ICU teams across Canada get patients moving to recover faster
When Jide Olabode started working in the University of Alberta Hospital’s Intensive Care Unit nine years ago, the physiotherapist admits he felt useless.
“I kind of was wondering: ‘What was my role here?'” Olabode said. “‘What am I supposed to be doing for these patients?'”
“They’re so sick, what can we do?”
The ICU is where the sickest patients stay, often for weeks. For each day someone spends in bed, they lose at least one per cent of their muscle strength. Twenty years ago, heavy sedation was common in the unit. But in the past decade, staff have noticed a culture shift.
“Many patients and families have the perspective that [patients] are sick, and they need to rest,” said Dr. David Zygun, a senior medical director with Alberta Health Services. “It is true that there are patients that are too unstable to mobilize. But surprisingly, most of our patients can start some mobilization on Day 1.”
“The goal is to get [patients] moving, as soon as possible,” Olabode said, “whenever it’s safe.”
The latest research shows keeping people in bed prolongs their hospital stay and leads to greater complications. Now many ICU teams across Canada are encouraging patients to move within their first day or two on the unit. Even some patients who are still in a coma can have their feet strapped to a mechanized bed bike, passively pedalling.
Terry Bugg of Lethbridge, Alta. recently returned to the ICU, due to complications from his double lung transplant in June. One week after his re-admission, the 61-year-old was pedalling both an arm and leg bike, and walking around the unit when possible.
“Once I got up and started moving around, I started being able to get my strength back quickly,” Bugg said.
Bugg feels exercise helps him breathe better, and even helps with his delirium.
Up to 80 per cent of ICU patients experience severe confusion or hallucinations, due to medications and sleep deprivation. A new province-wide project, funded by Alberta Health Services, is testing movement to prevent or treat delirium.
“The upright posture – patients tend to be more awake and alert,” Zygun explained.
These days, Olabode is busier than ever – helping patients leave the ICU sooner and stronger.
“It’s one thing to save someone’s life, which is very important,” the physiotherapist said. “But it’s another thing that they have a life to get to when they get out of here.”
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