A single center observational study of the incidence, frequency and timing of critical care physiotherapy intervention during the COVID-19 pandemic.

Jessica Rich,Mark Coman,Amanda Thomas,Daniel Church,Alison Sharkey,Jessica Pawson

doi:10.1177/1751143721991060

Jessica Rich, Mark Coman + Show 4 more

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https://doi.org/10.1177/1751143721991060

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Abstract

IntroductionThe recent COVID-19 pandemic saw many patients admitted to an intensive care setting and requiring mechanical ventilation. The NHS increased their critical care beds which included expanding the amount of staff. Physiotherapists were a key part of this and were required to complete numerous interventions within the COVID critical care setting throughout the pandemic. Our aim was to collect the incidence and frequency of physiotherapy interventions performed during the COVID-19 pandemic in a critical care setting.MethodData was collected across all critical care beds at the Royal London Hospital for an eight-week period between March- April 2020. We retrospectively collected physiotherapy interventions for example, endotracheal suctioning and functional rehabilitation for every patient in the critical care setting. The Chelsea Critical Care Physical Assessment Tool (CPAx) scores were also obtained for patients on ACCU admission and discharge.ResultsA total of 213 patients were included in the sample, 163 COVID-19 positive and 50 COVID-19 negative. Recorded sessions included secretion management (821), weaning (271), rescue therapy (82) and functional rehab (534) across the eight-week period. The mean CPAx score on admission to ACCU for the entire sample was 9/45 points. On discharge that score had improved to 25/45 points.ConclusionThis unique project has enabled us to report on the critical care physiotherapy interventions provided during the COVID 19 pandemic. This interesting data on frequency and timing of interventions may be useful to plan future relocation staffing plans and optimal allocation of care.

Highlights

The recent COVID-19 pandemic saw many patients admitted to an intensive care setting and requiring mechanical ventilation
COVID-19 practice recommendations for Physiotherapists in acute hospital settings first appeared in late March, 2020.1,2 These recommendations were based on best available evidence and expert consensus from countries yet to be significantly affected by the virus,[1] and the specific experience of Physiotherapists from northern Italy who had been experiencing an exponential growth of COVID-19 infections since early February, 2020.2
Design and setting: This was a single center observation completed at the Adult Critical Care Unit (ACCU) of the Royal London Hospital (RLH), London, United Kingdom

Summary

Introduction

The recent COVID-19 pandemic saw many patients admitted to an intensive care setting and requiring mechanical ventilation. The NHS increased their critical care beds which included expanding the amount of staff. Our aim was to collect the incidence and frequency of physiotherapy interventions performed during the COVID-19 pandemic in a critical care setting. Method: Data was collected across all critical care beds at the Royal London Hospital for an eight-week period between March- April 2020. We retrospectively collected physiotherapy interventions for example, endotracheal suctioning and functional rehabilitation for every patient in the critical care setting. Conclusion: This unique project has enabled us to report on the critical care physiotherapy interventions provided during the COVID 19 pandemic. The ensuing COVID-19 pandemic reached its peak in the UK in April, 2020, requiring a rapid response from the National Health Service (NHS) This response included expansion of critical care services and redeployment of staff groups to facilitate enhanced capacity. COVID-19 practice recommendations for Physiotherapists in acute hospital settings first appeared in late March, 2020.1,2 These recommendations were based on best available evidence and expert consensus from countries yet to be significantly affected by the virus,[1] and the specific experience of Physiotherapists from northern Italy who had been experiencing an exponential growth of COVID-19 infections since early February, 2020.2

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