as applicable. Depending upon the clinical manifestations, mechanical ventilation may be required. The patient must be assessed for signs and symptoms of
pulmonary distress. The physiotherapist must be involved in the care conducting chest percussion, airway suctioning, incentive spirometer, turning the patient in the bed and if feasible mobilising out of bed to a chair (Holcome and Kern Feeley. A refractory metabolic acidosis with a pH < 7.1 would be an indicator to commence RRT