​There are many reports about COVID-19 patients struggling to breathe, with low oxygen levels in their blood. So what are our physiotherapists thinking, making these patients in the Intensive Care Unit (ICU) exert themselves by standing up or walking around?

“We tailor our care to take into account how the virus affects the COVID-19 patients. We give them more oxygen before exertion. Interestingly, we notice that after exercising, they tend to recover from the exercise faster than my typical non COVID-19 patients in the ICU,” said Principal Physiotherapist Vimal Palanichamy who is caring for COVID-19 patients in the Intensive Care Unit (ICU).

“Physiotherapy serves the same purpose for all patients, and we do our best to deliver similar care, COVID-19 or not,” he said.

“Patients' conditions deteriorate from prolonged bed rest. They may suffer from secretion retention (in their lungs). Lung and heart functions may be impaired.  It also increases the risk of developing venous thrombosis and losing muscle mass, thereby affecting sitting posture or standing balance," explained Vimal.  

Mobilising these patients out of their beds have a positive impact on their physical and mental health and promotes a faster recovery. Vimal comes up with individualised plans to train their muscle strength and endurance, getting them to stand, march on the spot or walk about. He spends around an hour with each patient daily.

When expertise and experience matter

Prior to the pandemic, Vimal was the lead critical care physiotherapist in the Surgical ICU. Did he expect to be activated to care for COVID-19 patients?

“I was first redeployed from SICU to an Acute Respiratory Infection ward. So I knew it was a matter of time and was mentally prepared that I would be caring for COVID-19 patients. Someone has to do it,” said Vimal matter-of-factly.

He is not fazed by the presence of a ventilator or lines in getting these patients to move around. “This is no different from what I do in SICU, and I am trained to screen if patients are fit enough to be moved out from their beds.”

Vimal also performs chest physiotherapy to help these COVID-19 patients open up their lung air sacks and to clear sputum.

“Once, I was handling a suspected patient who had a collapsed lung. After just one physiotherapy session, the patient's lung opened up. I was glad to have made a difference,” recalled Vimal.

A committed team

He is all praise for the ICU team of nurses, doctors, respiratory therapists, pharmacists, occupational therapists and medical social workers.

“The nurses always make time to help us get patients out of bed, which is almost impossible to do alone. Our infection prevention control nurses would watch over us to ensure we don and doff our PPE correctly, or update us on any changes in infection control practices. The ward nurse manager makes sure we have what we need quickly, whether it’s a special cushion for the patient, or even lockers for us. And my supervisor would check on us regularly to find out how we are coping.

"I now have such a great sense of belonging in SGH, having received so much care and support from my colleagues. They continue to motivate me and keep me going on,” said Vimal.

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