AHPs step in to help patients recover from COVID-19

You’ll have read a lot about our nursing and medical colleagues’ outstanding care of patients who had COVID-19 in our critical care unit and hospital wards, but what about those patients who were no longer COVID-19 positive and still recovering from the effects of the virus?

Patients who have COVID-19 pneumonia and require ventilating and sedating lose a lot of muscle mass and strength, and this weakness left them physically unable to go home from hospital while undergoing rehabilitation - which can take weeks or even months.

They can struggle to get back to their normal way of life and this can have a lasting psychological effect on them.

And that’s where our excellent team of Allied Health Professionals (AHPs) stepped in.

From dietitians and speech and language therapists, who usually work in neuro rehabilitation and stroke care, to psychologists, occupational therapists and physiotherapists, our AHPs worked together with colleagues in intensive care and our wards to help COVID-19 patients in their recovery from the virus.

One patient who benefited greatly from the involvement of our AHPs in critical care was David, a 62 year old surveyor from Taunton, who was admitted to hospital with a fever and cough before he tested positive with COVID-19.

David was in fact the first COVID-19 positive patient at Musgrove Park who needed to have a tracheostomy inserted during his time in critical care, to help him progress to getting off the ventilator.

And thanks to a clinical pathway that didn’t even exist before the pandemic, he was able to receive input and support from our speech and language therapists while still in intensive care to help rehabilitate his voice and help him to swallow.

A tracheostomy involves creating an opening in the neck in order to place a tube into a person's windpipe to allow air to enter the lungs. Sometimes these are necessary to support a patient weaning from ventilation but this means that a patient cannot use their voice and may have difficulties eating and drinking.

After being on a ventilator for four weeks David was very weak when his sedation was able to be reduced and, along with significant physical weakness, he also experienced difficulties swallowing so he could only be fed with a tube through his nose.

This was mainly because his swallow muscles were weakened and deconditioned due to the effect of the intubation tube through the mouth and throat.

Dr Helene Lindsay, one of our intensive care consultants, said: “It is recognised that for every 24 hours a person spends on a ventilator they can lose between 0.5 and – 1 per cent of their muscle mass, which is the amount most people lose every year after about the age of 40, unless they exercise to maintain it.

“During his time on our critical care unit in effect, David’s body aged about 20 years through no fault of his own. Not surprisingly his weakness was really noticeable. Our physiotherapy team has always started working with patients right from the start of their stay, but previously we haven’t had the benefit of many of the other AHP teams in the way we have during the pandemic.

“Once a patient’s breathing muscles are strong enough to leave critical care, it's the team of neuro rehab specialists that really take over a patient’s care. The physiotherapists help them to start moving and walking again.

“And our occupational therapists get involved to help patients with simple tasks such as washing and dressing to help ensure they would be safe when back in their home setting.

“Speech and language therapists and dietitians also work with the patients to ensure they can eat and drink safely and take enough orally to remove feeding tubes.

“And it’s not just about how the virus affects the physical body. We know an intensive care stay can cause real psychological harm to a patient – this is why we also involve psychology colleagues in our patients’ care.”

Emma Wicks, our speech and language therapy clinical lead for neurorehabilitation, said:

“It’s crucial for a patient like David to set goals on what they want to achieve and what’s important to them and our team of AHPs were able to this with him on the ward.

“He originally struggled to sit up in bed independently and was quickly out of breath, but after a few weeks he became a lot more independent to the extent that before he left hospital he was able to take a shower and even able to make a drink and a snack independently in our kitchen area.

“David is now working really hard to get back into a good physical condition, his eating and drinking difficulties have now resolved and our teams of therapists are working closely with him on his rehabilitation in the community.

“Everyone who cared for David remarked on how he had such a positive attitude and we wish him all the best in the future.”