Jashore university of science and

technology

A presentation on physiotherapy management in ICU for the

patient of lung diseases

Presented by: Presented to:

Name: Md Sakib Ahammad Dr. Zahid Hossain, PT
Roll: 182401 Lecturer, Department of physiotherapy
Department of physiotherapy and and rehabilitation
rehabilitation Jashore university of science and
Jashore university of science and technology
technology
 Learning outcomes
1. Important modalities that are used in ICU for patient management

2. Aims of physiotherapy intervention for ICU patients

3. Know about physiotherapy management technique in critical conditions

Important modalities that are most
commonly used in ICU to manage
different kinds of lung diseases
1. Suction machine:
A suction machine, also known as an aspirator, is a type of medical device that is primarily used
for removing obstructions — like mucus, saliva, blood, or secretions from a person's airway.
Two types of suctioning
1. Nasal suction (suctioning by nose)
2. Oral suction (suctioning by mouth)
2. Mechanical ventilator
A mechanical ventilator is a machine that helps a patient breathe (ventilate) when they are having
surgery or cannot breathe on their own due to a critical illness. The patient is connected to the
ventilator with a hollow tube (artificial airway) that goes in their mouth and down into their main
airway or trachea.
3. Syringe pump/Infusion pump:
Syringe pumps are used to deliver a very small amount of medications, mechanically moving the
piston of a syringe to send medication into IV tubing. The medical infusion pump is basically
designed for the delivery of controlled amounts of fluids, for example, nutrients, drugs, and blood to
patients.
4.Patient monitor:
The vital signs monitor (referred to as the patient monitor) is a device or system
that measures and controls the patient’s physiological parameters, and can be
compared with the known set values. If it exceeds the limit, it can issue an alarm.
They are typically sorted into two broad categories: bedside patient monitoring
systems and remote patient monitoring systems.
5. BiPAP machine
 BiPAP (also referred to as BPAP) stands for Bilevel Positive Airway Pressure.
 A BiPAP machine is a non-invasive form of therapy for patients suffering from sleep
apnea.
6. CPAP machine
Continuous positive airway pressure (CPAP) is a form of positive airway pressure (PAP)
ventilation in which a constant level of pressure greater than atmospheric pressure is
continuously applied to the upper respiratory tract of a person.  
Aims of physiotherapy intervention in
ICU

1)To reduce shortness of breath

2)to decrease complication of immobility such as DVT, pressure sore

3)Early liberation from mechanical ventilation

4)To facilitate early out of bed & promote functional independence.

5)To improve respiratory muscle integrity

6)To improve overall patient condition

Physiotherapy management in ICU
A. Positioning:
2 hourly changing position
combat the risk of pressure sore, DVT
 1. Chair sitting

 promotes further ADL activity & patient gain confidence.

 3. Prone Position:
2.Popped up position: • Redistribute Oedema
To decrease breathlessness • Short term improvement in
Oxygenation for 57-92% patient
with severe Respiratory failure
&ARDS
4. Sidelying: 5. Long sitting within bed:
improvement in lung function for patient with -to avoid aspiration
unilateral lung disease. -Facilating ventilatory pattern
-decrease muscle work of respiration
B. Mobilization:
For Mechanical Ventilated patient:
1)Active ROM
- Maintaining joint ROM
- Maintaining soft tissue length.
- Decrease risk of embolism.
2) Active moving or turning in bed, getting out of bed via mechanical lifted
machine, standing, transfer from bed to chair, walking.

3)Active cycling for 20 minute

(M.Arumug et al.,2019)
For Unconscious patient:
- Passive exercise
- Stretching
- CPM should be applied daily for 20 minute.
- Passive cycling for 20 minute.
(S.Berney et al.,2012)
Breathing exercises:
1) Diaphragmatic breathing exercise
2) Pursed lip breathing exercise.
3) Glossopharyngeal breathing exercise
4) Chest expansion breathing exercise
5) Forced expiration technique
Suctioning: by placing small tube into the lungs to suck out the excess sputum
Thank you