Early
Did you get a stress ball?
:)
What are some cardiac benefits to early mobility?
Can patients on a ventilator be mobilized?
(Sat in a chair, walked down the halls, etc?)
Yes!
Can you safely mobilize a patient on paralytics or sedatives? Why or why not?
Nope.
A patient will not have any control over their movements, will have no purposeful movements, and the key to early mobilization is patient effort
Should acute MI patients be walked/mobilized?
No
Acute MI's are a contraindication to mobilization
What are some benefits of Early Mobility
Decreased LOS, improved mental health, allows airways to open up, etc.
What vitals should be monitored when mobilizing a patient?
Heart rate, respiratory rate, SpO2, blood pressure
Who can mobilize patient
1. Nurses (with training)
2. family
3. PT/OT
4. Nutrition/meal staff
Which of these patients should have an RT assisting when walking down the hall?
1. 2 day post open heart patient on 2L NC
2. 1 week post tracheostomy patient on SIMV
3. 1 day post TAVR patient on RA
4. 3 day post open heart patient on RA who uses CPAP at night
2. 1 week post tracheostomy patient on SIMV
Because the patient is still connected to a vent, the RT should be available to monitor!
You're helping move a patient from bed to chair on a BiPAP. You notice their heart rate jumps from 88 to 110, and their SpO2 drops from 98% to 84% on an FiO2 of 60%. What should you do?
Safely get the patient back to a resting position, increase FiO2 until they stabilize, notify practitioner
A patient is able to roll to their side and push up in bed, and are ready to try to sit up at the side of the bed. Who should be called to assist the patient with sitting up for the first time?
Physical therapist
What are some pulmonary complications associated with prolonged immobility
Atelectasis, retained secretions, increased likelihood of VAP
A trach patient is hooked up to a vent and a full IV pole of drips. You're in the room to do a vent check, when you see the patient is sitting in their chair. The patient says they're tired, and want your help getting back to bed.
Should you help them back to bed by yourself?
No, always get a nurse or PT/OT to help you move!
Would getting a patient up to walk the halls improve their mental health?
Yes!
It allows for a change of scenery, and a return of sense of independence.
Which is NOT an example of Early Mobility in the ICU
1. Walking a trach patient on the vent
2. Moving a vented patient from bed to chair
3. Moving the tube from the Left to the Right corner of the mouth
4. Wedging a patient up on their right side
3. Moving the tube from the Left to the Right corner of the mouth
Nursing just rolled your trach patient onto their side, when the high pressure alarm starts beeping on the vent. What should you check?
Cuff pressures, suction, tubing connections, cannula in place, etc.
Should all patients be mobilized following the same timeline?
No, each patient is different, and will have different progress than others.
Mobilization plans should be tailored to each individual patient.
Should you, an RT, be present when moving a mechanically ventilated patient from bed to chair?
Yes! You should be there to help keep an eye on the vent, ensuring no disconnects and to keep an eye on the vent numbers.
Is patient effort important when mobilizing patients?
Yes! Patient effort is extremely important
What are some complications associated with prolonged immobility?
Rapid muscular wasting
Increased likelihood of VAP
Increased LOS