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Thursday, November 26, 2020

Canberran plays role in ICU rehab guidelines for COVID-19 patients

A physiotherapy expert from the University of Canberra is part of a cross-border collaboration that has published open access clinical guidelines for ICU physiotherapists treating COVID-19 patients.

Published in the Journal of Physiotherapy, the guidelines can be scaled to any local healthcare context and have also been made freely available on social media. They are now being translated into a dozen languages.

“Early rehabilitation is very important to the recovery of COVID-19 patients,” said Dr Bernie Bissettt, Discipline Lead in Physiotherapy at the University of Canberra’s Faculty of Health.

A member of the collaborative group, she joined colleagues from Australia, the United Kingdom, Canada and Hong Kong to come up with the clinical guidelines for effective planning and staffing, best practices and risk management, to maximise efficacy and keep patients and clinicians safe.

The group was initiated by Lanthe Boden, Cardiorespiratory Lead Physiotherapist at Launceston Hospital in Tasmania. Dr Peter Thomas, head of the Physiotherapy Intensive Care and Surgical team at the Royal Brisbane and Women’s Hospital led them in developing the guidelines. 

Drawing on all available research and their combined clinical experience, they drew up the guidelines in just one week.

“We considered the physiotherapy treatments available and used existing evidence to advise which are safe and which are risky with COVID-19 patients,” said Dr Bissett.

The guidelines stress that personal protective equipment (PPE) is essential.

“Because so many of our physiotherapy treatments can make a patient cough, our work is particularly risky,” said Dr Bissett. “All healthcare workers working with COVID-19 patients need to take full precautions for airborne disease.”

The guidelines also outline the ideal staffing ratio – one physiotherapist to every four patients.

“However, even if this ideal ratio isn’t always possible, we hope that the guidelines will help physio teams and managers have a clearer idea of which patients to focus on, and which treatments to avoid.”

“We also need enough equipment like walking frames, weights and tilt tables, so that we aren’t shifting equipment between patients who are infectious and those who aren’t,” said Dr Bissett.

Dr Bissett says that Canberra Hospital and University of Canberra staff have been leading the way in the optimisation of ICU rehabilitation for over a decade, and experts from both will further collaborate with international colleagues as the COVID-19 pandemic continues to unfold.

“Our ultimate goal was to get these guidelines out to everyone who needed them,” she said. “We’ve had feedback on social media that they have already proved invaluable to physiotherapy teams around the world.”

The group plans to publish more guidelines soon, this time on optimising the recovery of COVID-19 patients beyond the ICU.

Click here to access Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations.

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