Exercise in the ICU

Question 1

What is the critical care bundle?

Answer 1

• Assess, prevent and manage pain
• Both spontaneous awakening and spontaneous breathing trials
• Choice of analgesia and sedation
• Delirium: assess, prevent and manage
• Early mobilization
• Family engagement

Question 2

Muscle mass diminishes within ___ hours in the ICU and pts may lose __% of more in first week of illness

Answer 2

24;10

Question 3

ICU acquired weakness can be measured in more than __% of pt’s ventilated for longer than 48 hours

Answer 3

50

Question 4

____ and ____ should be considered if pt is difficult to wean and/or is not responding to strengthening exercises

Answer 4

CIP;CIM

Question 5

4 pt populations in ICU especially susceptible to CIM/CIP?

Answer 5

1. ARDS
2. sepsis
3. systemic inflammatory response syndrome
4. multiple organ failure

Question 6

CIP and CIM involve _________ axons and ______ muscle weakness

Answer 6

sensorimotor; skeletal

Question 7

Only way presently to reduce incidence of CIP and CIM?

Answer 7

reduce risk factors

Question 8

Avoid / limit use of ________ blocking agents and _______ to reduce risk of CIP/CIM (also early rehab!)

Answer 8

neuromuscular; corticosteroids

Question 9

4 categories for safety considerations for active mobilization of mechanically ventilated criticially ill adults?

Answer 9

1. resp
2. CV
3. neurological
4. other

Question 10

4 things to always monitor when mobilizing in ICU?

Answer 10

1. HR
2. RR
3. SpO2
4. BP

Question 11

3 principles of positioning?

Answer 11

1. neutral
2. upright
3. open

Question 12

Functional mobilization should be carried out by all staff (T/F)

Answer 12

TRUE

Question 13

5 examples of outcomes measures PT could use in the ICU?

Answer 13

1. goal attainment scale (pt centered)
2. stages of mobility
3. CPAx
4. ICU mobility scale
5. DEMMI

Question 14

Ultimate goal of exercise in the ICU?

Answer 14

optimize strength and function