Attachment Duration

2 - 4 weeks

Criteria

Only for practising and/or registered physiotherapists.

Note: Each request is subject to Department's review and approval

Objectives

To provide clinical environment for the training and development of advanced knowledge and clinical skills in physiotherapy in critical care. The participant will develop knowledge and skills in,

1. Screening ICU cases for chest physiotherapy , prevention of ICU acquired weakness and rehabilitation.
2. Extracting physiotherapy relevant content from case notes.
3. Monitoring in critical care unit and its relevance to physiotherapy – ECG, pulse oximetry, capnometry , respiratory rate, cardiac index, arterial and non invasive blood pressure monitoring.
4. Ventilator monitoring – saw tooth flow scalar, intrinsic PEEP, compliance, Ppeak ,PPlateau, Vte etc.
5. Clinical reasoning in various secretion clearance techniques - cough assist, vest therapy , Cornet therapy, Acapella, ventilator hyperinflation, manual hyperinflation etc.,
6. Factors to be considered in pre and post extubation chest physiotherapy.
7. Bed to chair mobilization of ventilated patients with and without ceiling hoist.
8. Ambulating ICU patients with/without mechanical ventilator.
9. Various equipments that could be used to exercise patients  in ICU- motorized cycle, tilt table, shuttle mini leg press, walkers etc.,
10. Inspiratory muscle training – indications, precautions and contraindications for ventilated patients.
11. Physiotherapy for patients on non invasive ventilation.
12. Differences in approach to physiotherapy assessment and intervention for critical care conditions in adult surgical, medical, burns, neuromedical and neurosurgical intensive care units.

Outline

The specific duration and area of attachment will be individualised to meet the participant’s need. The attachment may also include the specialty areas are adult surgical, medical, burns, neuromedical and neurosurgical intensive care units.

Methodology

• Observation or practical hands on sessions (depending on Singapore Allied Health Professional Council licensure requirement)
• Simulation technology
• Case discussion session
• Cardiopulmonary team in-services
• ICU ward rounds
• On-line reading materials