Early Mobility Best Practices: Assessment and Activity Considerations
Presented by Ellen Hillegass
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Nonfinancial: Ellen Hillegass is a volunteer with the Academy of Cardiovascular & Pulmonary PT of the APTA. She has no competing nonfinancial interests or relationships with regard to the content presented in this course.
This course was developed to help the clinician working with complex patients, mostly those who are found in the ICU and who would do worse if left on bed rest. Bed rest and inactivity have their own set of problems that prevent functional improvement in a timely manner after a serious illness. Early mobility requires additional knowledge and skills that are presented in this course, including activity requirements and the contraindications to mobility; the medications, lab values, and diagnostic tests that are essential to know and understand when working with these patients; and the evidence on safety when mobilizing with different lines and tubes. An overview of the initial examination is discussed, as are interventions for the ICU patient and outcome measures that could be utilized in the ICU. The course ends by briefly discussing key factors that are essential for developing or improving an early mobility program. This course is appropriate for all members of the mobility team, including PTs, PTAs, OTs, speech therapists, respiratory therapists, and nurses.
Meet your instructor
Ellen Hillegass
Dr. Ellen Hillegass is a physical therapist with APTA board certification in the cardiovascular and pulmonary clinical specialty. She is currently a professor on the core faculty at South College Knoxville and South College Atlanta and is an adjunct professor at Mercer University in Atlanta in the department of physical…
Chapters & learning objectives
1. Activity Requirements and Contraindications to Mobility
This chapter covers treatment goals in the ICU, early activity requirements, and parameters that indicate lack of readiness of the patient for mobility. These are important for planning early mobility activities.
2. The Importance of Reviewing Medications and Lab Values for Early Mobility
This chapter covers knowledge and competencies needed to work with patients in the ICU, including ICU medications, key lab values, and key diagnostic tests. Successful and safe early mobility programs require staff to have advanced knowledge to work with these patients.
3. Safety and Evidence of Mobility With Lines and Tubes
This chapter covers the safety of mobilizing patients with arterial lines, mechanical support, and mechanical ventilation. Knowledge of these devices and the precautions that need to be taken are important to safely mobilize these patients.
4. Components of the Initial Examination
This chapter discusses the need to assess lines/tubes/ventilator settings, cognition, and hemodynamic status. It also covers the amount of assistance in changes in position as well as the assessment of lung and heart sounds.
5. Interventions and Outcome Measures Utilized for the ICU
This chapter discusses interventions that are most beneficial for ICU patients, including breathing exercises, positioning, use of oxygen, activities, and the criteria for terminating a mobility session. Outcomes to measure in an early mobility program are also briefly presented.
6. Key Factors for Initiating an Early Mobility Program
This chapter discusses factors that are key for initiating an early mobility program as well as those that are most beneficial to add or modify when working on improving an existing program.
