Physical and Occupational Therapy and COVID-19:
What We Really Need to Know
By: Catherine Valentino, OTD, OTR/L, MHS
It is fair to say at this point we are all aware of the growing impact of COVID-19 on our communities and clinics. It’s time to put those yearly PPE and Contamination in-services to use! As healthcare professionals we have been trained since school on handling contaminants while continuing to provide quality care, and our COVID-19 patients are no different. What is changing; however, is the necessity of early detection and utilization of standard precautions. The Centers for Disease Control (CDC) has easy to follow guides on all of the necessary precautions which are available in the resources below. If we take to heart and follow pre-screening and infection control protocols, we will be able to make huge impacts in slowing the spread of COVID-19.
Understanding the characteristics of this disease will help lead the way for safe patient handling. There can be up to a 14-day incubation period before symptoms develop which is why it is so important to practice good hygiene and sterilization in our clinics. Cascella et al (2020) report the highest risk of transmission to be from symptomatic individuals. As this disease is linked to our respiratory systems being cognizant of not touching any of our respiratory mucus membranes and not having our patient’s touch their mucus membranes is critical to stop the spread. We need to make sure we wipe equipment down between all contact (us or our patients) and keep treatment surfaces sanitary as well (tables, rails, mats, etc.). Proper hand washing procedures are the first line of defense to stop the spread of COVID-19. Patients who feel they may be symptomatic or have been exposed to COVID-19 should use face masks to protect against the spread of droplets from their respiratory tract.
Our immunocompromised patients and those with underlying comorbidities are at the highest risk for serious illness. Therefore, we must be extra vigilant for the key symptoms of COVID-19 including coughing, fever, and shortness of breath. Many centers are screening for fever upon entry and making hygiene stations mandatory as individuals walk through the door. This helps to lower the risk from individuals within our communities. For therapists working in the in-patient settings donning masks and eye protection throughout your shift as part of your PPE while caring for suspected COVID-19 patients is recommended by the CDC (2020). Screening at-risk patients and identifying symptomatic individuals will help us get supplies to units which have the highest needs. We are part of the screening process too. If you feel you are developing symptoms of COVID-19 be responsible and talk with your supervisors and get checked.
Tips for Fun and Successful Treatment:
We need to ensure that we deliver wonderful rehabilitation experiences to all of our patients during this time of crisis. Choosing treatment tools which are non-porous will help ensure good sanitation for both clinic and limiting patient to patient risks. Some patients prefer to see you disinfect surfaces in front of them again, and that it ok. Remember, we develop trusting relationships with our clients, so they are placing their wellbeing in our hands. Lead by example, practice good hygiene and work to calm their fears so they can get the most out of each session. The Centers for Medicare Services is working to streamline telehealth opportunities so we can continue to meet patients’ needs by all avenues possible.
There is no one treatment recommended for a COVID-19 patient from a rehabilitation perspective. We need to constantly be assessing the needs of our clients and identifying deficits in which we can develop skills and restore function. For our patients who are coming to us during this risky time continuing to meet their needs in the safest way possible is what it is all about. Follow your company guidelines and keep watch of the CDC updates for your safety and for the safety of your patients!
Resources for You and Your Clinic:
- Cascella M, Rajnik M, Cuomo A, et al. (March 8, 2020). Features, evaluation and treatment coronavirus (COVID-19). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554776/
- CDC Standard Precautions and Infection Control: https://www.cdc.gov/infectioncontrol/basics/standard-precautions.html
- CDC on COVID 19: https://www.cdc.gov/coronavirus/2019-ncov/index.html
- OSHA Guidelines for COVID-19 Management: https://www.osha.gov/SLTC/covid-19/
- PPE Guide for Healthcare Professionals: https://www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf
- The Whitehouse Guidelines for Managing the Spread of COVID 19: https://www.whitehouse.gov/wp-content/uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf
To learn more from Catherine Valentino, browse her Summit courses here!