9B: Covid

Question 1

What are acute symptoms of covid?

Answer 1

Fever, chills, cough, SOB, fatigue, myalgia, headache, loss of taste or smell, sore throat, congestion, nausea, diarrhea

Question 2

What three cardiovascular impairments are the result of covid?

Answer 2

1. V/Q mismatch
2. Cardiac myocarditis
3. Thromboembolus

Question 3

Describe V/Q mismatch with covid

Answer 3

• ARDS like presentation
• Lower surfactant levels
• Hypoxemia

Question 4

Why can you develop hypoxemia due to covid?

Answer 4

Fluid is blocking V/Q matching

Question 5

What is cardiac myocarditis?

Answer 5

Inflammation of muscle fibers

Question 6

What are the effects of cardiac myocarditis?

Answer 6

• Arrhythmias
• Increased myocardial O2 demand

Question 7

What are interventions for acute covid?

Answer 7

• Proning
• Maintain O2 transport system
• Maintain functional endurance
• IMT as needed

Question 8

How do you work to maintain the O2 transport system?

Answer 8

• Optimal supplemental O2
• Maximize O2 stats with movement, hygiene, coughing

Question 9

What is proning?

Answer 9

Prone positioning that is recommended in acute care, especially for severe cases and pulmonary decompensation

Question 10

What is the recommended time for proning?

Answer 10

12-16 hours straight

Question 11

Why does PT need to assist with proning?

Answer 11

Prevent pressure injuries at head, clavicles, sternum, ASIS, patellas, feet

Question 12

What are the three effects of proning?

Answer 12

1. Gravity allows airways to open back up
2. Post lung segments function
3. Re-establish V/Q matching to increase PaO2 levels

Question 13

What is the intensity of acute PT for covid?

Answer 13

12 on the Borg or 2 on the Modified Borg

Question 14

What is the frequency of acute PT for covid?

Answer 14

5-7 days/week

Question 15

Describe early rehab in the home or outpatient following covid?

Answer 15

• IMT and HEP
• Teach controlled or deep or pursed lip breathing for ambulation
• Breath timing with conditioning

Question 16

How is covid effecting patients long-term in comparison to other ICU stays?

Answer 16

Greater muscle mass loss

Question 17

Why might there be greater muscle mass loss with covid?

Answer 17

• Viral load
• Impact of prolonged lack of oxygenation on muscle tissue
• Long periods of increased RR, HR, decreased PaO2

Question 18

What are home health interventions for covid?

Answer 18

• Monitor O2 and supplement
• Maintain functional mobility
• Endurance and strength
• Balance
• ICUAW
• QOL

Question 19

What is the duration of strength training following covid?

Answer 19

Start with 15-20 reps of each exercise, can break into multiple sets

Question 20

What is the intensity of strength training following covid?

Answer 20

Start with low weight and high reps and then progress

Question 21

What is the frequency of strength training following covid?

Answer 21

Subacute: 2-3 days/week
Home health: 2-4 days/week

Question 22

What is the definition of long covid?

Answer 22

Signs, symptoms, and conditions that continue to develop after an acute covid infection

Question 23

What is the timeframe of developing long covid?

Answer 23

Disagreement - 2 weeks to 2 months after initial infection

Question 24

What are symptoms of long covid?

Answer 24

SOB, fatigue, chest pain, weakness, brain fog, headache, dizziness, anxiety

Question 25

What are the recommended interventions for long covid?

Answer 25

Aerobic and strength can improve symptoms at a low duration and low intensity

Question 26

What activities can exacerbate symptoms with long covid?

Answer 26

Load bearing and upright such as walking or running

Question 27

How do you teach energy conservation with long covid?

Answer 27

Home set up, spacing out activities, O2, equipment, minimize stairs and bending, breaks