Discuss early active mobilisation in the general intensive care unit.
(10 marks)
Syllabus topic/section: 2.1 Medical Expert: Management including supportive treatment (2.1.3-18)
Discussion:
Overall, this was a well answered question, and the candidates had a good knowledge of the rationale behind early mobilisation and the potential benefits.
Good answers utilised the glossary, addressed advantages (including neuromuscular, functional, physiological, outcomes), disadvantages (risks including disconnections, dislodgements) and controversies with regards to early active mobilisation. Some synthesis of current evidence, describing limitations (many small, single-centre trials; heterogenous patient populations; complex/variable interventions groups in terms of type/timing/duration/dose; differing outcome measures) and variability in outcomes was required to score well.
Candidates are reminded to pay attention to their handwriting especially towards the end of the examination. The rubric is included to aid the candidate's future study.
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Discuss early active mobilisation in the general intensive care unit. (10 marks) |
Superficial or incorrect answer limited to neuromuscular benefits only Limited appreciation of evidence, outcomes and limitations. Advantages and disadvantages 0-4.5 marks |
List some neuromuscular, physiological and functional benefits Mentions falls, disconnections and some cardiorespiratory risks Able to state some outcomes from trials and challenges in interpretation of evidence. 5- 7 marks |
At standard PLUS Comprehensive list of benefits including most categories listed. Must include neuromuscular. Comprehensive list of potential risks (most listed) Excellent synthesis of evidence, describing limitations and variability in outcomes. Able to identify most specific outcome benefits and at least one trial. 7.5 – 10 marks |