Montgomery, H; Kipps, C; Paton, B; Corner, E; Whyte, G; (2020) Responding to COVID-19 and Beyond: Framework for assessing early rehabilitation needs following treatment in intensive care Musculoskeletal and Physiotherapy for COVID-19 patients in ICU and Beyond. [Digital scholarly resource]. https://www.ics.ac.uk/ICS/ICS/GuidelinesAndStandar...

Text 2020-09-25- ICS_Framework_for_assessing_early_rehabilitation_needs_post_ICU.pdf - Accepted Version Access restricted to UCL open access staff Download (4MB)

Abstract

Background The COVID-19 pandemic has challenged critical care units across the United Kingdom. As of 28 May 2020, more than 9347 patients with confirmed COVID-19 have been admitted to critical care units in England, Wales and Northern Ireland over an eleven week period (1). Resources have been considerably constrained, affecting patient management strategies. Over 1285 patients were last reported as still receiving critical care and many more remain on inpatient wards. Up to half of critical care patients experience physical, psychological and cognitive compromise, collectively known as Post-Intensive Care Syndrome or PICS (2). Some will recover quickly with few long-term sequalae, while others will follow a slower trajectory requiring ongoing support. At this point in time, there is no evidence to suggest that the burden of survivorship (PICS) is any different for patients with COVID-19. Some organ specific phenomena may emerge, but these will occur in conjunction with aspects of survivorship. Outcomes for these patients can be improved when needs are identified sufficiently early to enable effective support to be put in place (3). However, there is significant variation in practice and available expertise across NHS Trusts. A need exists to develop a national framework that is applicable across all Trusts, to support hospitals that have scanty support services, reduce variation and improve patient outcomes. In April 2020 the Intensive Care Society (ICS) convened a national group – the National Post-Intensive Care Rehabilitation Collaborative (subsequently referred to as the Collaborative) – consisting of over thirty multi-professionals. They convened over five sessions to generate discussion and make practical recommendations to facilitate early post-intensive care assessment and support. Representative groups included rehabilitation specialists; allied health professionals including physiotherapists, occupational therapists, speech and language therapists, dieticians, psychologists, related fields such as ear, nose and throat (ENT); patient representatives and the intensive care community. National bodies provided leadership - the Intensive Care Society, British Society of Rehabilitation Medicine and UCL Partners.

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