Bells & Whistles(SM) is geared to the ICU beginner and veteran alike. It includes an in depth review of equipment and procedures (e.g. auscultation, lines/tubes/drains, telemetry, and ventilators) and focuses on improving a therapist's ability to monitor a patient's status with ICU equipment so that an appropriate rehab technique can be performed.

Target audience

Bells & Whistles(SM) is especially appropriate for PTs, PTAs, OTs, OTAs, SLPs, SLPAs, and students. Please review the educational credit opportunities of which you might be able to take advantage.

Come to Bells & Whistles and you will be able to talk with an OT, PT, or SLP to answer your questions from a variety of viewpoints.

Through participation in the Bells & Whistles(SM) course, you should be able to:

• Ask questions you are otherwise afraid to ask
• Improve your knowledge and comfort level in the ICU
• Improve the skills necessary to treat in the ICU
• Differentiate between precautions and contraindications
• Learn how to advance ICU patients

Course objectives

• Able to list safe limits of monitored systemic functions
• Able to list three common ICU procedures and how they may affect rehabilitation
• Able to list three techniques to optimize pulmonary function
• Able to name two options for communication with non-verbal patients
• Able to state four treatment precautions/contraindications that could adversely affect a patient’s status and why

Some issues that will be discussed in each presentation include (the following is a partial sampling of topics):

• Auscultation: Hear the difference between a crackle and a wheeze. What are rhonchi, atelectasis, pneumonia, etc.? Practice auscultating technique. For which reason do I use the diaphragm or bell of the chest piece?
• Airway clearance: Why is this important? Who should do this? Why Chest PT? How to incorporate bronchial hygiene into an OT/PT/SLP treatment. How do I suction? What is the most common lobe for atelectasis? What can you do to ease the sensation of breathlessness? What body positions make it easier for a patient to inhale/exhale?
• Lines/tubes/drains: What is the difference between a PICC line and a Midline? How do I move a patient with a chest drain? Which chest drain chamber should be bubbling? Is there anything special to be aware of with a patient with a lumbar drain?
• ICU Beds:  What is important to understand in a bed?  How can you utilize a bed to your advantage in a rehab treatment?  How does the bed position affect your therapy?  How to work ICU beds.  What type of beds are out there?
• ICU Treatments:  What are the general principles in an ICU treatment?  What things should you be wary of - precautions/contraindications?  Why are multidisciplinary treatments advantageous?  What are some multidisciplinary ideas for treatment?
• ICU Documentation :  Why is it important?  What do other disciplines (particularly MDs) write in the chart? What does the information in the physician/nursing note mean?  What, in a physician/nursing note, is important to me as a therapist? What should be included in an ICU note?  What about goals/discharge planning?  When should it be completed?  Common mistakes/pitfalls.
• Telemetry: What rhythms are potentially dangerous? What heart rate is too fast? Does it make a difference if the patient has a faster heart rate in atrial fibrillation? How many PVCs in a row is ventricular tachycardia?
• Blood pressure: What blood pressure is too low? How can I raise a patient's blood pressure? Who is more likely to have an inaccurate NIBP, a bradycardic, or tachycardic patient? What does a Swan-Ganz catheter measure? What is MAP?
• Pulse oximetry: When doesn't a pulse ox reading of 100% ensure that the patient is receiving all of the oxygen they need? Can a patient suffocate while using a non-rebreather? How many forms of hemoglobin does pulse oximetry measure? What does nail polish and the color of your skin do to the saturation reading? Why is SVO2 important?
• Ventilators: What should I do when the low-pressure alarm goes off? What do I do with water in the corrugated tubing? What joint complication is common with ventilated patients? What does CMV/AC/SIMV/CPAP/PSV/PEEP mean?
• Codes: What is a Peri-arrest situation? Practice a mock code.