An important ‘step’ towards the standardisation of care offered by physiotherapists working in an ICU in a low- to middle-income country

Abstract

The discipline of Critical Care Medicine has evolved from being a Cinderella speciality to one of offering support to our sickest and most vulnerable patients. These patients are referred from all the various Departments of Medicine and the Critical Care Physician/Intensivist must attend to them, irrespective which department has referred them into the Intensive Care Unit (ICU). This evolution of Critical Care Medicine as a stand-alone division has been accompanied by the establishment of unique management protocols and the use of several new or repurposed lifesaving equipment to allow the Intensivist to master his trade in saving lives. However, the Intensivist functions predominantly as the “Captain” of the ICU and is very reliant on all his supporting staff to aid him in managing the ICU patient. There is a constant flux in ICU management protocols and the introduction of antibiotic stewardship and infection control measures has brought critical care to the cutting edge of medicine.  This is further complicated by the use of novel mechanical devices for various forms of organ support like ventilators, Continuous Renal Replacement / Dialysis machines and Extracorporeal Membrane Oxygenators (ECMO). Hence, the ICU environment can appear very intimidating if not hostile to the unfamiliar.