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6572250-111379000January 2019January 2019First Word for the YearWelcome to 2019, a year to be anticipated as the countdown to WCPT2019 Geneva rapidly approaches its climax. See page 3 for further details of the WCPT Geneva Congress. The ICCrPT will have a stand within the exhibition hall – we look forward to welcoming many of you to share some colleagiality amonst our cardiorespiratory community at this meeting point.Memberships for 2019 to the ICCrPT are now due – please join / renew with us as we continue our efforts to support and promote the specialty area of cardiorespiratory physical therapy. Page 6 of this edition of the newsletter provides thoughts on the benefits of ICCrPT membership. Contact our membership team at membership@cardioresp.physio for details on renewal or joining for 2019. Numerous opportunities to be an active contributor to the functioning of the ICCrPT are possible, including scope to be on the Executive Committee from May; if interested in finding out more please contact any of the Executive Committee members for information.The ICCrPT Constitution is presently under review, its first major refresh following the inaugural version of June 2011 (see: ). A draft amended Constitution for the ICCrPT, based on the updated WCPT Constitution being proposed for the WCPT General Meeting in Geneva, is currently circulating for consultation / feedback from members – it is available for review and comments, via . Please forward any comments on this draft to myself via email below, or to the ICCrPT Secretary (Diana Hopkins-Rosseel<secretary@cardioresp.physio>) by 7th February 2019. It is anticipated that a final draft will be proposed at the ICCrPT General Meeting in May in Geneva.Enjoy your newsletter…351028122784200Shane Patman (president@cardioresp.physio)Meet our member organisations 2018Australia (foundation member)Cardiorespiratory Physiotherapy AustraliaBrazilAssocia??o Brasileira de Fisioterapia Cardiorrespiratória e Fisioterapia em Terapia Intensiva (Assobrafir)Canada (foundation member)Cardiorespiratory Division DenmarkDanish Society for Cardiovascular and Respiratory Physiotherapy GermanyAG Herz-Kreislauf im physio-Deutschland ZVK Hong KongCardiopulmonary Specialty Group (CPSG) IranIranian Cardiopulmonary Physical Therapy AssociationIrelandChartered Physiotherapists in Respiratory Care CPRCJapan (foundation member)Special Interest Subgroup in Cardiovascular, Pulmonary and Metabolic Physical Therapy New Zealand Physiotherapy New Zealand Cardiothoracic Special Interest GroupNorway (foundation member)NFFs group of Cardiorespiratory Physical TherapistsSaudi ArabiaCardiopulmonary and Vascular Physical therapy divisionSouth Africa (foundation member)Cardiopulmonary Physiotherapy Rehabilitation GroupSweden (foundation member)Sektionen for andning och cirkulation United Kingdom (foundation member)Association of Chartered Physiotherapists in Respiratory Care (ACPRC)Associate members 2018Jorge C (Columbia)Rasha O (Jordan)Peer A (UAE)50577759525Important dates and links:31 January 2019 Deadline for early bird registration 26 March 2019 Deadline for advance registration 1 May 2019 Deadline for booking accommodation dates and links:31 January 2019 Deadline for early bird registration 26 March 2019 Deadline for advance registration 1 May 2019 Deadline for booking accommodation 2019 News"Used with the permission of the World Confederation for Physical Therapy"?Almost 2,000 people registered at the super early bird rate for WCPT Congress 2019 in Geneva, Switzerland. When the deadline closed, 1,965?super early bird registrations had been made to attend WCPT Congress 2019, 10-13 May 2019.Jonathon Kruger, WCPT Chief Executive Officer, said: ‘it’s great to see how people have responded to the super early bird rate. The calibre of speakers and programme content is outstanding and, combined with the location, has obviously made WCPT Congress 2019 an attractive proposition for physical therapists. Attending congress gives presenters an opportunity to share knowledge and research at an international level and gives delegates an opportunity to network, build relationships and experience a diverse continuing professional development opportunity covering the breadth of physical therapy.’The preliminary program is varied and will include the following content:-Focused symposia Focused symposia are one of congress’s key sessions, which include high profile speakers and draw large audiences to engage in lively discussion.?Lasting 1.5 hours, each symposium is organised by a recognised expert in the field who leads a coherent session with 3-4 international speakers working together thoughtfully to highlight the latest practice, research, education and professional issues.Cutting edge relevant topics will be explored from a global perspective. Presentations from a range of countries and WCPT regions will ensure the implications of the latest research and thinking will be examined, as well as laying the foundations for future interactions and initiatives.?The 26 focused symposia sessions for Geneva 2019 can be found here:- . The ICCrPT will be delivering one of the symposium Cardiorespiratory: technology revolution (FS-04): Preparing cardiorespiratory physical therapists for the technology revolution in the digital age, but there are many more of interest to the Cardiorespiratory Physiotherapy community including:Physical activity (FS-06): Physical activity: positioning physiotherapy as a global force for changePreoperative physiotherapy (FS-13):Preoperative physiotherapy management for patients undergoing major visceral surgeryMobility of hospitalised patients (FS-17):Improving mobility levels of hospitalised patientsCancer survivor rehabilitation (FS-26): Exercise testing and training considerations for cancer survivor rehabilitationDiscussion SessionsThis is where constructive debate and controversy happen, with delegates given the opportunity to explore hot topics with leaders in the field. Sessions start with brief introductory comments by the chair and speakers, followed by questions from the audience, with plenty of opportunity for lively debate, before concluding comments from the chair.A classic debate is a formal discussion on a particular matter in which opposing arguments are put forward, questions from the floor addressed and which usually ends with a working SessionsNetworking sessions are hugely popular at congress, offering an informal opportunity to meet and talk with colleagues who share common interests. A designated chair opens and guides discussions. All sessions consider how to continue communication after the congress. Sessions may also be facilitated in languages other than English. The ICCrPT will lead a Networking Session around the theme of Cardiorespiratory Competency Frameworks in Geneva 2019SeminarsSeminars offer an engaging way to have in-depth discussions on particular topics. Delivered by a diverse panel, they focus on clinical or professional issues and may be led by WCPT’s international subgroups or subject matter leaders.?WCPT professional seminars?are designed to introduce delegates to aspects of WCPT’s international work or address specific professional issues of global interest.??“Focus on…” seminars?cover a range of topics related to physical therapist practice, research, education or managementPlatform abstract presentationsThere are three types:?State of the art: 12 minute platform presentations from the highest quality cutting edge abstracts that are likely to influence practice, with a 30 minute moderated discussion led by a leader in the field.?Classic: eight platform presentations lasting eight minutes each followed by three minutes for questions.?Rapid five: a platform presentation session of 10 abstracts each delivering key messages using no more than five slides in five minutes (5 x 5) along with moderated discussion times.?Poster abstract presentationsPoster presentations are changed daily and are grouped by topic within the poster area in the exhibition hall. Posters are displayed for one day during exhibition hours, with presenters attending their poster for 45 minutes for discussion with delegates.?Virtual poster walksE-posters provide an opportunity for a chair to lead delegates through a small number of selected posters for discussions with presenters. A number will be facilitated in languages other than English.Indaba sessionsThe Indaba is a “meeting and inspiration zone” within the exhibition hall. First introduced at the WCPT Congress 2017, it constitutes one of the legacy outcomes from the first WCPT Congress held in Africa. This informal networking space aims to break down language barriers and the distinction between ‘speaker’ and ‘delegate’. The programming of this area will allow for some late topics prompted by delegates and support sessions in different languages.Two areas will facilitate the more informal format:?Kitchen table discussions?will explore a range of issues led by a facilitator and may include additional contributors sitting within the audience.??“Points of view” discussions?will allow for short talks and exchanges with the audience, drawing on their experiences.?CoursesA full list of pre- and post-congress courses is available at and will be available to add via your online registration. Courses are filling up quickly!RegistrationsEarly bird registrations to WCPT Congress 2019 are open now, with Early Bird rates available until 31st January 2019 – have you registered yet?? See: Why is it important to belong to the ICCrPT?What are the outward facing benefits of Membership of the International Confederation of Cardiorespiratory Physical Therapy (ICCrPT) - an official sub-group of the World Confederation of Physical Therapy (WCPT)?WCPT subgroups are independent organisations in their own right. They have a specific area of interest, and promote the advancement of physical therapy in their area of speciality. More importantly, the international sub-group structure allows speciality Physiotherapy groups to inform and contribute to the core business of WCPT. Without speciality sub-group representation at an international level, there is a risk that the speciality area interests may not be recognised or promoted. This is particularly true for the smaller sub-group organisations. There are currently 12 WCPT official subgroups representing the following specialities:-AcupunctureAnimal PracticeCardiorespiratoryEPA’sManual TherapyMental HealthNeurologyOlder peoplePaediatricsPrivate PracticeSportsWomen’s HeathTwo further groups are attempting to achieve sub-group status:-Occupational Health and ErgonomicsOncology and Palliative CareThe ICCrPT recognise that the continuity of the specialty cardiorespiratory sub-group in the short and long term is dependent on the continued support of the cardiorespiratory member organisations and associated members from around the globe who have already joined or are eligible to do so. Inherent in this support is an appreciation of the benefits of membership for the global cardiorespiratory community, and an understanding of how the existence of the ICCrPT will ensure continuing Cardiorespiratory Physiotherapy representation at all levels within the World Confederation of Physical Therapy. Specifically this benefit includes bit is not limited to:-Ensuring representatives of the international Cardiorespiratory Physiotherapy community are informing and contributing to key WCPT platforms including:Policy and StandardsPolicy ResourcesPractice ResourcesEducation ResourcesGlobal Health ResourcesWorld PT Day ResourcesInternational CampaignsInternational CollaborationsExecutive Management BoardsEnsuring that the international Cardiorespiratory Physiotherapy community is informing and contributing to key international WCPT events including:Conference Planning CommitteesInternational Scientific CommitteesAbstract selection panelsInternational awards nomination and selection pathwaysConference prize nomination and selection pathwaysThe development and delivery of Cardiorespiratory themed focussed symposiumThe development and delivery of Cardiorespiratory themed pre and post congress coursesThe inclusion of Cardiorespiratory themed networking sessionsEnsuring that the international Cardiorespiratory Physiotherapy community remain informed of, and supported to access WCPT information sharing including:-Other professional networksOther international speciality networksWCPT information gatewaysWCPT communication channelsThe WCPT Experts database (DOVE)WCPT press releasesWCPT social mediaWCPT ToolkitsWCPT collated resourcesInformation about commercial partnershipsPublicity materialsMeet one of our Member OrganisationsFysioterapeuternas sektion f?r Andning och Cirkulation, Cardiopulmonary physiotherapy; a subgroup of the Swedish Association of Physiotherapists The Swedish Association of Physiotherapists is an organization with approximately 12,800 members and was founded 1943. The Association is one of the founding members of the World Confederation for Physical Therapy (WCPT) and is also the member of the European Region of World Confederation of Physical Therapy (WCPT).Within the Swedish association there are 16 sub-groups of which the cardiopulmonary group is one. Our group was founded 1975 and has approximately 500 members from all over the country. The group covers several areas of expertise: respiration (within the fields of surgery and pulmonary medicine); circulation (cardiology and cardiac/vascular surgery); intensive care, nephrology and transplantation. Our patients are of all age groups and found in hospitals, out-patient clinics and private practices. The management board consists of nine colleagues who represent all parts of Sweden and areas of expertise and are both clinicians and researchers. The management board meets twice a year and have telephone conferences in between. One of our board members is a delegate in the Swedish association's board of professional issues and another one is an executive committee member of theICCrPT. The aims of the Swedish sub-group are:To be a network for knowledge translation between colleagues. To arrange postgraduate education, courses, symposia and workshops also in cooperation with the other subgroups, the mother organization and through international collaboration.To stimulate development and implementation of treatment and outcome methodsTo stimulate research in clinical practiceA newsletter is sent out to the members twice a year. In addition we have a website where information about the sub-group can be found news and activities are presented. Twice a year members can apply for a scholarship to cover costs for further education through courses, congress visits and for research work.On behalf of the board of the Swedish sub-group, Monika Fagevik Olsén and Maria Sehlin Board membersLook at some of your Member ServicesThe Register of ExpertiseSince 2013 the ICCrPT has, as a member service, a register of expertise within the scope of Cardiorespiratory Physical therapy. The spectrum of the register covers the diversity of practice that exists within this speciality area and presently includes 15 specialists with both clinical and academic expertise. If you wish to share your knowledge, skill, or attributes in your area of interest and speciality to others, please register for inclusion into the database by completing the form which appears on the members only side of the website (). Information from the form marked with an * will be presented on our web page. If you have any questions about completing the form please contact Monika Fagevik Olsen ().If you wish to apply for expert help, see the contact information to the experts on the web-page after logging in with your member organisation details. It is the responsibility of both parties to establish that the requirements can be met and agreed. Any financial arrangements are the responsibility of the two parties. The ICCrPT serves as a facilitator in getting people together but takes no responsibility for the collaboration. Data will not be passed on or sold to any other organisation. If you wish to apply for expert help or information on other speciality areas or broader, more general expertise within Physical Therapy, the World Confederation for Physical Therapy (WCPT) has a database of experts. They may be contacted via email info@ or post:World Confederation for Physical TherapyVictoria Charity Centre11 Belgrave RoadLondon SW1V 1RBResearch supportAt the Cardiorespiratory Networking Session at WCPT Cape Town 2017, participants requested ICCrPT explore opportunities to foster research collaboration. Therefore, if you wish to get involved in research or to promote research collaborations and/or opportunities, here is your chance to do so.Do you have a research idea or project you are seeking input on or participants for? Consider sharing your requests via the ICCrPT newsletter. Therefore, if you wish to get involved in research or to seek out recruits/participants, or to promote a potential research collaboration, and/or opportunities then provide us with a short paragraph or two about your request / needs that you would like posted in this section of the newsletter. Provide succinct information about the study / links to relevant information, along with a contact email address for readers wishing to access more information. Contact newsletter@cardioresp.physio for further information or to lodge any submission.Professional Development CoursesSpinal Cord Injury Physiotherapy Massive Open Online Course (SCIPT MOOC) An online training course in SCI physiotherapy. An initiative of Education Committee of the International Spinal Cord Society (ISCoS) Target audience: Physiotherapy students and physiotherapists with no or little experience in the management of people with spinal cord injuries. When: commences 30th July 2018 Where to register: Cost: FREE Time commitment: 5 hours per week Duration: 5 weeks Course co-ordinators: Professor Lisa Harvey and Dr Joanne Glinsky (University of Sydney, Australia) Pre-requisites: Reasonable knowledge of the principles of physiotherapy Further details: Sponsors: The Spirit Foundation and The University of Sydney with support through the Australasian Spinal Cord Injury Network'Rehabilitation in the Acute Setting (ICU)'A Masters level coursework subject from The University of Melbourne, available to all multidisciplinary team members Click on the following link to watch a video about this subject:? 9-week subject involves cutting edge highly interactive education with highly regarded experts from Australia and overseas. You will have the opportunity to learn from worldwide experts in Australia, North America, Europe/United Kingdom, Asia, South America and South Africa and all in the one place!Topics covered include (but not limited to):Foundational anatomy, physiology and pathology relevant to the ICU setting including monitoring and supportive lines and attachments?Understanding the legacy of post intensive care syndrome and muscle wasting?Assessment in the ICU setting - Safety,?Rehabilitation in the ICU setting - considering all facets of rehabilitation from different disciplinary perspectives and socioeconomic settingsOutcome Measurement?Culture Change and Leadership?Post ICU Rehabilitation?For more information please refer to the following handbook link: Is it mainly lectures and listening to someone talking??This subject is highly flexible and designed to fit into your everyday working and other life commitments. Each week is designed as a series of lessons which involve interactive videos, graphic features, readings and so much more! It is definitely not lectures and listening - you will be engaged in your learning from the start. Time commitment is approximately 15 hours per week.?If you would like to express interest please contact: selina.parry@unimelb.edu.au to be added to the mailing list for updates. BreatheThis is an online course about long-term mechanical ventilation (LTMV) and how to use it. Useful Critical Care Websites Critical Care Reviews is run by Rob Mac Sweeney, an Intensivist in Belfast. His site has the largest collection of accessible critical care review articles on the internet and also a Top 100 Contemporary Critical Care Studies Wessex Intensive Care Society is based in Southern England and provides a #FOAMed resource to local and global health professionals ICM Case Summaries provides a catalogue of interesting cases written by ICM Trainees in the UK SMACC is a FOAMed charity that promotes education and knowledge sharing in Critical Care. They also host epic conferences!Are you aware of any useful web resources for cardiorespiratory physical therapy practice that may be worth sharing? Contact newsletter@cardioresp.physio for further information or to lodge any submission.Meet the Current Executive CommitteeWho are your current ICCrPT office bearers?President: Shane Patman (Aus)Vice President: Amanda Thomas (UK)Secretary: Diana Hopkins-Rosseel (Canada)Treasurer: Natasha Plani (South Africa)Membership Team: Judy King (Canada), Monika Fagevik Olsen (Sweden), Brenda Morrow (South Africa)Knowledge Translation: Brenda O’Neil (UK), General Members: George Ntoumenopoulos (Aus), Yoshimi Matsuo (Japan) Please contact the executive committee through the website info@cardioresp.physio Call for Nominations to the ICCrPT Executive Committee 2019WCPT Congress 2019 (Geneva) will also be the venue for the ICCrPT General Members Forum and Meeting – this will be where appointments to the next Executive Committee will be resolved. Many of the existing Executive Committee will be stepping down in Geneva so there are numerous vacancies to be filled including the President, Vice President, Secretary and Treasurer and and fresh volunteer input will be greatly valued. Nomination forms for executive committee positions will be sent to your cardiorespiratory Special Interest Group with this newsletter edition, and require the nominations to be signed by 2 members in good standing of the group to which the nominee belongs. Please consider if you would like to contribute to these important roles. Additionally the ICCrPT Executive Committee is very keen to receive and foster assistance with individuals willing to provide input outside of the Executive Committee roles– for example, newsletter coordination and webmaster are two opportunities currently on offer. Nominations will close 3 months prior to the General Members meeting in May, so act quickly! Please don’t hesitate to contact a member of the executive committee if you would like to discuss these nominations or require more information on (president@cardioresp.physio).Coming Events 2019Paediatric Respiratory Conference 5th King's John Price Paediatric Respiratory Conference 2 - 4 April 2019, London TSANZSRS 2019TSANZSRS 2019 will be held at the Gold Coast Convention and Exhibition Centre from March 29th to 2nd April 2019 (ANZSRS 29/3-1-4, TSANZ 30/3-2/4). Preliminary information about the scientific program is available via CHEST is taking its initiatives to a wider global audience. The inaugural event is their World Congress, which will take place in Bangkok, Thailand, on?10-12 April 2019.Bangkok, Thailand, will set a perfect backdrop for CHEST World Congress 2019, co-hosted by the Thoracic Society of Thailand and CHEST.?They look forward to connecting their leadership, clinical experts, and specialists from around the world in Bangkok. Association of Chartered Physiotherapists in Respiratory Care (ACPRC) Biennial conference Friday 26th and Saturday 27th April 2019, Birmingham Conference & Events CentreAmerican Thoracic Society Critical Care Research Forum (UKCCRF) June 2019European Respiratory SocietyERS International Congress 201928 September - 2 October, 2019Madrid, SpainEuropean Society of Intensive Care Medicine28 September – 2 October 2019, Berlin – City Cube Critical Care Canada Forum Sunday November 10 – Wednesday November 13, 2019British Thoracic Society Winter meeting Queen Elizabeth II Centre, London, UK 4-6 December 2019 Intensive Care Society State of the art Queen Elizabeth II Centre, London, UK, December 2019For other events in 2019 please see Translation ResourcesUpdated October 2018The ICCrPT compiles a list of useful resources to support Knowledge Transfer every 2 years. The resources are divided into the following topics:-Respiratory JournalsEuropean Respiratory Journal Respiratory ReviewThorax Open Respiratory Research Pulmonary Medicine Research Care Medicine Pulmonology Critical Care Medicine Intensive Care Medicine Care Medicine Care Lancet Respiratory medicine : Journal of COPD organisations/useful linksAGREE The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument evaluates the process of practice guideline development and the quality of reporting. Thoracic Society Asthma UK of Chartered Physiotherapy in Respiratory Care .ukBritish Thoracic Society (BTS) website brit-Breathe easy Lung Foundation Society of Physiotherapy Library CF Trust Ireland Respiratory Society Fysioterapeuterna, Swedish physical therapists: fysioterapeuterna.seMobilization-network offers an open forum for all professionals, who are interested in the early mobilization and rehabilitation of mechanically ventilated intensive care patients throughout the whole critical care pathway, from passive to active rehabilitation within the ICU and post critical care rehabilitation. mobilization-network ICU Steps Long Term Outcomes research for Acute Respiratory Failure Institute of Clinical Excellence (NICE) is a free database of over 25,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy. practice guidelines (Language – English)AsthmaBritish guideline on the management of asthma: a national clinical guideline (SIGN 152). [British Thoracic Society (BTS), Scottish Intercollegiate Guidelines Network (SIGN)] 2016BronchiectasisBritish Thoracic Society, Bronchiectasis (non-CF) Guideline Group. Guideline for non-CF Bronchiectasis. 2018 (under consultation)Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J 2017; 50: 1700629 [ 10.1183/13993003.00629-2017]CardiacExercise-based cardiac rehabilitation in patients with chronic heart failure: a Dutch practice guideline. Achttien RJ, Staal JB, van der Voort S, Kemps HM, Koers H, Jongert MW, Hendriks EJ, Practice Recommendations Development Group [Dutch Royal Society for Physiotherapists (KNGF)] Netherlands Heart Journal 2015 Jan;23(1):6-17The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017 Scottish Intercollegiate Guidelines Network (SIGN). Cardiac rehabilitation. Edinburgh: SIGN; 2016. (SIGN publication no. 150). [July 2017]. Available from URL: Bott J, Blumenthal S, Buxton M, et al (2009). Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax; 64 (Suppl 1): i1-i52.COPDLanger D, Hendriks E, Burtin C et al (2009) A clinical practice guideline for physiotherapists treating patients with chronic obstructive pulmonary disease based on a systematic review of available evidence. Clinical Rehabilitation, 23(5): 445-462.The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease. Lung Foundation Australia and the Thoracic Society of Australia and New Zealand 2017 CareNational Institute for Health and Clinical Excellence (NICE ) Quality Standards for Rehabilitation After Critical Illness 2017National Institute for Health and Clinical Excellence (NICE). Rehabilitation after critical illness. 2009 (Clinical Guideline 83). .uk/CG83S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders: revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Bein T, Bischoff M, Bruckner U, Gebhardt K, Henzler D, Hermes C, Lewandowski K, Max M, Nothacker M, Staudinger T, Tryba M, Weber-Carstens S, Wrigge H [German Society of Anaesthesiology and Intensive Care Medicine (DGAI)] Der Anaesthesist 2015 Sep 3:Epub ahead of printChaseling W, Bayliss S-L, Rose K, Armstrong L, Boyle M, Caldwel, J, Chung C, Girffiths, K, Johnson K, Rolls K and Davidson P (2014) Suctioning an Adult ICU patient with an artificial airway; Agency for Clinical Innovation NSW Government Version 2 Chatswood, NSW, Australia ISBN 978-1-74187-952-0 Morrow B, Argent A (2008) A comprehensive review of pediatric endotracheal suctioning: effects, indications and clinical practice. Pediatric Critical Care Medicine 9(5):465-77.Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Juultje Sommers, Raoul HH Engelbert, Daniela Dettling-Ihnenfeldt, Rik Gosselink, Peter E Spronk, Frans Nollet and Marike van der Schaaf. Clinical Rehabilitation 2015, Vol. 29(11) 1051–1063BTS/ICS Guidelines for the Ventilatory Management of Acute Hypercapnic Respiratory Failure in Adults. British Thoracic Society /Intensive Care Society Acute Hypercapnic Respiratory Failure guideline group 2016Surviving sepsis guidelines. SCCM and ESICM 2016 D,?Anderson C,?Carter MA,Downes LA, Keenan SP, Kelsey CJ, Lacy JB Clinical Practice Guideline for Suctioning the Airway of the Intubated and Non-Intubated Patient Canadian Respiratory Journal Volume 8, Issue 3, Pages 163-181 CF Trust. Standards for the Clinical Care of Children and Adults with Cystic Fibrosis in the UK. 3rd Edition 2017 Available from .uk (last accessed Jan 20th 2016).Dyspnoea/breathlessnessAn official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, Calverley PM, Gift AG, Harver A, Lareau SC, Mahler DA, Meek PM, O'Donnell DE, American Thoracic Society Committee on Dyspnea [American Thoracic Society (ATS)] American Journal of Respiratory and Critical Care Medicine 2012 Feb 15;185(4):435-452Exercise TestingAn official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Sally J. Singh, Milo A. Puhan, Vasileios Andrianopoulos, Nidia A. Hernandes, Katy E. Mitchell, Catherine J. Hill, Annemarie L. Lee, Carlos Augusto Camillo, Thierry Troosters, Martijn A. Spruit, Brian W. Carlin, Jack Wanger, Ve?ronique Pepin, Didier Saey, Fabio Pitta, David A. Kaminsky, Meredith C. McCormack, Neil MacIntyre, Bruce H. Culver, Frank C. Sciurba, Susan M. Revill, Veronica Delafosse and Anne E. Holland. Eur Respir J 2014; 44: 1447–1478 | DOI: 10.1183/09031936.00150414Health ServiceBerry A, Beattie K, Bennett J, Cross , Cushway S, Hassan A, Longhurst E, Moore R, Phillips D, Plowman E, Scott J, Thomas L and Elliott D (2014) Physical Activity and Movement: a Guideline for Critically Ill Adults. Agency for Clinical Innovation NSW Government ISBN 978 -1-74187-976 – 6 The Northern Ireland service Framework for Respiratory health and Wellbeing (2014) – .uk Lung CancerManagement of lung cancer: a national clinical guideline. Fergusson R, Asif M, Brown J, Byrne E, Carnochan F, Davidson S, Han S, Jones R, Kerr K, Little F, MacLean F, Mirsadraee S, Nicolson M, O'Brien G, O'Rourke N, Riedel B, Smith A, Stein A, Wallace W, Webster L [Scottish Intercollegiate Guidelines Network] 2014NMDPaediatric NMD: British Thoracic Society Standards of Care Committee (2012) Respiratory Management of Children with Neuromuscular Weakness. Volume 67 Supplement 1 | THORAX July 2012Paediatric cardiorespiratoryClinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, Brown MA, Nathanson I, Rosenblum E, Sayles S 3rd, Hernandez-Cancio S [American Academy of Pediatrics, American Academy of Family Physicians, Agency for Healthcare Research and Quality, and RTI International-University of North Carolina Evidence-Based Practice Center] Pediatrics 2014 Nov;134(5):e1474-e1502 Pediatric community acquired pneumonia – BTS Guidelines on Community Acquired Pneumonia in Children, Volume 66 Supplement 2 | THORAX October 2011.TuberculosisNICE Guidelines for preventing, diagnosing and managing TB TRACHEOSTOMY SAFETY PROJECT This site contains excellent resources developed by the UK National Tracheostomy Safety Project including Tracheostomy Algorithms, Signage and Competency Statements. TherapyAdult Domiciliary Oxygen Therapy Clinical Practice Guideline March 2014. Christine F McDonald, Ken Whyte, Sue Jenkins, John Serginson, Peter Frith,Jeffrey J. Pretto. BTS guideline for oxygen use in adults in healthcare and emergency settings. British Thoracic Society Emergency Oxygen Guideline Development Group 2017BTS guideline for Home Oxygen use in Adults. British Thoracic Society BST Home Oxygen Guideline Group 2015Pulmonary RehabilitationBritish Thoracic Society guideline on pulmonary rehabilitation in adults (2013) Bolton CE, et al. Thorax 2013;68:ii1–ii30. doi:10.1136/thoraxjnl-2013-203808AARC clinical practice guideline: effectiveness of nonpharmacologic airway clearance therapies in hospitalized patients. Strickland SL, Rubin BK, Drescher GS, Haas CF, O'Malley CA, Volsko TA, Branson RD, Hess DR [American Association for Respiratory Care (AARC)] Respiratory Care 2013 Dec;58(12):2187-2193Carolyn L. Rochester, Ioannis Vogiatzis, Anne E. Holland, Suzanne C. Lareau, Darcy D. Marciniuk, Milo A. Puhan, Martijn A. Spruit, Sarah Masefield, Richard Casaburi, Enrico M. Clini, Rebecca Crouch, Judith Garcia-Aymerich, Chris Garvey, Roger S. Goldstein, Kylie Hill, Michael Morgan, Linda Nici, Fabio Pitta, Andrew L. Ries, Sally J. Singh, Thierry Troosters, Peter J. Wijkstra, Barbara P. Yawn, and Richard L. ZuWallack; on behalf of the ATS/ERS Task Force on Policy in Pulmonary Rehabilitation. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med Vol 192, Iss 11, pp 1373–1386, Dec 1, 2015 British Thoracic Society Adult Pulmonary Rehabilitation Guidelines 2013, Published in the September 2013 issue of Thorax practice guidelines (Other ICCrPT member languages]) Swedish national guidelines i samband med buk- och thoraxkirurgi (Physical therapy for patients undergoing abdominal- and thoracic surgery) Swedish Association of Physiotherapists, 2018Tr?ning inf?r buk- och thoraxkirurgi (Physical therapy interventions before abdominal and thoracic surgery). Swedish Association of Physiotherapists, 2016Tidig mobilisering inom intensivv?rden (Early mobilization in intensive care) Swedish Association of Physiotherapists, 2015Cochrane Reviews 2017-18The ICCrPT Knowledge Translation Committee have chosen to highlight the following 2017-18 Cochrane Reviews relevant to Cardiorespiratory Physical Therapy Practice: Hageman D, Fokkenrood HJP, Gommans LNM, van den Houten MML, Teijink JAW. Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD005263. . Long L, Anderson L, Dewhirst AM, He J, Bridges C, Gandhi M, Taylor RS. Exercise-based cardiac rehabilitation for adults with stable angina. Cochrane Database of Systematic Reviews 2018, Issue 2. Art. No.: CD012786. Lane R, Harwood A, Watson L, Leng GC. Exercise for intermittent claudication. Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD000990. Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity for women with breast cancer after adjuvant therapy. Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD011292. Hill K, Cavalheri V, Mathur S, Roig M, Janaudis-Ferreira T, Robles P, Dolmage TE, Goldstein R. Neuromuscular electrostimulation for adults with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No.: CD010821. Hilton N, Solis-Moya A. Respiratory muscle training for cystic fibrosis. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No.: CD006112. Freitas DA, Chaves GSS, Santino TA, Ribeiro CTD, Dias FAL, Guerra RO, Mendon?a KMPP. Standard (head-down tilt) versus modified (without head-down tilt) postural drainage in infants and young children with cystic fibrosis. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD010297. Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD006458. McNamara RJ, Epsley C, Coren E, McKeough ZJ. Singing for adults with chronic obstructive pulmonary disease (COPD). Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD012296. Luo F, Annane D, Orlikowski D, He L, Yang M, Zhou M, Liu GJ. 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No.: CD012264. Risom SS, Zwisler AD, Johansen PP, Sibilitz KL, Lindschou J, Gluud C, Taylor RS, Svendsen JH, Berg SK. Exercise-based cardiac rehabilitation for adults with atrial fibrillation. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD011197. Morris NR, Kermeen FD, Holland AE. Exercise-based rehabilitation programmes for pulmonary hypertension. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD011285. Rose L, Adhikari NKJ, Leasa D, Fergusson DA, McKim D. Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD011833. you like to become a PT DOVE and register as a volunteer or expert, or join WCPTs mailing lists? See: ‘Physical Assessment in cardio-respiratory physiotherapy - Time for consistency and leadership”Thomas AJ and Mansell SKThis article is designed to generate discussion in the profession and is not the consensus opinion of the members of the ICCrPT or the WCPT. This article was first published in the Journal of the Association of Physiotherapists in Respiratory Care (Journal of ACPRC, 2017, Vol 49, page 5-9) and is reproduced with the permission of the Authors. Members are invited to respond to amandathomas@bartshealth.nhs.uk The clinical reasoning process in cardiorespiratory physiotherapy begins with the collection of both subjective and objective data (Holdar et al, 2013). The specific approaches or techniques used to collect this data are variously described within the cardiorespiratory physiotherapy literature, including explanations of cardiorespiratory symptoms and signs which may be observed, palpated, percussed or auscultated (Hough, 2001) and examination based on each body system (central nervous system, cardiovascular system, respiratory system, renal and musculoskeletal systems (Harden, 2005; Jones and Moffatt, 2002). Multi-systems assessment and analysis is widely taught within both pre-registration and postgraduate physiotherapy education. It is thus a widely utilised assessment method and is occasionally documented via completion of an assessment checklist (Broad et al, 2012). Despite its prevailing predominance, cardiorespiratory physiotherapy multi-system assessment lacks specific literature evaluating its process, advantages, disadvantages or effectiveness.Studies which aim to explore the clinical reasoning and decision making of cardiorespiratory physiotherapists (Holdar et al, 2013; Smith et al, 2008) typically reveal a highly complex, cyclical, evolving and flexible process, where decisions and actions are intertwined and heavily influenced by contextual factors, including the level of practitioners experience (Holdar et al, 2013). The assessment method used by participating therapists in these clinical reasoning studies is never explicitly stated. It is likely (based on the dominance of the multi-systems clinical assessment),that these studies are exploring the reasoning process elicited through multi-systems assessment approaches. The complexity of factors related to the cardiorespiratory clinical reasoning process may contribute to the differences observed between experienced and inexperienced practitioners in clinical practice (Dunford et al, 2011).An alternative to the multi-systems approach to cardiorespiratory clinical assessment is the systematic (ABCDE) assessment method (Bennett et al, 2016; Thim et al, 2012; Elnour and Shankar- Hari, 2011). The systematic ABCDE assessment approach proposed is that used by resuscitation training programmes, multi-professional first responder training programmes (Resuscitation Council UK, 2010), programmes associated with rapid recognition of abnormal cardio-respiratory physiology (Frost and Wise, 2012; Mulryan, 2011; NICE, 2007) and simulation based education (Gaba, 2010; Gaba et al, 2001 ). The systematic ABCDE approach was developed in the 1970’s when Dr James Styner recommended the process in his advanced traumatic life support courses following a plane crash involving him and his family (Pasha et al, 2017; Thim et al, 2012). Styner found, from personal experience, that emergency teams were ill prepared to respond to deteriorating patients. The method uses a logical, systematic approach, in a strict chronological order; starting with examination of the airway “A” and progressing through breathing “B”, circulation “C”, disability “D” and exposure “E”. The ABCDE systematic approach allows findings to be quickly assimilated and enables urgent priorities to be identified and managed, before moving on to the next component. In this sense, it is a valuable technique for managing deteriorating patients in the acute or on-call situation. Clinicians in chronic care may feel the systematic ABCDE approach is less relevant to their practice, but the method is also applicable across the spectrum of clinical presentations in cardio-respiratory health, including chronic stable patients and those patientsin the community. The clinician undertaking the assessment determines which component of assessment (A, B, C, D, E) should be specifically emphasised in each clinical setting. Additionally, the systematic nature of the ABCDE approach reduces the likelihood of omission of key clinical considerations during the assessment process (Bennett et al, 2016), which may improve patient safety and facilitate critical thinking (NICE, 2007). Furthermore the approach encourages rapid assessment and required action, and can be employed by experienced clinicians and students alike (Pasha et al, 2017). Indeed the approach is taught to any lay person attending a first aid course (Resuscitation Council UK, 2010).The ABCDE assessment method is taught throughout nursing and medical undergraduate and postgraduate training (Frost and Wise, 2012; Mulryan, 2011; Resuscitation Council UK, 2010; NICE, 2007). These professions are well versed in the technique and document their assessments accordingly. Documenting physiotherapy assessment findings using this systematic ABCDE order, within the SOAP (subjective, objective, assessment, plan) format (Weed, 1971), may permit standardisation between professional groups, thus enabling clear communication of salient assessment findings. Furthermore, communication and team work during an acute or deteriorating patient scenario are enhanced by clinicians’ utilising the same assessment approach (Gaba et al, 2001). Currently cardiorespiratory physiotherapists are using different assessment approaches to our MDT colleagues, making both written and verbal communication of physiotherapy findings and recommendations cumbersome to articulate. Smith, Higgs and Ellis (2008) have suggested that acute cardiorespiratory decision making is a collaborative process involving the integration of information and advice from other health professionals. Using the same approach to the assessment and communication of key findings may support the integral role of collaboration in safe patient care.Introducing a new assessment approach may seem daunting to educators and experienced clinicians, however the ABCDE approach to assessment is taught to physiotherapy staff as part of their basic life support training, which is mandatory in all areas of clinical practice (Resuscitation Council UK, 2010). Although anecdotally this widely used approach is not routinely included in undergraduate or postgraduate physiotherapy education; it is a technique physiotherapists will be familiar with. The content of a physiotherapy cardiorespiratory assessment would not change, just simply be conducted in a more systematic and user friendly approach. It should therefore be straightforward to adapt the systematic ABCDE approach to cardiorespiratory clinical assessment. Furthermore, within simulation based education SBE the systematic ABCDE approach is consistently taught and encouraged in the management of all acute and non-acute scenarios. There is a rapidly growing use of SBE within postgraduate physiotherapy education (Gard et al, 2014; Gosling and Murch, 2015; Harlow et al, 2015; Thomas and Gill, 2015), providing a unique opportunity for the education of cardiorespiratory physiotherapists on implementing this method. Anecdotally, as the use of SBE as a component of physiotherapy on call training programmes increases across the UK, use of the systematic ABCDE approach to objective assessment may become more prevalent.As experienced cardiorespiratory physiotherapy practitioners, the authors propose the introduction of the systematic ABCDE assessment approach as the physiotherapy professions standard method of performing and documenting a cardiorespiratory clinical assessment. The introduction of the systematic ABCDE assessment approach within undergraduate and postgraduate education programmes could improve the quality and consistency of cardiorespiratory physiotherapy practice. Additionally, as individual role models for cardiorespiratory specialist and non-specialist staff, ACPRC (Association of Chartered Physiotherapists in Respiratory Care) members have a responsibility to demonstrate practice which is consistent across multiple settings. ACPRC members have a further opportunity to lead change and to adopt a contemporary integrated documentation method which is standardised within the profession. In order to promote the cardiorespiratory physiotherapy profession, and to ensure safe interdisciplinary working, the documentation of cardiorespiratory physiotherapy clinical assessment must be more recognisable and accessible to other professional groups. From a pragmatic point of view, at the very least, it is important to ensure staff moving across clinical areas, hospitals and trusts, are not confronted with a less than contemporaneous approach (or with multiple approaches) to cardiorespiratory clinical assessment, critical thinking and documentation.The authors further propose that cardiorespiratory physiotherapy practitioners and members of the ACPRC scrupulously consider this opportunity to lead the profession by demonstrating a consistent approach to clinical assessment, critical thinking and documentation.Key points? The systematic ABCDE assessment method is routinely taught and employed in nursing and medical education and practice, yet not universally by cardiorespiratory physiotherapists.? Use of the same assessment methods across the multi-professional team enhances communication, improves patient safety and increases the profile of the cardiorespiratory physiotherapy profession. ? We propose both undergraduate and postgraduate education programs review the cardiorespiratory assessment methods currently taught and consider the systematic ABCDE approach as a preferential method.AcknowledgementsThe authors would like to thanks Lauren Geddes for her opinions during the preparation of this manuscript. ReferencesBennett, K. A., Robertson, L. C. Al-Haddad, M. 2016. Recognizing the critically ill patient. Anaesthesia & Intensive Care Medicine, 17(1): pp 1-4.Broad, M. A., Quint, M., Thomas, S. Twose, P. 2012. Cardiorespiratory Assessment of the Adult Patient: A clinician’s guide. Edinburgh: Churchill Livingstone Elsevier.Dunford, F., Reeve, J. Larner, P. 2011. Determining differences between novice and expert physiotherapists in undertaking emergency on-call duties. New Zealand Journal of Physiotherapy, 39(1) pp 20-29.Elnour, S. and Shankar-Hari, M. 2011. The critically ill patient: identification and initial stabilization. British journal of hospital medicine, 72(9): pp 138-40.Frost, P. J. and Wise, M. P. 2012. Early management of acutely ill ward patients. British Medical Journal, 345 e5677 pp43-47.Gaba, D. M. 2010. Crisis resource management and teamwork training in anaesthesia. British Journal of Anaesthesia, 105(1): pp 3-6.Gaba, D. M., Howard, S. K., Fish, K. J., Smith, B. E. Sowb, Y. A. 2001. Simulation-based training in anesthesia crisis resource management (ACRM): a decade of experience. Simulation & Gaming, 32(2): pp 175-193.Gard, J., Corner, E., Atrill, K., Thomas F., Bushby, D. 2014. Simulation: A novel approach to physiotherapy on-call training. Journal of the Intensive Care Society, 15(1): s28.Gosling, J. and Murch, N. 2015. Inter-professional, high fidelity respiratory simulation training for medical, nursing and physiotherapy postgraduates. Physiotherapy, 101(Suppl 1): e468-e469.Harden, B. 2005. An exploration of emergency respiratory on-call service provision within the United Kingdom. Journal of the Association of Chartered Physiotherapist in Respiratory Care, 37: pp 17-24.Harlow, S, Harvey, A. Thomas, A. 2015. Does high fidelity simulation training increase the self-evaluated confidence of non-specialist physiotherapists providing an on-call respiratory physiotherapy service? Physiotherapy, 101(Suppl 1): e530-e531.Holdar, U., Wallin, L. Heiwe, S. 2013. Why Do We Do As We Do? Factors Influencing Clinical Reasoning and Decision-Making among Physiotherapists in an Acute Setting. PhysiotherapyResearch International, 18(4): pp 220-229.Hough, A. 2001. Physiotherapy in respiratory care: an evidence-based approach to respiratory and cardiac management, Cheltenham: Nelson Thornes.Jones, M. and Moffatt, F. 2002. Cardiopulmonary physiotherapy, Oxford: BIOS Scientific Guildford.Mulryan, C. 2011. Acute Illness Management, London: SAGE Publications Ltd.National Institute for Health and Clinical Excellence 2007 Acutely ill adults in hospital: recognising and responding to deterioration NICE guideline (CG50) , S., Yengej, F. Y., Limper, M., et al. 2017. How one plane crash changed the way we work. The Netherlands Journal of Medicine, 75(3) p98.Resuscitation Council UK 2010. Resuscitation guidelines. London: Resuscitation Council UK.Smith, M., Higgs, J. and Ellis, E. 2008. Characteristics and processes of physiotherapy clinical decision making: a study of acute care cardiorespiratory physiotherapy. Physiotherapy Research International, 13(4): pp 209-222.Thim, T., Krarup, N., Grove, E. L., Rohde, C. V. L?fgren, B. 2012. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. International Journal of General Medicine, 5: pp 117-21.Thomas, A. and Gill, R. 2015. FISEO, SPOT and ISPOT–full immersion simulation workshops for post graduate physiotherapy learning in acute care. Physiotherapy, 101(Suppl 1): e1509-e1510.Weed, L. L. 1971. Medical records, medical education and patient care: the problem oriented record as a basic tool. Annals of clinical Research 3(3): pp 131-4. ................
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