Surviving in an intensive care unit as a patient is traumatic and disorienting, with fear being a common psychological state. ICU delirium exacerbates trauma and impacts cognition. A comprehensive prospective study of delirium published in 2018 found delirium affecting 740 (71%) of 1040 critically ill patients at some point during the study period, and the authors recommend delirium be treated as acute brain injury as a means to prevent permanent cognitive impairments. Accelerated muscle catabolism is part of critical illness. The viability of skeletal muscle is directly tied to the survival and return to independent functioning of critically ill patients. Yet, up to 80% of ICU patients develop neuromuscular dysfunction, and 25-55% leave the hospital with physical, cognitive, and/or psychological impairments preventing their return to full independence - a condition known as post-intensive care syndrome, or PICS. The speakers will use randomized control trials, systematic reviews, case studies, and patient experience along with principles of neurologic acute rehab treatments to restore complex critically ill patients psychologically, cognitively, and physically before they leave the acute care setting.

Learning Objectives:

1. Define the harms to skeletal muscle, neuro-cognition, and psychological associated disability for the patient prevented by early mobility.
2. Describe assessment and communication needed for ICU early mobility interventions.
3. Select patients to target for highest-intensity ICU physical therapist services and select treatment interventions that match patient phase of recovery appropriately.
4. Apply specific information from current evidence base to early mobility intervention treatment choices.

Course Instructions

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