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A multi-disciplinary approach for developing a novel mobility program for VV-ECMO patients in the MICU
Cardiopulmonary Physical Therapy Journal ; 33(1):e8, 2022.
Article in English | EMBASE | ID: covidwho-1677321
ABSTRACT

PURPOSE:

This presentation will describe an evidence-based development and implementation of a multi-disciplinary approach for a novel program for the early mobilization of COVID-19 positive patients receiving VV-ECMO in a medical intensive care unit (MICU). DESCRIPTION During previous viral pandemics, patients with severe acute respiratory distress syndrome (ARDS) have been treated with advanced modalities, including ECMO. Many programs were quickly created to meet patient needs during each outbreak. It was anticipated that non-ECMO centers would have increased referrals to ECMO programs for patients with impending clinical deterioration, which disproportionately affects hospitals with ECMO programs. The current COVID-19 pandemic began at a time when worldwide ECMO research is more developed than a decade ago. In addition, there is increasing literature that shows the benefits of engaging in early mobilization for patients in the ICU, including the feasibility and safety of early mobilization of patients receiving ECMO. A reoccurring theme in the literature of successful early mobilization of patients receiving ECMO is the implementation of a well-trained multidisciplinary team led by an advanced trained physical therapist. Studies have also emphasized the importance of well-defined roles, inclusion, exclusion, and termination of therapy criteria, and mobilization progression guidelines. Using guidance from recent literature for safe mobilization of the patient receiving ECMO, our hospital developed and implemented a novel multi-disciplinary approach for early mobilization for COVID-19 positive patients receiving VVECMO. SUMMARY OF USE Our program's multidisciplinary team consisted of cardiothoracic surgeon, ICU intensivists, ICU nursing staff, nursing educators, perfusionist, respiratory therapists, and physical therapists. Nursing staff completed didactic and simulation lab training prior to being assigned to patients receiving ECMO. All members of the team presented at the didactic class. In addition, the team developed a mobility check list and simulation video for mobilizing patients receiving VVECMO. Physical therapy also utilized a competency check off for observation and demonstration to train additional staff, along with a set of guidelines for inclusion and exclusion for therapy. IMPORTANCE TO MEMBERS This presentation can provide education based on our hospital's approach to addressing the rehabilitation needs of critically ill patients receiving ECMO due to COVID-19, and assist others in developing and refining their programs. It provides a description of our protocol based on evidencebased practice to develop and implement a unique protocol, while maintaining safety, providing multidisciplinary treatment, improving communication, and advocating for early rehabilitation in the intensive care unit.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study Language: English Journal: Cardiopulmonary Physical Therapy Journal Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study Language: English Journal: Cardiopulmonary Physical Therapy Journal Year: 2022 Document Type: Article