ABSTRACT

Physiotherapy is an integral component of the multidisciplinary management of patients in intensive care units (ICUs); however, the role and treatment methods vary between hospitals due to staffing levels, local approaches and experience. Some of these variations are being addressed following the publication of the NHS England service specification (D16) and GPICS standards. Survival rate following admission to ICU is increasing due to advances in medical care but this is also increasing the number of patients with long-term physical impairments. Assessment encompasses the respiratory, musculoskeletal, cardiovascular and neurological needs of the patient. Physiotherapists are uniquely qualified with skills and expertise to work with the assessment and management of respiratory complications, physical deconditioning, and neuromuscular and musculoskeletal conditions. Rehabilitation commences whilst the patient is sedated with passive movements to minimise joint stiffness and soft tissue contractures, advancing to active exercises as soon as the patient is able to participate.