Physiotherapy in severe polytrauma patients: a therapeutic care model
DOI:
https://doi.org/10.5935/0104-7795.20170007Keywords:
Trauma Centers, Intensive Care Units, Wounds and Injuries, Physical Therapy Modalities, Exercise Therapy, RehabilitationAbstract
Objective: In view of the high degree of complexity that the polytrauma patient represents to the multiprofessional team in the elaboration and execution of their care plan in the intensive care unit (ICU), combined with the lack of evidence on the subject, this study suggests a model of early physiotherapeutic assistance to critical polytrauma patients based on the clinical experience of recent years. Method: The model was elaborated based on the practices verified in the records of 6,388 physiotherapy sessions performed in 198 patients hospitalized between December 2009 and September 2011 in polytraumas-specialized ICU. The activities/care were inserted in the model after approved in discussion with the multiprofessional team. All patients enrolled were aged 18 years or older and were victims of severe trauma according to the Injury Severity Score (ISS). Results: The proposed model was structured in such a way that the physical therapy activities/ care were organized according to the injured body region (traumatic brain injury, face fractures, spine fractures, thoracic trauma, abdominal trauma, pelvic fracture and extremities fractures). The routine of the ICU encouraged daily discussions with the medical team to know the particularities of each clinical case, to establish therapeutic goal and to design the rehabilitation program. Conclusion: The proposed model became routine and consolidated the physiotherapeutic action in the respective care unit. The physiotherapy team started working 24 hours a day. The model made possible the standardization of physical therapy assistance and greater safety for the severe polytrauma patient.
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