Guidelines by for COVID 19

Objective
The objective of this Guideline is to explain the role of respiratory physiotherapy in confirmed Covid 19 patients in acute hospital settings. Respiratory physiotherapy aims to

1) Optimize ventilation and Oxygenation thereby reducing the need of supplement al oxygen to maintain saturation. This would minimize the additional need of oxygen as resource.

2) Relieve dyspnea and work of breathing hence reducing the load on respiratory muscles.

3) Remove secretions if present and clear airways to facilitate breath ing and improve ventilation.

4) Alleviate anxiety and depression which would help in reducing the stress on breathing, making patients more comfortable and improve their ability to follow commands.

5) Reduce complications associated with bedrest and ICU admi ssion hence reducing the length of hospital stay and improve quality of life

Scope

This document provides fundamental information to physiotherapists involved in acute COVID - 19 care settings.

1) Screening and assessment for physiotherapy intervention

2 ) Indications and contraindications for respiratory physiotherapy

3) Pulmonary exercise interventions and

4) Safety and personal protection policy

Setting and Timing:

Early respiratory physiotherapy is not recommended for severely and critically ill patients if their conditions remain unstabilised or if progressive deterioration is seen. The timing of respiratory physiotherapy intervention should exclude contraindicati ons and should not aggravate infection. The staged respiratory management measures can be used during different stages for patients with different sequela.

Core viewers:

Physiotherapists involved in the care of adult COVID - 19 patients in intensive care un its, hospital care centers , jumbo centers, home ICUs and any other acute care settings.

Acute Care ICU & Step - down unit: These are high dependency units where individual patients need to be evaluated with close monitoring. Physiotherapist should use person al protective equipment (PPE) while treating patients with COVID 19. It may include geriatric patients, obese patients and patients with multiple co - morbidities, one or more organ failure, the physiotherapy team here should design a tailor - made rehab care plan based on individual problems of each patient.

Wards & Jumbo centers : Patients that are stable and do not need one on one monitoring can be treated with group therapy and contactless through the use of tele - physiotherapy , educational videos, remote co nsultations through sound systems, self - management booklets, exercise videos which are employed to reduce the usage of protective equipment and to avoid cross infections. During contact group therapy use of PPE is advocated.