2. Goals of PT in ICU
1. Improve / maintain normal or baseline
ventilation and oxygenation
2. Improve / maintain musculoskeletal system
within functional limit
- Improve range of motion
- Improve muscle strength and endurance
- Prevent joint deformities and
contractures
3. Goals-contd...
3. Improve circulatory system function
4. Improve / maintain neurological system and
cognitive status within the functional limits.
5. Improve / maintain level of functional status
within patient tolerance
21. Physiological effects of Positioning
• Optimizes oxygen transport by improving V/Q mismatch
• Increases lung volumes
• Reduces the work of breathing
• Minimizes the work of heart
• Enhances mucociliary clearance (postural drainage)
23. Chest Percussion / Vibration
PERCUSSION consists of rhythmic clapping on the chest
with loose wrist & cupped hand.
• Effect : Dislodges & loosens secretions from the lung
VIBRATIONS consists of a fine oscillation of the hands
directed inwards against the chest, performed on exhalation
after deep inhalation.
• Effects: Helpful in moving loosened mucous plugs towards
larger airway
24.
25.
26. Manual Hyperinflation (MH)
• This is inflating the lungs with oxygen and manual compression to a
tidal volume.
Indications
• To aid removal of secretions
• To aid reinflation of atelectatic segments
• To assess lung compliance
• To improve lung compliance
27.
28. Hazards of Manual Hyperinflation
• Reduction in blood pressure
• Reduced saturation
• Raised intracranial pressure
• Reduced respiratory drive
• Hemodynamic and metabolic upset
• Risk of barotrauma
• Discomfort and anxiety
30. Advantages of MH
• Reverses atelectasis
• Improves oxygen saturation and lung compliance
• Improves sputum clearance
31. Suctioning
• Suctioning is the mechanical aspiration of pulmonary secretions from a
patient with an artificial airway in place.
• Indications
– Inability to cough effectively
– Sputum plugging
– To assess tube patency
33. • The suction catheter used must be less than
half the diameter of endotracheal tube.
• The vacuum pressure should be as low as
possible. (60-150mmHg)
• Suction should never be routine, only when
there is an indication
37. Mobilization
• ICU rehabilitation has been shown to accelerate
recovery
• Early mobilization for unconscious patients
starts right from turning the patient every two
hours.
• Graded exercises can be started as soon as the
patient regains consciousness.
38. • Activity is required to maintain sensory input,
comfort, joint mobility and healing ability.
• Activity minimizes the weakness caused by
loss of muscle mass
• Graded ambulation can be started depending
on patients condition