#PhysioTalk Transcript
Healthcare social media transcript of the #PhysioTalk hashtag.
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| Profile | Tweet |
|---|---|
 | physiotalk @physiotalk Good evening and welcome to tonights #physiotalk The topic tonight is a #COVID19 update with a respiratory focus. |
 | Anna Evans 💙 @AnnaKEvans RT @physiotalk: ONE hours time! Our #COVID19 respiratory update tweetchat is tonight at 8pm BST #physiotalk https://t.co/mntV97eumY https://t.co/2Azp1vodr9 |
| physiotalk @physiotalk But before we start tonight - let us know who you are and where you are tweeting from! #physiotalk |
 | Ema Swingwood (She/her) @emaroids1 @physiotalk Ema from Bristol-just finishing my tea #physiotalk |
| physiotalk @physiotalk @hfdub Welcome! Just a reminder to put #physiotalk in all your tweets please! |
 | ACPRC @TheACPRC We are keen to contribute to the discussions to and share our experiences #physiotalk |
 | Physiotherapy Association of Saint Lucia Inc. @pasl_pt Hi Everyone. Nice to be here tweeting from St. Lucia in Caribbean #physiotalk |
| physiotalk @physiotalk @emaroids1 Welcome! Hope you are having something tasty! #physiotalk |
| physiotalk @physiotalk @TheACPRC Brilliant - great to have you taking part tonight. #physiotalk |
 | Helen Michel @hfdub @physiotalk Oops #physiotalk #noob |
 | Anna Spiteri @spiteri_anna Hello from London. I'm the hashtag detective tonight for @Physiotalk. Don't forget to add #Physiotalk to all your tweets |
 | Physiophilip @physiophilip @TheACPRC GREAT!!! #physiotalk |
| physiotalk @physiotalk @pasl_pt Welcome! Its always a pleasure to have you joining in #physiotalk |
| physiotalk @physiotalk @hfdub Oh we all forget at some point :) #physiotalk |
 | Cath Edwards @cathedwards_1 @physiotalk Cath from Wigan 🤗hi everyone #physiotalk |
| physiotalk @physiotalk Just to get us warmed up - a quick first question coming up! #physiotalk |
 | Prashna Singh @pshappymommy @physiotalk Hi from Toronto #physiotalk |
| physiotalk @physiotalk Q1 Have you treated people with COVID19 in a critical care / respiratory setting? #physiotalk |
| physiotalk @physiotalk @cathedwards_1 Welcome Cath #physiotalk |
| physiotalk @physiotalk @pshappymommy Welcome! #physiotalk |
 | Rob Yeldham (he/him) @RobYeldham Lurking until wife and daughter back from walk #physiotalk |
| physiotalk @physiotalk @deborah70191380 You are so welcome! But don't forget to add #Physiotalk to all your tweets even if you are commenting on a comment with the hashtag already in the comment #Physitotalk |
| Physiophilip @physiophilip @physiotalk #physiotalk no it is not something i have had to undertake. |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Yes! Very lucky to have treated its through the pathway-critical care, high care, rehab through to discharge (with an amazing team)! #physiotalk |
| physiotalk @physiotalk I just love #physiotalk (Well obviously I do...) But its great to have input from Wigan to Toronto via St Lucia! |
 | Janet Thomas @JanetThomas47 I've only seen #COVID19 patients in a rehab setting - so its a good job I'm just tweeting out the questions tonight :) #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @JanetThomas47 Still such valuable info though in case we can adapt our approach further upstream #physiotalk |
 | Debbie Park @DebbieParkPT @physiotalk Not personally but we two ICUs where I am supporting staff that are treating these patients #physiotalk |
| Physiotherapy Association of Saint Lucia Inc. @pasl_pt @physiotalk Q1. Although some of the Caribbean islands are seeing in Critical care but St. Lucia so far has has smaller numbers and none in Resp. Distress #physiotalk |
| physiotalk @physiotalk @emaroids1 From what I've seen on Twitter the team work over the whole NHS has been superb! #physiotalk |
| Anna Spiteri @spiteri_anna Not me but so proud of all my fellow Physiotherapy colleagues delivering excellent care to patients in the acute setting. Have really enjoyed reading all your tweets and sharing your insights #Physiotalk |
 | Gemma McCraith @GMcELHT @physiotalk Yes both in a ward setting and on critical care #physiotalk |
| physiotalk @physiotalk @pasl_pt Hopefully it stays that way as well #physiotalk |
| Cath Edwards @cathedwards_1 @physiotalk I’ve supported our amazing CrCu teams treating #COVID19 patients #physiotalk |
| Rob Yeldham (he/him) @RobYeldham Small request #physiotalk @physiotalk if referring to #CovidRehab can you use that # and also #RightToRehab to help us curate ideas? |
| Cath Edwards @cathedwards_1 RT @physiotalk: I just love #physiotalk (Well obviously I do...) But its great to have input from Wigan to Toronto via St Lucia! |
| physiotalk @physiotalk So... On to the more specific questions regarding resp and #COVID19 for tonight #physiotalk |
| Physiotherapy Association of Saint Lucia Inc. @pasl_pt Indeed! Talk of possible 2nd wave when borders are opened...so preparing/learning. #physiotalk |
| ACPRC @TheACPRC @MossaMorris @SRigby92 @laura_mylott @ZoeWilligen @amyphysiosmith @CharlieHardaker @EveCorner @rachaelmoses Darn it #physiotalk |
| physiotalk @physiotalk Q2 What is your experience of the type of ventilation support that they have needed? #physiotalk |
| Rob Yeldham (he/him) @RobYeldham RT @physiotalk: Q2 What is your experience of the type of ventilation support that they have needed? #physiotalk |
| Debbie Park @DebbieParkPT @physiotalk Our docs are trying to avoid ventilation if possible with HFNO but if on the vent, using low volumes. #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Both invasive and non invasive CPAP, higher oxygen levels often for more prolonged periods than what we would normally see. CPAP has worked well for sure in our experiences @uhbwNHS #physiotalk |
| physiotalk @physiotalk RT @deborah70191380: @physiotalk Our docs are trying to avoid ventilation if possible with HFNO but if on the vent, using low volumes. #physiotalk |
| physiotalk @physiotalk RT @emaroids1: @physiotalk Both invasive and non invasive CPAP, higher oxygen levels often for more prolonged periods than what we would normally see. CPAP has worked well for sure in our experiences @uhbwNHS #physiotalk |
| physiotalk @physiotalk @deborah70191380 I am going to have to be the non resp person who asks HFNO? High Flow something I'm guessing? #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @uhbwNHS When I say invasive I mean SIMV, APRV etc not invasive CPAP! #Physiotalk |
| physiotalk @physiotalk @emaroids1 @uhbwNHS Over and above anything else? #physiotalk |
 | Karen McIntosh @KEMmalus RT @physiotalk: Get yourself ready! Our #COVID19 respiratory update tweetchat is in half an hour at 8pm BST #physiotalk https://t.co/mntV97eumY https://t.co/IC8dt75E6B |
| Cath Edwards @cathedwards_1 @physiotalk I’ve seen a range of vent modes from CPAP, SIMV, APRV, DUOpap.... #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @deborah70191380 High flow nasal oxygen #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @cathedwards_1 @physiotalk Ooooh whats DUOpap????? #physiotalk |
| Debbie Park @DebbieParkPT @physiotalk Yes, sorry. Our organization is terrible for short forms. :) High Flow Nasal Oxygen. #physiotalk |
| physiotalk @physiotalk @emaroids1 @uhbwNHS Eeek - the acronyms are flowing think and fast. I think I'll give up now and just go with the expectation that if you work in resp you will know what they mean... #physiotalk |
| Karen McIntosh @KEMmalus RT @emaroids1: @physiotalk Both invasive and non invasive CPAP, higher oxygen levels often for more prolonged periods than what we would normally see. CPAP has worked well for sure in our experiences @uhbwNHS #physiotalk |
| Gemma McCraith @GMcELHT @physiotalk Noticing each patient is different and requiring different modes of ventilation. Many starting on non invasive CPAP however some eventually requiring intubation needing APRV ventilation with high PEEP. Hard to categorise as all being affected differently #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @uhbwNHS Most of our self ventilating pts are on either CPAP or higher oxygen levels and are self probing-this has def prevented/reduced ITU transfers. Obviously not in all cases in which case timely/proactive move to ICU for monitoring or escalation of ventilation #physiotalk |
 | James Armstrong @PhysioArmstrong RT @physiotalk: Q2 What is your experience of the type of ventilation support that they have needed? #physiotalk |
| physiotalk @physiotalk @cathedwards_1 Please explain the abbreviations for our non respiratory colleagues on #Physiotalk this evening |
| physiotalk @physiotalk @emaroids1 @uhbwNHS What does self probing mean? #Physiotalk |
| physiotalk @physiotalk I think I'll put an abbreviations list alongside the transcript... #physiotalk |
| Cath Edwards @cathedwards_1 @emaroids1 @physiotalk Basically BiLevel ventilation. I’ve had to proper upskill my vent modes knowledge but was ok with this one! #physiotalk lots of teaching from @Siphysio ☺️ |
| James Armstrong @PhysioArmstrong @physiotalk Final Yr Physio student, hopefully starting first post very shortly. I'll be watching with interest tonight. A great topic yet again. #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @cathedwards_1 Eeeew sorry! CPAP-continuous positive airway pressure SIMV- synchronised intermittent mandatory ventilation APRV-airway pressure release ventilation #physiotalk |
| physiotalk @physiotalk @CharlieHardaker @emaroids1 @uhbwNHS Don't forget the #Physiotalk |
| Cath Edwards @cathedwards_1 @emaroids1 @physiotalk Thanks Ema! I was struggling to type them quick enough #physiotalk |
| physiotalk @physiotalk So would you say there was a preferred type of ventilation or was there a great deal of variety based on clinical presenation? #physiotalk |
| Cath Edwards @cathedwards_1 RT @GemmaFordELHT: @physiotalk Noticing each patient is different and requiring different modes of ventilation. Many starting on non invasive CPAP however some eventually requiring intubation needing APRV ventilation with high PEEP. Hard to categorise as all being affected differently #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @uhbwNHS Slight typo there-I def meant proning (predictive text nightmare) #Physiotalk |
| physiotalk @physiotalk @CharlieHardaker @emaroids1 @uhbwNHS #Physiotalk. |
| physiotalk @physiotalk @emaroids1 @cathedwards_1 Thank you! Its been 20+ years since I was in an ICU (although I did know some...) #physiotalk |
| physiotalk @physiotalk RT @emaroids1: @physiotalk @cathedwards_1 Eeeew sorry! CPAP-continuous positive airway pressure SIMV- synchronised intermittent mandatory ventilation APRV-airway pressure release ventilation #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Depends on the clinical presentation for sure and what resources you have available Also consideration of AGP (aerosol generating procedures) so we have had less use of HFNC #physiotalk |
| physiotalk @physiotalk And I suppose I must ask, was type of ventilation ever decided based on what machines were available?? #physiotalk |
| Debbie Park @DebbieParkPT @emaroids1 @physiotalk The use of high flow nasal oxygen is limited to an isolation room as it is an Aerosol General Procedure. #physiotalk |
 | Rachael Moses @NHSLeader @physiotalk IMHO this is dependant on the choice/opinion/experience of ICU Consultant/Anaesthetist #physiotalk |
| physiotalk @physiotalk @deborah70191380 @emaroids1 And was this ever an issue (for example did you have enough isolation rooms?) #physiotalk |
| physiotalk @physiotalk @emaroids1 @cathedwards_1 Is duo pap a synonym for bipap? #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Yes and no for sure. Also will depend on the consultant opinion/experience on ICU. We have had a great MDT approach #physiotalk |
| physiotalk @physiotalk @rachaelmoses And any emerging evidence at all rather than choice / experience? And thank you for joining in :)! #physiotalk |
| Debbie Park @DebbieParkPT @physiotalk @emaroids1 Not an issue so far, touch wood. We have prepared ~200 ICU beds but have only had ~25 patients in ICU at a time. #physiotalk |
| ACPRC @TheACPRC Some useful examples of ventilation experiences from a variety of clinicians https://t.co/acLmvNi6th #physiotalk |
| Cath Edwards @cathedwards_1 @physiotalk @emaroids1 Essentially yes, depends on ventilation manufacturer to what they call it #physiotalk |
 | Laura Byrne @physio_laura @physiotalk Laura from Dublin! #physiotalk |
| physiotalk @physiotalk OK - onto the next question as we have a lot to get through... #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @cathedwards_1 @physiotalk This def means additional training and support for clinicians to ensure everyone feels comfortable and confident #physiotalk |
| physiotalk @physiotalk Q3 What about proning - was it effective? #physiotalk |
| physiotalk @physiotalk @physio_laura Welcome! #physiotalk |
| physiotalk @physiotalk RT @TheACPRC: Some useful examples of ventilation experiences from a variety of clinicians https://t.co/acLmvNi6th #physiotalk |
| physiotalk @physiotalk @TheACPRC Thank you! One for our resources list as well! #physiotalk |
| physiotalk @physiotalk @rachaelmoses Welcome @rachaelmoses. Thank you for being a great advocate for our profession everyday #physiotalk. We have learnt so much. |
| Laura Byrne @physio_laura @physiotalk #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk YES! Safe, well tolerated, optimised oxygen saturations, reduced oxygen requirements Not for everyone though, needs to be risk Ax and monitored. Education for n/s and gd comms essential @CharlieHardaker @amyphysiosmith #Physiotalk |
| Rachael Moses @NHSLeader @physiotalk Multitasking on a video call 😉 Lots on APRV mode of ventilation and keeping sedated until oxygen levels good and ventilation as optimised as possible #physiotalk |
| Gemma McCraith @GMcELHT @physiotalk Definitely! Both conscious proning and unconscious proning. We’ve yet to see if implementing conscious proning earlier is preventing escalation to ITU, something our fantastic acute care team are looking into #physiotalk |
 | Ruth wood @Ruthrespphysio @physiotalk We’ve had about 6 patients called to icu looking like need to intubate but have managed to prone and prevent intubation plus or minus niv. If needed intubation proned To improve ventilation /reduce fi02 req on aprv #physiotalk |
| Laura Byrne @physio_laura @physiotalk It has changed over the course of the few weeks. Seeing some very difficult to ventilate patients requiring very high settings. Others setting pretty normal just needing the time and supportive care to improve. High FiO2 definitely a common theme no matter the mode #physiotalk |
| Rob Yeldham (he/him) @RobYeldham RT @emaroids1: @physiotalk YES! Safe, well tolerated, optimised oxygen saturations, reduced oxygen requirements Not for everyone though, needs to be risk Ax and monitored. Education for n/s and gd comms essential @CharlieHardaker @amyphysiosmith #Physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physio_laura @physiotalk Time is key! Weaning is slow-this pt group can not be treated like a NIV wean of a COPD exactly #physiotalk |
| Cath Edwards @cathedwards_1 @physiotalk Yes seen some good outcomes in awake proning on our respiratory wards @JessicaAThorpe #physiotalk |
| Rob Yeldham (he/him) @RobYeldham RT @TheACPRC: Some useful examples of ventilation experiences from a variety of clinicians https://t.co/acLmvNi6th #physiotalk |
| physiotalk @physiotalk @physio_laura Thank you for being on the frontline. We are proud of you and our colleagues who have risen to the challenge #Physiotalk |
| Rachael Moses @NHSLeader @GemmaFordELHT @physiotalk Yes some of the Italians found conscious proning very helpful too but only in those with high oxygen requirements+lower RR - those that have an ARDS type presentation may find it impossible and those tend to be intubated - anyone else got any experience @Davido744?? #physiotalk |
| physiotalk @physiotalk So - proning a definite plus point. Any top tips for proning people then? I know Twitter has been awash with proning teams - any learning from them? #physiotalk |
| physiotalk @physiotalk RT @emaroids1: @physio_laura @physiotalk Time is key! Weaning is slow-this pt group can not be treated like a NIV wean of a COPD exactly #physiotalk |
| physiotalk @physiotalk RT @rachaelmoses: @GemmaFordELHT @physiotalk Yes some of the Italians found conscious proning very helpful too but only in those with high oxygen requirements+lower RR - those that have an ARDS type presentation may find it impossible and those tend to be intubated - anyone else got any experience @Davido744?? #physiotalk |
| Ruth wood @Ruthrespphysio @physiotalk Bearing in mind 8 bedded icu this has stopped us surging so far #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @rachaelmoses @GemmaFordELHT @physiotalk @Davido744 Exactly the same! I do think you can split most its into phenotypes per se……but others not so much!!! #brainache #physiotalk |
| physiotalk @physiotalk @rachaelmoses @GemmaFordELHT @Davido744 And is conscious proning well tolerated? #physiotalk |
| Rachael Moses @NHSLeader RT @TheACPRC: Some useful examples of ventilation experiences from a variety of clinicians https://t.co/acLmvNi6th #physiotalk |
| Gemma McCraith @GMcELHT @rachaelmoses @physiotalk @Davido744 I think our acute care team have also noticed this, the physio team have been implementing conscious proning in the less acute type of patient, by the time they’re needing acute care with an EWS>6 and proning is implemented we’re noticing they get escalated to ITU #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Individual risk Ax, close monitoring, clear communication with pt and MDT, clear plan for timings We have created proning charts, pt leaflets etc @CharlieHardaker @amyphysiosmith @SRigby92 @RossGEdgar #Physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @rachaelmoses @GemmaFordELHT @Davido744 Yes #Physiotalk |
| physiotalk @physiotalk Onto the next question... #physiotalk |
| Ruth wood @Ruthrespphysio @physiotalk For Self prone we came up with a guideline as quickly as we could. How to do it/ end to do it and clear Guideline for when to contact icu of no progress. Happy to share. For icu intubated we use pasty technique and sop in place already #physiotalk |
| physiotalk @physiotalk Q4 Any learning about weaning from ventilation support? #physiotalk |
| Cath Edwards @cathedwards_1 @emaroids1 @physiotalk @rachaelmoses @GemmaFordELHT @Davido744 I second that...yes! #physiotalk |
| Rachael Moses @NHSLeader @physiotalk @GemmaFordELHT @Davido744 I am clinically limited in this but apparently if they can self prone this is an indicator that they will have a positive response & should be trialled, this continues throughout the patients stay and to discharge....our Italian friends found this also @StefanoNava5 #physiotalk |
| Gemma McCraith @GMcELHT @physiotalk @rachaelmoses @Davido744 Yes patients who can manage are self proning themselves at regular intervals and reporting reduced work of breathing once proned, also shown in their obs with improved SpO2 and RR #physiotalk |
| physiotalk @physiotalk @Ruthrespphysio I'm so hoping that the pasty technique is not a spelling error! Please let me know more (as a non resp non ICU person...) #physiotalk |
 | Paula Manning Physio She/Her @Manning2Paula RT @rachaelmoses: @physiotalk @GemmaFordELHT @Davido744 I am clinically limited in this but apparently if they can self prone this is an indicator that they will have a positive response & should be trialled, this continues throughout the patients stay and to discharge....our Italian friends found this also @StefanoNava5 #physiotalk |
| Paula Manning Physio She/Her @Manning2Paula RT @GemmaFordELHT: @physiotalk @rachaelmoses @Davido744 Yes patients who can manage are self proning themselves at regular intervals and reporting reduced work of breathing once proned, also shown in their obs with improved SpO2 and RR #physiotalk |
 | Helen Sharma @helensharmaPT RT @TheACPRC: Some useful examples of ventilation experiences from a variety of clinicians https://t.co/acLmvNi6th #physiotalk |
| physiotalk @physiotalk RT @physiotalk: Q4 Any learning about weaning from ventilation support? #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Done in a timely manner with detailed Ax and MDT input LUS can also be useful @sonophysio @Wilkinsonjonny #Physiotalk |
| Anna Spiteri @spiteri_anna @Ruthrespphysio @physiotalk I’m very curious about pasty technique #physiotalk |
| Cath Edwards @cathedwards_1 @physiotalk @Ruthrespphysio You wrap the patient in a Cornish pasty type technique to turn them into prone #physiotalk https://t.co/ottODLvLez |
| Ema Swingwood (She/her) @emaroids1 @rachaelmoses @physiotalk @GemmaFordELHT @Davido744 @StefanoNava5 Totally agree with this #physiotalk |
| physiotalk @physiotalk @cathedwards_1 @Ruthrespphysio Now that's exactly what I had imagined! Thank you for picture as well #physiotalk |
| Paula Manning Physio She/Her @Manning2Paula RT @cathedwards_1: @physiotalk @Ruthrespphysio You wrap the patient in a Cornish pasty type technique to turn them into prone #physiotalk https://t.co/ottODLvLez |
| physiotalk @physiotalk RT @cathedwards_1: @physiotalk @Ruthrespphysio You wrap the patient in a Cornish pasty type technique to turn them into prone #physiotalk https://t.co/ottODLvLez |
| Debbie Park @DebbieParkPT @physiotalk @cathedwards_1 @Ruthrespphysio there are some helpful videos on YouTube and Lippincott has a procedure as well. #physiotalk |
| Physiotherapy Association of Saint Lucia Inc. @pasl_pt RT @cathedwards_1: @physiotalk @Ruthrespphysio You wrap the patient in a Cornish pasty type technique to turn them into prone #physiotalk https://t.co/ottODLvLez |
| physiotalk @physiotalk @emaroids1 @sonophysio @Wilkinsonjonny What might you be looking for with LUS findings? #physiotalk |
| physiotalk @physiotalk @Ruthrespphysio @cathedwards_1 #Physiotalk |
| physiotalk @physiotalk #Physiotalk |
| Gemma McCraith @GMcELHT @physiotalk Again very individual depending on the patient. Varying presentations responding differently. Multidisciplinary input looking at fatigue, delirium and secretion management as well as ventilation requirements #physiotalk |
| physiotalk @physiotalk @TheACPRC @MossaMorris @TJQPNI #physiotalk |
| Rachael Moses @NHSLeader @physiotalk Once the patients are awake they can be extubated pretty quickly. Depending on sedation strategy some may not have adequate resp drive post extubation & require NIV, some need CPAP. Once awake enough to cough secretions can be cleared but some need chest physio++ #physiotalk |
 | Charlotte Hardaker @CharlieHardaker @physiotalk To increase proning adherence, education to both the patient and the MDT is required. Having everyone on board and working with what the patient can achieve is key #physiotalk |
| physiotalk @physiotalk #Physiotalk |
| Debbie Park @DebbieParkPT @physiotalk @emaroids1 @sonophysio @Wilkinsonjonny Very curious about this as this is a new concept for me. #physiotalk |
| physiotalk @physiotalk RT @rachaelmoses: @physiotalk Once the patients are awake they can be extubated pretty quickly. Depending on sedation strategy some may not have adequate resp drive post extubation & require NIV, some need CPAP. Once awake enough to cough secretions can be cleared but some need chest physio++ #physiotalk |
| physiotalk @physiotalk Lots of missing hashtags #Physiotalk |
 | Fiona Yung @DrFYung RT @rachaelmoses: @physiotalk Once the patients are awake they can be extubated pretty quickly. Depending on sedation strategy some may not have adequate resp drive post extubation & require NIV, some need CPAP. Once awake enough to cough secretions can be cleared but some need chest physio++ #physiotalk |
| Ruth wood @Ruthrespphysio @emaroids1 @physiotalk @sonophysio @Wilkinsonjonny Fatigue had been a huge element to take into consideration. Ensure cuff leak as Some places reporting larangyeal swellling #physiotalk |
| physiotalk @physiotalk Onto the next question... Aware there is only 10 minutes left! #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk @sonophysio @Wilkinsonjonny Ax as per normal process rather than ‘looking for’ COVID symptoms. Presence of A/B lines, lung sliding etc useful to inform PT input and readiness to wean/push in some cases An article by the main man (he knows way more than me) @sonophysio #physiotalk https://t.co/ELvbyqy75i |
| physiotalk @physiotalk Q5 What was the most effective physiotherapy support? #physiotalk |
| physiotalk @physiotalk RT @emaroids1: @physiotalk @sonophysio @Wilkinsonjonny Ax as per normal process rather than ‘looking for’ COVID symptoms. Presence of A/B lines, lung sliding etc useful to inform PT input and readiness to wean/push in some cases An article by the main man (he knows way more than me) @sonophysio #physiotalk https://t.co/ELvbyqy75i |
| Debbie Park @DebbieParkPT @rachaelmoses @physiotalk I think that pre-extubation it has been helpful to mobilize the patient to assess activity tolerance, almost as an assessment in readiness for extubation. #physiotalk |
| physiotalk @physiotalk @emaroids1 @sonophysio @Wilkinsonjonny Thank you #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @deborah70191380 @physiotalk @sonophysio @Wilkinsonjonny It’s fascinating and has opened up a whole new part of a resp Ax Follow @sonophysio @Wilkinsonjonny for some great updates and resources #physiotalk |
| physiotalk @physiotalk RT @deborah70191380: @rachaelmoses @physiotalk I think that pre-extubation it has been helpful to mobilize the patient to assess activity tolerance, almost as an assessment in readiness for extubation. #physiotalk |
| Rachael Moses @NHSLeader RT @deborah70191380: @rachaelmoses @physiotalk I think that pre-extubation it has been helpful to mobilize the patient to assess activity tolerance, almost as an assessment in readiness for extubation. #physiotalk |
| physiotalk @physiotalk @deborah70191380 @rachaelmoses And what would you be monitoring for? #physiotalk |
| physiotalk @physiotalk #physiotalk |
| ACPRC @TheACPRC Some additional proning resources https://t.co/QqyYsHziuL #Physiotalk |
| physiotalk @physiotalk RT @physiotalk: #physiotalk |
 | Robyn Stiger @RobynStiger @physiotalk Interesting question! #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @physiotalk What do you mean? Most effective PT intervention or role? #physiotalk |
 | Dee @DeeThePhysio @physiotalk Absolutely, in the right circumstances with the right patient. I’m part of the new ‘proning team’ that has been set up. We’ve seen positive results, for both conscious and unconscious patients but it is not without risk and needs to be monitored by the whole team #physiotalk |
| physiotalk @physiotalk RT @TheACPRC: Some additional proning resources https://t.co/QqyYsHziuL #Physiotalk |
| Cath Edwards @cathedwards_1 @physiotalk My take-home is the hugely valuable & skilled assessment physio has to offer this patient cohort from acute respiratory, to recognising delirium to early rehab & beyond! #physiotalk |
| Charlotte Hardaker @CharlieHardaker RT @TheACPRC: Some additional proning resources https://t.co/QqyYsHziuL #Physiotalk |
| Gemma McCraith @GMcELHT RT @cathedwards_1: @physiotalk My take-home is the hugely valuable & skilled assessment physio has to offer this patient cohort from acute respiratory, to recognising delirium to early rehab & beyond! #physiotalk |
| Rachael Moses @NHSLeader @Leishm1Philippa @deborah70191380 @physiotalk Great Q #physiotalk |
| physiotalk @physiotalk @emaroids1 Either really! Intervention certainly I suppose - but perhaps we were best used in some other capacity rather than providing direct physiotherapy supprt? #physiotalk |
| Robyn Stiger @RobynStiger @emaroids1 @physiotalk I would like to know your thoughts on intervention @emaroids1 My input has been mainly academic so far but hoping to be more involved as academic years calms down a bit. #physiotalk |
 | KellyMorris @MossaMorris This is a great resource too produced by the wonderful team at gstt #physiotalk https://t.co/ujAmOR8A0U |
| Paula Manning Physio She/Her @Manning2Paula RT @TheACPRC: Some additional proning resources https://t.co/QqyYsHziuL #Physiotalk |
| physiotalk @physiotalk RT @MossaMorris: This is a great resource too produced by the wonderful team at gstt #physiotalk https://t.co/ujAmOR8A0U |
| Paula Manning Physio She/Her @Manning2Paula RT @cathedwards_1: @physiotalk My take-home is the hugely valuable & skilled assessment physio has to offer this patient cohort from acute respiratory, to recognising delirium to early rehab & beyond! #physiotalk |
| Rachael Moses @NHSLeader RT @MossaMorris: This is a great resource too produced by the wonderful team at gstt #physiotalk https://t.co/ujAmOR8A0U |
| physiotalk @physiotalk @cathedwards_1 Yes we are so so proud of our colleagues in the respiratory setting for being such fabulous advocates for the @thecsp. What better time to be a Physiotherapist #Physiotalk |
| physiotalk @physiotalk And with two minutes to go - our final and opposing question! #physiotalk |
| Robyn Stiger @RobynStiger @MossaMorris Yes. I’ve signposted to this one. #physiotalk |
| Paula Manning Physio She/Her @Manning2Paula RT @physiotalk: @cathedwards_1 Yes we are so so proud of our colleagues in the respiratory setting for being such fabulous advocates for the @thecsp. What better time to be a Physiotherapist #Physiotalk |
| physiotalk @physiotalk Q6 What did you find was NOT effective with COVID19 patients? #physiotalk |
| Gemma McCraith @GMcELHT @cathedwards_1 @physiotalk Completely agree! Finding early implementation of the CPAx assessment also useful in showing patients how far they’ve come as they progress through weaning and rehab #physiotalk - physios have plenty of wide ranging effective treatment with these patients |
| Ema Swingwood (She/her) @emaroids1 @physiotalk Direct PT support has been invaluable to this pt group! I am inspired by the knowledge and skill base of clinicians every day. Staff have been open minded to working ‘outside of the box’ and are the working definition of teamwork @TheACPRC @uhbwNHS @NightingaleBRS #physiotalk |
| Cath Edwards @cathedwards_1 @physiotalk @emaroids1 I’ve also witnessed the value my physio colleagues have added to support nursing staff, porters, medics & managers to name a few! We’ve been so adaptable & responsive to whatever’s been needed. True #MDT working #physiotalk |
| Dee @DeeThePhysio @physiotalk Yes, it’s both amazing and terrifying at the same time. I’m normally a hand physio but I’m enjoying learning new skills and being part of a fantastic team. However with no prior resp experience I don’t know how they differ from non-covid pts in an itu setting (yet) #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @RobynStiger @physiotalk Physiology knowledge has put us in a gd place to understand and implement oxygenation/ventilation strategies for sure, and complete detailed Ax and provide timely input/escalation #Physiotalk |
| Rachael Moses @NHSLeader @physiotalk 1000% expert hands on assessment, manual techniques, positional optimisation (inc proning teams), post extubatuon support, secretion managament, mobilisation, rehab. Physios all over the world are in a league of their own at the minute and I couldn’t be more proud #physiotalk |
| Robyn Stiger @RobynStiger @emaroids1 @physiotalk @TheACPRC @uhbwNHS @NightingaleBRS It’s been wonderful to see so many physios with transferable skills going back to respiratory @awgilbert11 @Alun_Bonello and the rest of them. The respiratory courses by @IcuRemote and @EveCorner fantastic resources to help. #physiotalk |
| Debbie Park @DebbieParkPT @cathedwards_1 @physiotalk @emaroids1 I think it is our Cardio-resp assessment, critical thinking, communication and collaboration all coming together in support of these patients #physiotalk |
| physiotalk @physiotalk RT @cathedwards_1: @physiotalk @emaroids1 I’ve also witnessed the value my physio colleagues have added to support nursing staff, porters, medics & managers to name a few! We’ve been so adaptable & responsive to whatever’s been needed. True #MDT working #physiotalk |
| physiotalk @physiotalk Thats the 'official' #physiotalk hour up! However please keep on chatting as we won't collect the transcript for a while! |
| Debbie Park @DebbieParkPT @DeeThePhysio @physiotalk Kudos to you for making such a big shift #physiotalk |
| physiotalk @physiotalk RT @rachaelmoses: @physiotalk 1000% expert hands on assessment, manual techniques, positional optimisation (inc proning teams), post extubatuon support, secretion managament, mobilisation, rehab. Physios all over the world are in a league of their own at the minute and I couldn’t be more proud #physiotalk |
| Rachael Moses @NHSLeader RT @emaroids1: @physiotalk Direct PT support has been invaluable to this pt group! I am inspired by the knowledge and skill base of clinicians every day. Staff have been open minded to working ‘outside of the box’ and are the working definition of teamwork @TheACPRC @uhbwNHS @NightingaleBRS #physiotalk |
| Rachael Moses @NHSLeader RT @RobynStiger: @emaroids1 @physiotalk @TheACPRC @uhbwNHS @NightingaleBRS It’s been wonderful to see so many physios with transferable skills going back to respiratory @awgilbert11 @Alun_Bonello and the rest of them. The respiratory courses by @IcuRemote and @EveCorner fantastic resources to help. #physiotalk |
| Ema Swingwood (She/her) @emaroids1 @rachaelmoses @physiotalk As @KMiddletonCSP encouraged us to do-we have stepped up and had a seat at the table. So proud to be a Physio right now and be able to contribute to the essential MDT #Physiotalk |
 | Anna Garner @AnnaGar62621386 RT @rachaelmoses: @physiotalk 1000% expert hands on assessment, manual techniques, positional optimisation (inc proning teams), post extubatuon support, secretion managament, mobilisation, rehab. Physios all over the world are in a league of their own at the minute and I couldn’t be more proud #physiotalk |
| Robyn Stiger @RobynStiger All the best bits of being a physio #physiotalk |
| physiotalk @physiotalk Thank you to you all for taking part tonight and sharing your expertise I'm already updating the blog posting with resources shared! https://t.co/mntV97eumY #physiotalk |
| Cath Edwards @cathedwards_1 RT @rachaelmoses: @physiotalk 1000% expert hands on assessment, manual techniques, positional optimisation (inc proning teams), post extubatuon support, secretion managament, mobilisation, rehab. Physios all over the world are in a league of their own at the minute and I couldn’t be more proud #physiotalk |
| Cath Edwards @cathedwards_1 RT @emaroids1: @rachaelmoses @physiotalk As @KMiddletonCSP encouraged us to do-we have stepped up and had a seat at the table. So proud to be a Physio right now and be able to contribute to the essential MDT #Physiotalk |
| Rachael Moses @NHSLeader @physiotalk Soz for the spelling - spell check hasn’t corrected the geordie-ness #physiotalk |
| physiotalk @physiotalk #Physiotalk |
| Robyn Stiger @RobynStiger @emaroids1 @physiotalk Love it. Thanks. Always the physiology which is so complex in this group. #physiotalk |
| Physiophilip @physiophilip @physiotalk #physiotalk Thanks all for the interesting insight and shared resources. As always most appreciated! |
| Ruth wood @Ruthrespphysio @emaroids1 @physiotalk ax and treatment of secretions/ breathlessness/ vq matching that weve always knopen about now hot topic/ weaning / early rehab/ fatigue management/ dc planning/ post icu support and classes/ follow up mdt #physiotalk |
| Laura Byrne @physio_laura @physiotalk Sorry keep forgetting😉! #physiotalk |
 | Karen Middleton (she/her) @KMiddletonCSP RT @emaroids1: @rachaelmoses @physiotalk As @KMiddletonCSP encouraged us to do-we have stepped up and had a seat at the table. So proud to be a Physio right now and be able to contribute to the essential MDT #Physiotalk |
| Gemma McCraith @GMcELHT @physiotalk Anyone finding that this patient group are desaturating and experiencing high levels of fatigue therefore wary of too much too soon and having to find a balance of regular functional rehab with a reasonably paced activity #physiotalk |
 | Laura Graham 💙 (She/Her) @goldens2482 RT @TheACPRC: Some additional proning resources https://t.co/QqyYsHziuL #Physiotalk |
| Janet Thomas @JanetThomas47 @GemmaFordELHT @physiotalk Can only comment on post COVID rehab patients (not been ventilated) but yes, some have considerable desaturation and fatigue initially #physiotalk |
| Robyn Stiger @RobynStiger @GemmaFordELHT @physiotalk I’ve heard quite a lot of this happening @GemmaFordELHT @OxfordICUPhysio may know more. #physiotalk |
 | Anthony Gilbert @awgilbert11 RT @RobynStiger: @emaroids1 @physiotalk @TheACPRC @uhbwNHS @NightingaleBRS It’s been wonderful to see so many physios with transferable skills going back to respiratory @awgilbert11 @Alun_Bonello and the rest of them. The respiratory courses by @IcuRemote and @EveCorner fantastic resources to help. #physiotalk |
| Physiophilip @physiophilip @physiotalk #physiotalk I have not been treating this group but from what you have said, I think, it is the clinical reasoning skills we develop that takes the profession to the next level of problem solving. If that is in ICU with a fragile PT or in a team that needs support, it is crucial. |
 | Shauna Hanrahan @shauna_hanrahan RT @rachaelmoses: @physiotalk 1000% expert hands on assessment, manual techniques, positional optimisation (inc proning teams), post extubatuon support, secretion managament, mobilisation, rehab. Physios all over the world are in a league of their own at the minute and I couldn’t be more proud #physiotalk |
| Helen Michel @hfdub @JanetThomas47 @GemmaFordELHT @physiotalk I’ve only seen one community patient post covid admission. Post pneumonia and PE, d/c with supplementary O2. Does anyone know what the recommended respiratory follow up is? #physiotalk |
| Karen Middleton (she/her) @KMiddletonCSP RT @emaroids1: @physiotalk Direct PT support has been invaluable to this pt group! I am inspired by the knowledge and skill base of clinicians every day. Staff have been open minded to working ‘outside of the box’ and are the working definition of teamwork @TheACPRC @uhbwNHS @NightingaleBRS #physiotalk |
| Laura Graham 💙 (She/Her) @goldens2482 RT @emaroids1: @physiotalk @sonophysio @Wilkinsonjonny Ax as per normal process rather than ‘looking for’ COVID symptoms. Presence of A/B lines, lung sliding etc useful to inform PT input and readiness to wean/push in some cases An article by the main man (he knows way more than me) @sonophysio #physiotalk https://t.co/ELvbyqy75i |
| Laura Byrne @physio_laura @physiotalk Ah not again!!! #physiotalk |
| Laura Graham 💙 (She/Her) @goldens2482 RT @rachaelmoses: @physiotalk @GemmaFordELHT @Davido744 I am clinically limited in this but apparently if they can self prone this is an indicator that they will have a positive response & should be trialled, this continues throughout the patients stay and to discharge....our Italian friends found this also @StefanoNava5 #physiotalk |
 | Suzanne Brown 💙 @suzeeyre @JanetThomas47 @GemmaFordELHT @physiotalk Some I’ve seen in the community are continuing to desaturate 3-4 weeks later. How much is due to the illness, how much is due to reduced activity levels, I’m not sure 🤷🏻♀️ #physiotalk |
| Dee @DeeThePhysio @physiotalk In my (very limited) experience we’ve found the patients are fatiguing quickly. Timing the vent wean and alternating between quiet physio rehab days and slightly more active rehab days to give them time to adjust has been helpful #physiotalk |
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