Lecture 6: Intervention Sequencing/Early Mobilization in ICU

Question 1

Platelets below 20,000

Answer 1

Norm: 150k-400k

ADLs only or bed rest

Question 2

Mobilization or Exercise?

Answer 2

Mobilization: primary purpose is to improve oxygen transport and move against gravity. (sit-stand)
Exercise: reps sets weights, strength, power, and endurance goals

Question 3

Richmond Agitation-Sedation Scale (RASS)

Answer 3

Used in ICU
+4: Combative: violent, immediate danger to staff
+3: Very Agitated: Pulls or removes tubes/catheters
+2: Agitated: Frequent non-purposeful mvmt, fights ventilator
+1: Restless: Anxious but not aggressive
0: Alert and Calm
-1: Drowsy: Not fully alert, Sustained awakening to voice (>10secs)
-2: Light Sedation: Briefly awakens w/voice (<10secs)
-3: Moderate Sedation:
-4: Deep sedation
-5: Unarousable
KNOW THAT WE WILL INTERVENE 1 SD from 0

Question 4

CAM-ICU (Confusion Assessment Method for ICU)

Answer 4

*If RASS is > or equal to -3, proceed to CAM-ICU

Question 5

Progressive Mobilization

Answer 5

1. Elevate head of bed
2. High sitting with legs horizontal
3. High sitting w/progressive leg lowering
4. Sitting EOB with feet supported