Pub Date : 2023-08-22DOI: 10.1097/cpt.0000000000000236
G. Ntoumenopoulos, S. Patman
The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19. An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted. The study was conducted in adult intensive care units. A total of 309 physical therapists participated in the study. A survey was used to determine current cardiopulmonary physical therapy practices in ICU. Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning. This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.
{"title":"International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19","authors":"G. Ntoumenopoulos, S. Patman","doi":"10.1097/cpt.0000000000000236","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000236","url":null,"abstract":"\u0000 \u0000 The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19.\u0000 \u0000 \u0000 \u0000 An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted.\u0000 \u0000 \u0000 \u0000 The study was conducted in adult intensive care units.\u0000 \u0000 \u0000 \u0000 A total of 309 physical therapists participated in the study.\u0000 \u0000 \u0000 \u0000 A survey was used to determine current cardiopulmonary physical therapy practices in ICU.\u0000 \u0000 \u0000 \u0000 Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning.\u0000 \u0000 \u0000 \u0000 This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.\u0000","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44021776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-22DOI: 10.1097/CPT.0000000000000232
M. Johanson, P. Bartlo, Naomi Bauer, Angela Campbell, Sagan Everett, Nancy Smith
Purpose: Competency-based education and creation of profession-based entrustable professional activities are current trends in physical therapist (PT) education. The purpose of this project is to determine the current entry-level PT competencies for cardiovascular & pulmonary (CVP) physical therapy. Methods: The Academy of Cardiovascular & Pulmonary Physical Therapy Competency Task Force was established to update and expand previous competencies. A mixed method approach of Subject Matter Expert (SME) consensus (modified Delphi process) and a broader survey process was used to develop these entry-level competencies. With SME guidance, a modified version of the levels of competence, None-to-Proficient, was adopted based on previous competency work by the American Council of Academic Physical Therapy. Results: Twenty-nine SME members engaged in the consensus process, and 268, 194, 305, and 222 respondents completed the 4 surveys, respectively. Six hundred fifty-one competency items were rated across most Commission on the Accreditation of Physical Therapy Education Standard 7 Curriculum areas, following the patient–client management model. Conclusions: These competencies establish specific expected levels of knowledge, skills, and behaviors essential for entry-level CVP PT practice. Adopting these competencies will help lay the groundwork for future competency-based PT education and aid in the development of the physical therapy profession's core entrustable professional activities.
{"title":"Cardiovascular and Pulmonary Entry-Level Physical Therapist Competencies: Update by Academy of Cardiovascular & Pulmonary Physical Therapy Task Force","authors":"M. Johanson, P. Bartlo, Naomi Bauer, Angela Campbell, Sagan Everett, Nancy Smith","doi":"10.1097/CPT.0000000000000232","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000232","url":null,"abstract":"Purpose: Competency-based education and creation of profession-based entrustable professional activities are current trends in physical therapist (PT) education. The purpose of this project is to determine the current entry-level PT competencies for cardiovascular & pulmonary (CVP) physical therapy. Methods: The Academy of Cardiovascular & Pulmonary Physical Therapy Competency Task Force was established to update and expand previous competencies. A mixed method approach of Subject Matter Expert (SME) consensus (modified Delphi process) and a broader survey process was used to develop these entry-level competencies. With SME guidance, a modified version of the levels of competence, None-to-Proficient, was adopted based on previous competency work by the American Council of Academic Physical Therapy. Results: Twenty-nine SME members engaged in the consensus process, and 268, 194, 305, and 222 respondents completed the 4 surveys, respectively. Six hundred fifty-one competency items were rated across most Commission on the Accreditation of Physical Therapy Education Standard 7 Curriculum areas, following the patient–client management model. Conclusions: These competencies establish specific expected levels of knowledge, skills, and behaviors essential for entry-level CVP PT practice. Adopting these competencies will help lay the groundwork for future competency-based PT education and aid in the development of the physical therapy profession's core entrustable professional activities.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"183 - 193"},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49180285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-25DOI: 10.1097/CPT.0000000000000234
Leslie M. Smith, Sindhuja Muralidharan, Diana Stanek, A. Yorke
Supplemental Digital Content is Available in the Text. Purpose: Hypertension (HTN) is a prevalent and preventable risk factor for several medical conditions that can lead to death. The purpose of this study was to investigate the frequency of physical and occupational therapists taking blood pressure (BP) in outpatient clinics before and after education focused on the clinical importance of monitoring BP. Methods: This pre/posttest model consists of 2 phases. In phase 1, physical and occupational therapists were surveyed regarding attitudes, behaviors, and barriers toward monitoring BP; and electronic medical records (EMR) were audited to determine frequency of BP documentation. For phase 2, educational webinars were developed highlighting the importance of BP monitoring and followed by another EMR audit. Results: Nine clinicians participated in our survey. Survey results indicated that one-third agreed that BP should be monitored during evaluations, but 100% responded that they rarely take BP. An audit of 488 EMR charts pre-education showed there was no BP documented. Three months after education, another 237 EMR charts were audited, with a 12.7% improvement in the frequency of BP documented. A chi-square analysis showed that this improvement was statistically significant (P < .001). Conclusions: Therapists did not monitor and document BP. After the webinar series, there was a significant increase, however still below recommendations for monitoring BP.
{"title":"Is Education Enough to Change the Practice of Monitoring of Blood Pressure in Outpatient Clinics? Case Report","authors":"Leslie M. Smith, Sindhuja Muralidharan, Diana Stanek, A. Yorke","doi":"10.1097/CPT.0000000000000234","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000234","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Hypertension (HTN) is a prevalent and preventable risk factor for several medical conditions that can lead to death. The purpose of this study was to investigate the frequency of physical and occupational therapists taking blood pressure (BP) in outpatient clinics before and after education focused on the clinical importance of monitoring BP. Methods: This pre/posttest model consists of 2 phases. In phase 1, physical and occupational therapists were surveyed regarding attitudes, behaviors, and barriers toward monitoring BP; and electronic medical records (EMR) were audited to determine frequency of BP documentation. For phase 2, educational webinars were developed highlighting the importance of BP monitoring and followed by another EMR audit. Results: Nine clinicians participated in our survey. Survey results indicated that one-third agreed that BP should be monitored during evaluations, but 100% responded that they rarely take BP. An audit of 488 EMR charts pre-education showed there was no BP documented. Three months after education, another 237 EMR charts were audited, with a 12.7% improvement in the frequency of BP documented. A chi-square analysis showed that this improvement was statistically significant (P < .001). Conclusions: Therapists did not monitor and document BP. After the webinar series, there was a significant increase, however still below recommendations for monitoring BP.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"171 - 176"},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45946349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/CPT.0000000000000223
D. O’Connell, Jill Jumper, Brad Hicks, Bubba Klostermann, Christopher Carl, Carmen Bell
Purpose: To examine pulse pressure (PP), systolic (SBP), and diastolic (DBP) pressure in outpatient physical therapy or maintenance fitness subjects by age (5 age groups) and in those younger than versus those who were 65 years and older. To test for differences in SBP, DBP, and PP in those with and without a hypertension (HTN) diagnosis. Methods: Ninety-eight physical therapy and maintenance fitness subjects in 1 urban outpatient clinic had PP and SBP/DBP measured and classified (ACC/AHA 2017 guidelines) using two different age classifications: (1) 20 to 44, 45 to 54, 55 to 64, 65 to 74, or ≥75 and (2) ≤64 or ≥65. Comparisons were also made in SBP, DBP, and PP based on a known hypertension diagnosis. Results: Forty male and 58 female subjects (height: 65.98 inches [SD = 4.19]; weight: 180.91 pounds [SD = 39.62]; body mass index: 29.11 [SD = 5.86]; age: 64.34 years [SD = 15.92]) participated in this investigation. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Systolic blood pressure significantly increases across 5 age groups. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Pulse pressure was significantly greater in those with hypertension. Pulse pressure was abnormal in 36.2% of the sample. Conclusions: Thirty-six percent of subjects receiving physical therapy treatment or participating in maintenance fitness had elevated PP while 78.9% and 47.3% had abnormal SBP and DBP, respectively. Both PP and blood pressure were significantly influenced by age. Therapists should measure resting BP and PP before treatment and refer as needed to achieve improved control.
{"title":"Prevalence of Elevated Pulse Pressure and Hypertension in Adults Participating in Outpatient Physical Therapy","authors":"D. O’Connell, Jill Jumper, Brad Hicks, Bubba Klostermann, Christopher Carl, Carmen Bell","doi":"10.1097/CPT.0000000000000223","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000223","url":null,"abstract":"Purpose: To examine pulse pressure (PP), systolic (SBP), and diastolic (DBP) pressure in outpatient physical therapy or maintenance fitness subjects by age (5 age groups) and in those younger than versus those who were 65 years and older. To test for differences in SBP, DBP, and PP in those with and without a hypertension (HTN) diagnosis. Methods: Ninety-eight physical therapy and maintenance fitness subjects in 1 urban outpatient clinic had PP and SBP/DBP measured and classified (ACC/AHA 2017 guidelines) using two different age classifications: (1) 20 to 44, 45 to 54, 55 to 64, 65 to 74, or ≥75 and (2) ≤64 or ≥65. Comparisons were also made in SBP, DBP, and PP based on a known hypertension diagnosis. Results: Forty male and 58 female subjects (height: 65.98 inches [SD = 4.19]; weight: 180.91 pounds [SD = 39.62]; body mass index: 29.11 [SD = 5.86]; age: 64.34 years [SD = 15.92]) participated in this investigation. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Systolic blood pressure significantly increases across 5 age groups. Systolic blood pressure, DBP, and PP were significantly higher in those older than 65 years. Pulse pressure was significantly greater in those with hypertension. Pulse pressure was abnormal in 36.2% of the sample. Conclusions: Thirty-six percent of subjects receiving physical therapy treatment or participating in maintenance fitness had elevated PP while 78.9% and 47.3% had abnormal SBP and DBP, respectively. Both PP and blood pressure were significantly influenced by age. Therapists should measure resting BP and PP before treatment and refer as needed to achieve improved control.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"133 - 140"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46488300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/cpt.0000000000000231
A. Fick
{"title":"Advocacy and Service: Opening Your Heart to Make a Vital Impact","authors":"A. Fick","doi":"10.1097/cpt.0000000000000231","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000231","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41699009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-09DOI: 10.1097/cpt.0000000000000225
Kerry Lammers, Daniel Ludwig
This clinical perspectives article provides a comprehensive and evidence-based overview of diagnosing and treating dizziness in complex patients. These patients typically present with overlapping comorbidities and symptoms that can create difficulty in discovering an accurate diagnosis and treatment plan. Vestibular dysfunction affects over 35% of adults older than 40 years, and that prevalence significantly increases with age. Eighty-five percent of adults older than 80 years had evidence of balance/vestibular dysfunction. We believe this differential diagnosis between cardiopulmonary and vestibular dizziness transcends all rehab environments across the continuum of care. We will provide evidence for vestibular background knowledge and clinical skills that intersects with evidence regarding pharmacology and competing cardiopulmonary diagnoses to provide clinicians with the framework, skills, and knowledge to differentially diagnose dizziness across multiple care settings. In addition, we will provide examples of appropriate interdisciplinary communication to assist the clinician in decision making and best practice management.
{"title":"Defining Dizziness: Acknowledging Vestibular Differential in Cardiopulmonary Diagnoses","authors":"Kerry Lammers, Daniel Ludwig","doi":"10.1097/cpt.0000000000000225","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000225","url":null,"abstract":"This clinical perspectives article provides a comprehensive and evidence-based overview of diagnosing and treating dizziness in complex patients. These patients typically present with overlapping comorbidities and symptoms that can create difficulty in discovering an accurate diagnosis and treatment plan. Vestibular dysfunction affects over 35% of adults older than 40 years, and that prevalence significantly increases with age. Eighty-five percent of adults older than 80 years had evidence of balance/vestibular dysfunction. We believe this differential diagnosis between cardiopulmonary and vestibular dizziness transcends all rehab environments across the continuum of care. We will provide evidence for vestibular background knowledge and clinical skills that intersects with evidence regarding pharmacology and competing cardiopulmonary diagnoses to provide clinicians with the framework, skills, and knowledge to differentially diagnose dizziness across multiple care settings. In addition, we will provide examples of appropriate interdisciplinary communication to assist the clinician in decision making and best practice management.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45272081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-05DOI: 10.1097/CPT.0000000000000222
C. DiPerna, L. Tucker, Danielle E. Rice, Cori Shank, Abigail J. Kettler, Colin L. Terry, Linda Ulerich, D. Roe, C. Hage
Supplemental Digital Content is Available in the Text. Purpose: Functional recovery after lung transplant is crucial to long-term outcomes. Despite rehabilitation, few reach the threshold of healthy function. The purpose of this study was to assess the potential benefit of rehabilitation in the Center of Life for Thoracic Transplant (COLTT) program by (1) measuring time to functional recovery, (2) identifying factors associated with functional recovery, (3) examining program outcomes, and (4) examining COLTT impact on unplanned hospital readmission. Methods: The study retrospectively examined 105 patients in COLTT after hospital discharge. Functional measures collected at enrollment and completion included 6-minute walk distance, walking speed, 1-minute sit-to-stand test, and single-leg stance. Demographic and hospital stay data were examined for associations between time to achieve COLTT goals and readmissions. Results: The median number of visits in COLTT was 18 (9–53). Significant functional gains were made across all outcome measures and near thresholds for healthy individuals. Age, hospital and intensive care unit (ICU) length of stay (LOS), lung disease type, and ventilation time were significantly associated with COLTT visits. The 30-day hospital readmission free rate after hospital discharge was 71.4%. Conclusions: Healthy adult functional outcomes were achieved in 18 visits. Age, hospital and ICU LOS, lung disease type, and prolonged ventilation are associated with functional recovery.
{"title":"Functional Recovery After Lung Transplantation Using a Comprehensive Rehabilitation Model","authors":"C. DiPerna, L. Tucker, Danielle E. Rice, Cori Shank, Abigail J. Kettler, Colin L. Terry, Linda Ulerich, D. Roe, C. Hage","doi":"10.1097/CPT.0000000000000222","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000222","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Purpose: Functional recovery after lung transplant is crucial to long-term outcomes. Despite rehabilitation, few reach the threshold of healthy function. The purpose of this study was to assess the potential benefit of rehabilitation in the Center of Life for Thoracic Transplant (COLTT) program by (1) measuring time to functional recovery, (2) identifying factors associated with functional recovery, (3) examining program outcomes, and (4) examining COLTT impact on unplanned hospital readmission. Methods: The study retrospectively examined 105 patients in COLTT after hospital discharge. Functional measures collected at enrollment and completion included 6-minute walk distance, walking speed, 1-minute sit-to-stand test, and single-leg stance. Demographic and hospital stay data were examined for associations between time to achieve COLTT goals and readmissions. Results: The median number of visits in COLTT was 18 (9–53). Significant functional gains were made across all outcome measures and near thresholds for healthy individuals. Age, hospital and intensive care unit (ICU) length of stay (LOS), lung disease type, and ventilation time were significantly associated with COLTT visits. The 30-day hospital readmission free rate after hospital discharge was 71.4%. Conclusions: Healthy adult functional outcomes were achieved in 18 visits. Age, hospital and ICU LOS, lung disease type, and prolonged ventilation are associated with functional recovery.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"141 - 149"},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41986901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/CPT.0000000000000228
PT Dpt Ccs Kari DiVito, PT Anne K. Swisher, MD Mph J.W. Awori Hayanga
Objective: Extracorporeal membrane oxygenation (ECMO) is a lifesaving modality that was in great demand for persons with severe COVID-19 infection. Although mobility of these patients has previously been safely reported anecdotally, there were no established guidelines to implement in a greatly expanded patient population, as occurred in the pandemic period. We describe the development and implementation of a program (Cannulate, Extubate, Ambulate) for team-based safe mobilization. Methods: The 3-phase protocol advances based on patient alertness/ability to actively participate. A physical therapist determined initial stage and progression and recommended mobility activities for carryover by nurses and/or ECMO specialists between skilled sessions. Results: The mobility program has been successfully implemented for 104 patients with severe COVID-19 without significant adverse events. Most patients (51%) ambulated while cannulated, and 60% were able to discharge directly home after hospitalization. Conclusions: This safe, effective program allowed extension of physical therapy goals in a highly complex patient population during a time of very high demand. Making early mobility a team goal enhanced buy-in, instead of relying exclusively on rehabilitation providers for mobilization. Utilization of the Cannulate, Extubate, Ambulate program may assist other programs to minimize complications of immobility in the ECMO population.
{"title":"Cannulate, Extubate, Ambulate: How the Pandemic Accelerated Development and Implementation of Early Mobility for Patients Requiring Extracorporeal Membrane Oxygenation","authors":"PT Dpt Ccs Kari DiVito, PT Anne K. Swisher, MD Mph J.W. Awori Hayanga","doi":"10.1097/CPT.0000000000000228","DOIUrl":"https://doi.org/10.1097/CPT.0000000000000228","url":null,"abstract":"Objective: Extracorporeal membrane oxygenation (ECMO) is a lifesaving modality that was in great demand for persons with severe COVID-19 infection. Although mobility of these patients has previously been safely reported anecdotally, there were no established guidelines to implement in a greatly expanded patient population, as occurred in the pandemic period. We describe the development and implementation of a program (Cannulate, Extubate, Ambulate) for team-based safe mobilization. Methods: The 3-phase protocol advances based on patient alertness/ability to actively participate. A physical therapist determined initial stage and progression and recommended mobility activities for carryover by nurses and/or ECMO specialists between skilled sessions. Results: The mobility program has been successfully implemented for 104 patients with severe COVID-19 without significant adverse events. Most patients (51%) ambulated while cannulated, and 60% were able to discharge directly home after hospitalization. Conclusions: This safe, effective program allowed extension of physical therapy goals in a highly complex patient population during a time of very high demand. Making early mobility a team goal enhanced buy-in, instead of relying exclusively on rehabilitation providers for mobilization. Utilization of the Cannulate, Extubate, Ambulate program may assist other programs to minimize complications of immobility in the ECMO population.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"34 1","pages":"164 - 170"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45390793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/cpt.0000000000000230
Paul Ricard, Stephen Cameron Ramsey, Hannah Fernald McHugh, Benjamin Michael Carrion
Practitioners need access to and the ability to openly discuss advances in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides a limited overview of cardiovascular and pulmonary research published in 2022 that the authors believe most important and relevant or speaks to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Each topic area is followed by a brief overview of clinical relevance and was open to discussion with the participants present at the 2023 Combined Sections Meeting held on February 24, 2023.
{"title":"Cardiovascular and Pulmonary Research: The Year (2022) in Review","authors":"Paul Ricard, Stephen Cameron Ramsey, Hannah Fernald McHugh, Benjamin Michael Carrion","doi":"10.1097/cpt.0000000000000230","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000230","url":null,"abstract":"Practitioners need access to and the ability to openly discuss advances in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides a limited overview of cardiovascular and pulmonary research published in 2022 that the authors believe most important and relevant or speaks to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Each topic area is followed by a brief overview of clinical relevance and was open to discussion with the participants present at the 2023 Combined Sections Meeting held on February 24, 2023.","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136370976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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