training in the early stages of activation. Daily goal setting tools, left in a patient’s room, documenting patient plans and gains, facilitates patient collaboration and input with early rehabilitation programs.  

Session content:

This session will describe some of the impacts of severe sepsis on the respiratory, renal and neuromuscular systems. A sample implementation plan for an early, progressive mobilization program will be discussed, that incorporates novel positions for respiratory and muscle strengthening programs. The goal setting tool used with the case study patient will be shown, as an option for developing meaningful, patient-centered goals. Throughout the presentation the audience has the opportunity to use the pre-circulated score card to answer 6 multiple choice questions.  

This session will be of interest to a variety of clinicians from the ICU setting, across the continuum of care for patients recovering from critical illness. Leadership, management and research professionals will find interest in the implementation of innovative, best practice.

Upon completion of this workshop participants will be able to:

At the end of this session, participants will be able to: 1) describe the impact of severe sepsis on the respiratory, renal and neuromuscular systems; 2) implement an early, progressive mobilization program that incorporates novel positions for respiratory and general muscle strengthening programs; 3) evaluate a goal setting tool for meaningful, patient-centered goals.

atient plans and gains, facilitates patient collaboration and input with early rehabilitation programs.  

SPEAKER(S) BIO:

Judy Kay is the Clinical Practice Leader for Cardio-respiratory at St. Clare’s Site of Eastern Health in St. John’s and an Adjunct Clinical Associate with Dalhousie University School of Physiotherapy.  A significant portion of her clinical practice involves the ICU at St Clare’s site of Eastern Health

She graduated from Queen’s University, Kingston, ON and has given presentations on respiratory assessment and management both provincially and nationally since 1999.

She is a member of the Cardio respiratory Division of CPA and has ongoing involvement with national cardio respiratory issues, including participation with the Specialization pilot project of CPA in 2010. She achieved the Clinical Specialist designation for Cardiorespiratory in 2012- 1 of the first 3 PTs in Canada to successfully complete the program for this area. Has been an invited participant to national Cardiorespiratory division strategic planning days and has participated in CPA congresses; this presentation was initially provided as a podium presentation at Congress 2018 in Montreal.