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

• Be able to name the most common lobe for Atelectasis
• Be able to name two contraindications to Chest PT
• Be able to name two invasive lines that can monitor blood pressure
• Be able to name a common mistake with Speaking Valve application
• Be able to name two options for communication for non-verbal patients
• Be able to name two reasons for a multi-podus boot
• Be able to name how many PVCs in a row makes 'Ventricular Tachycardia'
• Be able to state safe upper and lower limits for Systolic Blood Pressure
• Be able to name a reason why a pulse oximetry reading of 100% may not be accurate
• Be able to state two common reasons for ventilator high/low pressure alarms
• Be able to state what legally must be known about the patient before calling a code

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?
• Speaking valves: Can you use these with a patient on the ventilator? What kind of tracheostomies should you use a speaking valve with?
• Augmentative alternative communication: What are my options for communicating with a patient who is on a ventilator? What options are there for paralyzed patients?
• Splinting: Why use a wrist splint or multi-podus boot? What are common errors made with their application? Why do SLPs need to understand ankle and wrist splints? How do ankle splints help with positioning for feeding? How should you use a wrist splint with a swallowing/feeding evaluation?
• 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.