Previous evidence shows that early mobilization is beneficial in medical and surgical ICU's. However, the injuries and management of trauma and burns patients differs significantly: unstable fractures, chest trauma, inhalation injuries and open wounds require specific medical interventions that might interfere with mobilitization possibilities.
The team at UAB Hospital in Birmingham (USA) adapted and implemented an extensive early mobility programma, consisting of positioning, PROM (nurses), active assisted exercsises, sitting up edge of bed, active transfers, standing and walking (physiotherapist). Communication to progress programme and prevent complications was essential and secured by flow sheets, daily rounds, and daily multidisciplinary team meetings.
Early mobilization of patients admitted to a TBICU was safe and effective. Neither acute adverse events nor increased complications associated with early mobility were reported. Patients in the TBICU significantly reduced airway, pulmonary, and vascular complications. No reduction was found for hospital LOS, ICU LOS nor ventilator support
Staff satisfction and feasability were good; these kind of interdisciplinary protocols are possible due to a deliberate effort to involve all stakeholders in the planning process and a shift from multi-disciplinary to interdisciplinary patient care. Nurses, medical staff, physician assistants, respiratory therapists and physical therapists were all involved in implementing this beneficial programme.
> From: Clark et al., Phys Ther 93 (2) (2015-10-12 20:22:40) 186-96 (Epub ahead of print). All rights reserved to © 2013 American Physical Therapy Association. Click here for the online summary.
