Question 16

Outline  the  potential   benefits  and  risks  of  the  provision  of  physiotherapy  to  the critically ill patient.

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College Answer

There is still significant debate about the role of routine physiotherapy, but areas of physiotherapy
with their potential  benefit include:
•    Optimization of ventilation/respiratory function
•    Assistance in weaning
•    Advice on positioning of chest for improving ventilation
•    Joint protection
•    Minimise muscle damage, soft tissue injury
•    Muscle tone maintenance particularly in the neurological ICU patient
•    Early rehabilitation/mobilization
•    Liaison with medical and nursing staff

Potential risks/complications of physiotherapy techniques listed above include:
•    Deterioration in gas exchange
•    CVS instability
•    Barotrauma
•    Rise in ICP
•    Increased patient pain, stress and anxiety

Discussion

The role of physiotherapy is discussed in Question 24 from the second paper of 2013.