Joined: November 9, 2000
Dear rehabedge members Iam a senior physiotherapist woring with the respiratory team here at the Sunderland Royal Hospital in North East. We are planning to design a new criteria leaflet for the mobilsation programme for the critical patients in the ICCU.We are requesting for some feedback from the members regarding this topic,if anybody has already got a mobilisation criteria for critical patients in use at present considering all the basic observations with the critically ill patients. All the valuable guidance and opinions are much appreciated. MANY THANKS SHILU JACOB MCSP SENIOR PHYSIOTHERAPIST
Joined: October 21, 2005
Dear Shilu, I find the attempt for such criteria very difficult to define for such a variable group of patients. It is a question of emergence and scale. Just because at the scale of "hospital" these patients are similiar geographically (in the ICU), they have emerged to that scale via widely variable processes and such are very different patients. Trying to develop a criteria for mobilizing them is a very noble cause, it is essentially an attempt to make decisions at a scale that is more unique to a patient as opposed to just at the "hospital location" scale - i.e. - they are in the ICU, do not mobilize them. But what "scale" can be: 1. discriminatory between patients that should and should not mobilize, and also be a common concept for all patients. I think that, unlike making such criteria for less medically complex patients, when making criteria for ICU patients you first have to consider what scales are common for all patients that might emerge to the ICU? A simple way of proceeding then - what type of ICU is this? A general ICU? medical? surgical? neuro? trauma? When I worked at Mass General Hospital we had 9 ICU's, each had its own set of criteria, but by having 9 ICU's it was easier to develop criteria because some of the variability in the emergent process thatlanded patients together in that particular ICU had been eliminated.
Sean M. Collins, PT, ScD, CCS Associate Professor Research Coordinator Department of Physical Therapy Coordinator, Graduate Program in Disability Outcomes Adjunct Professor, Department of Work Environment School of Health &