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Critical Care

The OT critical care team works on HDU and ITU which are 8 bedded units of dependent patients who need organ support, respiratory support or advanced equipment.  We work as part of a multi-disciplinary team to provide early assessment and intervention.  The role of the OT would be to implement early rehabilitation alongside the other therapy staff.

Conditions

Many people are admitted to critical care because of an accident, an illness or for treatment after a major operation.  The sorts of conditions we see are critically ill patients, this could be due to respiratory failure, cardiac arrest, trauma, or for post-op monitoring.  There are several different risk factors associated with the impact of critical illness such as age, past medical history, severity of illness, sepsis, duration of ventilation, duration of immobilisation, sedations given.  Critical illness can have an impact on all body systems such as the respiratory system, endocrine system, reproductive system, excretory system, musculoskeletal system, nervous system, immune system, digestive system, cardiovascular system, integumentary system. 
OT Intervention

The OT interventions we complete are upper limb therapy, cognitive assessments, seating assessments, delirium monitoring, progress independence in functional activities and joint sessions with physiotherapy to progress sitting balance and mobility.  We also support the transition from critical care to other wards and to discharge.  

Student working hours

Student working hours:  8am-4pm 

Dress code: clinical uniform, black shoes. 

Learning Opportunities

 

Learn how to monitor patient’s cognition for improvement or deterioration. 

 

Learn how to facilitate upper limb therapy 

 

Learn how to engage critical patient’s in early rehab 

 

Learn how to improve functional activity in critical patients 

 

Learn what to do when someone is critically unwell and how to raise the alarm 

 

Learn about the step down transition and discharge pathway

Non OT Opportunities:

Observing a bronchoscopy 

 

Observing insertion of a tracheostomy 

 

Observation of intubation and/or extubation 

 

Spending time with other members of the MDT 

Reading list and useful topics to read up on

 

Delerium 

Respiratory system and breathing 

Schweickert WD, Pohlman MC, Pohlman AS et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 2009; 373(9678):1874-1882. doi:10.1016/S0-60658-9.  

Castro-Avila AC, Serón P, Fan E, Gaete M, Mickan S. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis. PLoS One. 2015 Jul 1;10(7):e0130722. doi: 10.1371/journal.pone.0130722. PMID: 26132803; PMCID: PMC4488896. 

Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, Spears L, Miller M, Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, McCallister KE, Hall JB, Kress JP. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009 May 30;373(9678):1874-82. doi: 10.1016/S0140-6736(09)60658-9. Epub 2009 May 14. PMID: 19446324. 

Lat I, McMillian W, Taylor S, Janzen JM, Papadopoulos S, Korth L, Ehtisham A, Nold J, Agarwal S, Azocar R, Burke P. The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients. Crit Care Med. 2009 Jun;37(6):1898-905. doi: 10.1097/CCM.0b013e31819ffe38. PMID: 19384221. 

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