A St George Hospital cardiorespiratory physiotherapist was instrumental in developing a training program to treat COVID-19 patients who require intensive care.
Wendy Chaseling, a senior cardiorespiratory physiotherapist with more than 30 years' experience, was part of a team, including Queensland physiotherapist Dr Peter Thomas and cardiorespiratory physiotherapist Michelle Paton from Victoria, who developed a two-day virtual training program to 'upskill' physiotherapists so they can treat COVID-19 patients in intensive care units.
The Physiotherapy Virtual Cardiorespiratory ICU Training for NSW Health was developed in three days and delivered in partnership with Australian Physiotherapy Association (APA) to more than 350 physiotherapists on March 28 and 29.
Since then, a further 503 NSW physiotherapists have reviewed the training videos, while 1771 physiotherapists from other states and 18 countries have also used the program, which recently drew praise from NSW Minister for Health Brad Hazzard.
Ms Chaseling said Australian physiotherapists were leading the world when it came to the developing recommendations for the treatment of COVID-19.
Ms Chaseling, who has spent almost her entire career in intensive care, said physiotherapists treating ICU patients had two major roles - clearing the lungs and positioning a ventilated patient in such a way as to optimise the oxygenation of their lungs.
The 'proning' position, which involves laying the patient face down - an image beamed around the world during the height of the coronavirus pandemic - was a standard practice to improve blood flow to the lungs and increase oxygen levels when a patient was ventilated, she said.
"When you are on a ventilator, the oxygen goes to the back of the chest. We need to match the blood flow and [the technique] maximises supply of oxygen to the blood," she said.
Ms Chaseling said COVID-19 patients in intensive care required 90 minutes of physiotherapy twice a day, and physiotherapists had to first put on layers of personal protection equipment (PPE) while a 'buddy' looked on. The correct way to put on and take off PPE was one of the topics covered in the training program.
As the most senior physiotherapist in St George Hospital's intensive care unit, Ms Chaseling treated all three COVID-19 patients who required ventilation in the ICU at the hospital. Of those, two survived.
"It's very gratifying when they recover," she said. "It's satisfying when you see them wake them and you can get them out of bed to walk."
Ms Chaseling said 30 physiotherapists from South Eastern Sydney Local Health District took part in the training, which meant local hospitals were very well prepared should there be a second wave of COVID-19 infection.
Mr Hazzard said the state government invested $34 million to build its own specialised workforce of physiotherapists and other allied health professionals to provide vital intensive care for COVID-19 patients.
"These highly skilled therapists play a critical role in the treatment of COVID-19 patients in the ICU and their recovery after they are discharged, as many experience very challenging medical complications," he said.
"This initiative is part of the NSW government's ongoing efforts to ensure we have the equipment and appropriately skilled workforce to care for our sickest COVID-19 patients.
"We should be extremely proud this innovative program has been picked up by physiotherapists in the UK and US, not unlike the way other countries have also followed the lead of NSW Health, embracing some of its containment measures."
COVID-19 patients can experience complications such as stiff and partially collapsed lungs, severe lack of oxygen, a build-up of secretions in the lungs, profound muscle weakness and reduced mobility.
NSW Health physiotherapists assisted COVID-19 patients with improving respiratory performance in severe respiratory failure, positioning, weaning from ventilators and improving mobility.
The $34 million allied health package is part of the government's $800 million investment in NSW Health to help boost intensive care unit capacity and purchase additional services and medical equipment.
