PHT563 Physiotherapy In Acute Care UITM Assignment Answer Malaysia 

The PHT563 Physiotherapy in Acute Care course at UITM in Malaysia focuses on the management and rehabilitation of surgical cases and critically ill patients in the intensive care unit (ICU). Students learn about both invasive and non-invasive monitoring techniques and ventilator management. The PHT563 course emphasizes the use of clinical reasoning and evidence-based practice in physiotherapeutic management.

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Assignment Task 1: Describe the terminology as well as devices commonly used (i.e. mechanical ventilator, invasive and non-invasive monitoring devices and oxygen therapy) in the management of ICU patients

Terminology:

• Mechanical Ventilator: A mechanical ventilator, also known as a respirator, is a device used to assist or replace spontaneous breathing in patients who are unable to breathe adequately on their own. It delivers a mixture of oxygen and air to the patient’s lungs, supporting their respiratory function.
• Invasive Monitoring Devices: These devices involve the insertion of probes or catheters into the patient’s body to directly measure various physiological parameters.
• Non-invasive Monitoring Devices: Non-invasive monitoring devices allow for the assessment of physiological parameters without the need for invasive procedures.Examples of tools used in acute care include pulse oximeters, ECGs, and non-invasive blood pressure monitors.
• Oxygen Therapy: Oxygen therapy involves the administration of supplemental oxygen to patients who have low oxygen levels in their blood. It can be delivered via various devices such as nasal cannula, oxygen masks, or high-flow nasal cannula systems.

Devices commonly used:

• Mechanical Ventilator: These devices provide controlled or assisted ventilation to ICU patients who have respiratory failure or are unable to breathe adequately. They deliver a controlled volume or pressure of air to the patient’s lungs, ensuring adequate oxygenation and ventilation.
• Invasive Monitoring Devices: Arterial catheters, central venous catheters, and pulmonary artery catheters are commonly used to monitor critically ill patients in the ICU. They allow for continuous monitoring of blood pressure, central venous pressure, cardiac output, and other hemodynamic parameters.
• Non-invasive Monitoring Devices: Pulse oximeters are widely used in ICUs to monitor oxygen saturation levels in the patient’s blood. ECG monitors help in monitoring the patient’s heart rate, rhythm, and detect any abnormalities. Non-invasive blood pressure monitors provide continuous blood pressure readings without the need for invasive procedures.
• Oxygen Therapy Devices: Nasal cannula, oxygen masks, and high-flow nasal cannula systems are commonly used to deliver supplemental oxygen to ICU patients. These devices provide a controlled flow of oxygen to ensure adequate oxygenation.

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Assignment Task 2: Analyze the usual physiotherapy care in people admitted to the ICU and the special ICU consideration in the management of neurosurgical patients, neonates and patients following cardiothoracic surgery

Physiotherapy Care in ICU:

 In the ICU, physiotherapy plays a crucial role in the management of critically ill patients. The usual physiotherapy care includes:

1. Breathing Exercises: Physiotherapists assist patients in performing deep breathing exercises, lung expansion techniques, and incentive spirometry to prevent complications such as atelectasis and pneumonia.
2. Chest Physiotherapy: Techniques such as percussion, vibration, and postural drainage may be used to help mobilize secretions and improve lung function in patients with excessive mucus production or impaired clearance.
3. Early Mobilization: Physiotherapists initiate early mobilization programs, including sitting, standing, and walking, as tolerated by the patient. This helps prevent muscle weakness, joint contractures, and functional decline associated with prolonged bed rest.
4. Muscle Strengthening: Therapeutic exercises are implemented to maintain or regain muscle strength and function. This includes active and passive range of motion exercises, resistive exercises, and neuromuscular electrical stimulation.

ICU Considerations for Specific Patients: 

• Neurosurgical Patients: Physiotherapy in neurosurgical patients focuses on early mobilization, maintaining head and neck alignment, preventing complications like pressure sores, and facilitating neurological recovery. Special care is taken to avoid increasing intracranial pressure during positioning and activities.

•  Neonates: Neonatal ICU physiotherapy aims to support respiratory function, facilitate normal development, and minimize complications such as bronchopulmonary dysplasia. Techniques include gentle handling, positioning, and respiratory support (e.g., nasal continuous positive airway pressure).
• Patients Following Cardiothoracic Surgery: Physiotherapy plays a vital role in optimizing respiratory function, preventing complications (e.g., atelectasis, pneumonia), and facilitating early mobilization. Techniques such as breathing exercises, coughing techniques, and mobilization are used to enhance recovery.

Assignment Task 3: Explain the common problem encountered in the ICU (e.g. the effect of immobilization/bed rest, the use of anesthesia and the effects of the heart, lung, vascular, thyroid and neck, gallbladder and liver, hernia, breast and gastrointestinal surgery)

• Effect of Immobilization/Bed Rest: Prolonged immobilization and bed rest in the ICU can lead to muscle weakness, joint contractures, loss of bone density (osteoporosis), decreased cardiovascular fitness, and impaired functional abilities. Early mobilization and physiotherapy interventions are essential to counteract these effects.
• Use of Anesthesia and its Effects: The use of anesthesia during surgical procedures can have various effects on the body. Common effects include respiratory depression, cardiovascular depression, temporary impairment of kidney and liver function, nausea, and vomiting. Proper monitoring and post-anesthetic care are vital to ensure patient safety and recovery.
• Effects of Heart, Lung, Vascular, Thyroid and Neck, Gallbladder and Liver, Hernia, Breast, and Gastrointestinal Surgery: Each type of surgery in these areas carries specific risks and potential complications. These may include infection, bleeding, organ dysfunction, surgical site complications, pain, and postoperative respiratory complications. Multidisciplinary care involving surgical, medical, and rehabilitation teams is necessary to manage these challenges effectively.

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