Early Mobility Solution
Mobilising critically ill patients in the complicated and often crowded ICU environment can be a significant challenge for the ICU team. Access to appropriate equipment, processes and know how is often required to support the introduction of early rehabilitation and mobility programmes in the ICU.
In Bed Mobilisation:
Where out of bed mobilisation is contraindicated or options are limited, there are methods for supporting rehabilitation and recovery for patients confined to bed.
Patient transfer out of bed:
When lateral and seated transfers out of bed are required, a range of patient handling equipment options are available to help the caregiver.
Out of bed mobilisation:
Whether the patient is ventilated or not, the process of sitting a patient on the edge of the bed forms an important part of the early patient assessment and subsequent provision of a structured rehabilitation programme and seating plan.
When sitting on edge of bed is too challenging:
The process of sitting on the edge of the bed can at times be labour intensive, particularly for patients who are obese, of low arousal or with profound ICU-AW, where it may take four or even five members of staff to transfer the patient to the edge of the bed. Alternatively, factors such as a poorly tolerated airway, multiple attachments including positional femoral lines, low dose inotropic support, postural hypotension may raise concerns around the process of moving a patient to sitting on the edge of the bed.
For those patients with a reduced Glasgow Coma Scale (GCS), postural hypotension or ready to commence more active rehabilitation the standing position of the Sara Combilizer can be used. This provides an excellent method of increasing arousal whilst facilitating weightbearing through the lower limbs, helping prevent joint contractures and improving lower limb strength. Straps to support the knees and trunk make this a very stable position, with the addition of the head pillow and head straps recommended for those patients with a low GCS to maintain a more supported posture.
Once the patient is able to maintain their sitting balance with minimal support and move their legs against gravity, they are ready to start attempts at standing.
Once an established seating plan has been formulated, with patients sitting out on a daily basis preferably on multiple occasions, progression can be made to more active exercise, standing and ambulation