On my surgical placement, i had to see a patient who was day 1 post op. He had an epidural insitu. My initial goal was to ambulate him when I saw him. Since he was attached to an epidural, it was necessary to check blood pressure in supine and standing, muscle strength and sensation in the LL's prior to walking the patient as a safety precaution.
In doing so, I found that he had slightly reduced sensation in his R LL and was unable to SLR with his R leg. Therefore, ambulating him would not have been a good idea, as he would have been at risk of a fall. I did not want to leave this patient without any physiotherapy input, so i decided to transfer the patient to a chair using a front on transfer, and did some deep br ex's, as sitting out of bed is a much better position for this patient than lying in bed.
THIS SCENARIO REAFFIRMS THE IMPORTANCE OF CHECKING THE SAFETY ASPECTS PRIOR TO STANDING A PATIENT UP. ALTHOUGH MOST OF THE TIME, IT WILL BE OK, SOME INCIDENTS HOWEVER, IF IT WERE NOT CHECKED THEN IT MAY BE UNSAFE FOR THE PATIENT. ALTHOUGH MY PLAN DID NOT GO AS I WANTED IT TO, I FEEL HE STILL HAD SOME BENEFIT FROM PHYSIO BY SITTING OUT OF BED. IN THE FUTURE, IF I AM UNABLE TO DO WHAT I INITIALLY PLANNED FOR THE PATIENT, I WILL COMPROMISE AND DO AS MUCH AS POSSIBLE WITH THE PATIENT, AS THIS WILL BE BETTER THAN NO PHYSIO TREATMENT.
2 comments:
I cant agree more i've done a placement on a medical ward and the patients you see often have more things going on than what they are in hospital for at this specific time so i found a lot of what you plan to do has to be modified and you have to make the compromise because doing something little is better then doing nothing at all
Well, I'll have to agree that my plans for patients most of the time does not fall through, I've had to modify treatment all the time and being on clinics had made me realise and learn to be flexible to be able to maximise each treatment session with the patient so that we achieve the goals set out for them.
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