Following my previous Tweet & the interesting debates.
Do you use @Strava?
Comments welcome on reasons for and against. Personally, I don't use it because it taps into my addictive/obsessive training behaviors.
COVID Reflections/moving forwards @TheACPRC course
My learning points 🤓
THREAD (long)⤵️
Huge thank you to all the speakers and for putting on a great webinar 🙏🏼
Looking forward to putting into practice with @RBH_ICU_Physio & @GoPerformUK
Intubation & Ventilation 🖥
- Different phenotypes = different results
- Tracheostomy in 14 days decreased ICU stay
- Physio important in ICU Mx - sputum/trache’s 💦
- 2nd wave showing reduced I&V patients 🌊
NHF
- reduces WOB, bronchospasm, helps AWC 💦
- Flow is key 🔑 10L/min = 1cm PEEP
- Prescribe FiO2 & Flow ranges 📈
- Start at 40% : 40L/ min
- Combo with proning
- AGP issues ? face mask 😷 with NHF but tolerance issues
- 5% wean at a time
Following #therapylive with my webinar on RED-S & based on some follow up questions, I would like to sign post these resources for those who would like to learn more 🤓(THREAD) ⤵️
#COVID reflections from ICU (THREAD) my experience & own views
💙 I have been blown away by the incredible human beings I’m working alongside - their compassion, ability to stay upbeat & calm doing tasks outside their comfort zone
⚙️MDT teamwork - everyone is an important cog working together. This is crucial & it’s been exceptional
🚩 Obesity, HTN & T2DM seems to be the a common trend of co-morbidities (I’m calling it the triple threat)
🌬Patients have ⬆️FiO2 requirements which fluctuate regularly
🎈Derecruitment often with repositioning = big ⬇️ SpO2 - preoxygenate & have dr nearby for vent recruitment is helpful. Once repositioned often need time to settle again (can be a 15 min nervous wait!)
This week, I’ll be going back to ICU
The info on treating #COVID19 involves regularly & the amount of info out there can be overwhelming. I’ve found the following most helpful
🦠@BTSrespiratory guidelines on ARDS
🦠@atscommunity breathe easy podcast covering physio guidelines
😷Respiratory Physiotherapy in pt's with COVID-19 in the Acute Setting: Position Paper from the Association of Italian Physiotherapists
😷Critical Care Global Grand Rounds podcast on ARDS
😷 Respiratory Physiotherapy in pt's with COVID- 19: Clinical Practice Guidelines
THREAD: Demonising food & promoting exercise as punishment, the message here is all wrong.
This will not help the obesity crisis
This promotes unhealthy relationships with food & exercise, triggering those vulnerable or going through eating disorders bbc.com/news/health-50…
The model is oversimplified
Everyone’s age, gender, body composition, physical activity levels, health status will impact their energy expenditure
200 calories of one food will have very difference nutritional density to another “worth” 200 calories
Instead of wasting money in worthless labelling of food but instead invest money in education on healthy relationships with food & exercise
Strength work for endurance athletes
🏃🏽♂️Improved running economy
📈Improved lactate threshold
😴Delay/reduced fatigue
🏋🏽♂️Increase peak power output ⚡️Increased anaerobic capacity
💨Improved maximal speed
🔥Improved peak force (Ronnestad & Mujika, 2014)
*Learning cleans 😳
I always find compound lifts are best when it comes down to “bang for your buck” by hitting multiple muscles at once (movement > muscles)
Add some resistance doing 3-5RM for 3-5 sets, you can get some decent strength training done in a relatively short session
2-3 x a week is plenty
Many endurance athletes struggle to fit this in, therefore getting their buy in to drop some junk miles for the gym is essential