Clinical Case Studies Across the Medical Continuum for Physical Therapists (eBook)

Julie Skrzat, Sean Griech (Autoren)

eBook Download: EPUB

2021 | 1. Auflage
450 Seiten
Georg Thieme Verlag KG
978-1-63853-692-5 (ISBN)

Infos

<p><strong><em>High-quality clinical case studies provide robust physical therapy learning and teaching tool</em></strong></p> <p>Direct access legislation and a growing aging population has led to a greater number of people with medical complexities seeking physical therapy services. To ensure physical therapy students are adequately prepared to enter the demanding workforce, academic educators must provide clinical case studies that match clinical demands. <cite>Clinical Case Studies Across the Medical Continuum for Physical Therapists</cite> by distinguished editors Julie Skrzat and Sean Griech and an impressive group of expert contributors was developed with that goal in mind.</p> <p>Twenty medically complex case studies, each with three standalone cases covering three distinct clinical settings, are presented to show medical and physical therapy management throughout the continuum of care. These high-quality case studies cover all the body systems and detail conditions including chronic, neurological, oncologic, and traumatic, which closely mirror cases seen in clinical practice. Each case study includes extensive medical data from an interprofessional team, imaging/diagnostic tests, social history, and physical therapy information. The text promotes interprofessional education by requiring learners to consider elements beyond the physical therapy plan of care.</p> <p><strong>Key Highlights</strong></p> <ul> <li>The design of the case studies enables learners to understand disease evolution, progression of medical management, and the reasoning behind subsequent changes in physical therapy care plans</li> <li>Questions and answers encompassing all levels of Bloom's Taxonomy, coupled with pause points and key points, promote critical thinking and problem solving</li> <li>Six videos demonstrate how experienced clinicians respond to real-time clinical challenges with effective patient management strategies</li> </ul> <p>This must-have resource for doctorate-level physical therapy students promotes synthesis of information across all aspects of care. It provides a multidimensional representation of the patient, facilitating optimization of physical therapy plans of care, both in the classroom and clinic.</p> <p>This book includes complimentary access to a digital copy on <a href='https://medone.thieme.com/'>https://medone.thieme.com</a>.</p>

Textauszug

1 Adolescent Sports Injury

General Information

Case no.

1.A Adolescent Sports Injury

Authors

Christopher Tumminello, PT, DPT, EP-C Brian Eckenrode, PT, DPT, Board Certified Clinical Specialist in Orthopaedic Physical Therapy Ari Kaplan, PT, DPT, CSCS, COMT, Cert MDT, Board Certified Clinical Specialist in Sports Physical Therapy

Diagnosis

Knee dislocation with multiligamentous knee injury (KD III-MC)

Setting

On-field assessment and emergency room management

Learner expectations

☑ Initial evaluation ☐ Re-evaluation ☐ Treatment session

Learner objectives

1.Describe the management of an acute on-field knee injury. 2.Determine the need for immediate medical attention of a patient with an acute on-field knee injury. 3.Describe the appropriate tests and measures considered for this patient in the acute phase of injury.

Pre-case clarification

Physical therapy scope of practice

It should be noted that all physical therapists are not qualified to provide coverage of athletic events. The highest qualification physical therapists can obtain in order to be able to provide athletic venue coverage is through becoming a board-certified sports clinical specialist (SCS) offered through the American Board of Physical Therapy Specialties (ABPTS). Additional credentials for physical therapists to be able to provide on-field coverage include the certified athletic trainer (ATC) or emergency medical responder (EMR) certification.

Medical

Chief complaint

Instability and pain in left knee

History of present illness

While assisting with on-field coverage of a high school football game with an athletic trainer and sports medicine physician, a 16-year-old, right-handed male, who plays quarterback, sustained a traumatic left knee injury. The quarterback was dropping back to attempt a pass, when he transitioned his weight to his front leg (left leg) and sustained a hit from an opposing player to the anterolateral aspect of his left knee.

Past medical history

Asthma

Past surgical history

None

Allergies

Peanuts

Medications

Albuterol inhaler as needed

Precautions/Orders

N/A—on-field assessment

Social history

Home setup

●Lives with his parents, younger sister, and dog in a two-story home. ●Four steps to enter, with right handrail when ascending. ●Bedroom is on the second floor. ●Half bathroom on the first floor, and full bathroom on the second floor. ●Indoor stairs have handrails on both sides.

Occupation

●Full-time high school student. ●Busses tables at a local restaurant on the weekends.

Prior level of function

●Independent with all activities of daily living.

Recreational activities

●Starting high school quarterback in the fall. ●Starting shortstop for baseball in the spring.

Physical Examination: On-Field Assessment

Subjective

“My knee bent backward, and I definitely heard a pop. Pretty sure everyone heard it.”

Objective

Observation

●No head or neck trauma noted with injury. ●Player is alert and oriented to person, place, and time. ●No blood or open wound present. ●No obvious deformity to the left lower extremity. ●Effusion absent to the left lower extremity.

Neurovascular assessment

●Unable to detect a left popliteal artery, posterior tibial artery, or dorsalis pedis pulse. (Fig. 1.1). ●No temperature change noted to the distal left lower extremity. ●No complaints of numbness or tingling at this time to the left leg.

Musculoskeletal assessment

●Knee special testing was deferred due to acuity of injury, combined with the loss of pulses to the left lower extremity.

Treatment

●Given the current presentation and inability to bear weight through the left leg, and undetectable pulses, the left knee was immobilized on field. ●An ambulance was called for immediate transportation to the hospital.

Fig. 1.1 Areas of auscultation and palpation of the peripheral arterial pulses. (a) Auscultation areas. (b) Palpation points. (c) Palpation techniques. (Source: Vascular diagnosis. In: Steffers G, Credner S, eds. General Pathology and Internal Medicine for Physical Therapists. 1st ed. Thieme; 2012.)

Pause points

Based on the above information, what is the priority ●Diagnostic tests and measures? ●Outcome measures? ●Treatment interventions?

Vital signs

Hospital day 0: emergency department

Blood pressure (mmHg)

132/80

Heart rate (beats/min)

92

Respiratory rate (breaths/min)

16

Pulse oximetry on room air (SpO2)

98%

Temperature (°F)

98.6

Hospital Day 0, Emergency Room: Physical Examination

Subjective

“I got hit, and my left knee got bent backward and popped. It’s really hurting now.”

Objective

General

Observation

●Well-nourished fit high school male. ●Appears to have left knee pain, cognitively intact and answering questions appropriately. ●Left lower extremity pallor, right lower extremity was unremarkable.

Pain (left knee)

●8/10 currently

Palpation

●Left lower extremity slightly colder to touch compared to the right lower extremity.

Head, ears, eyes, nose, and throat (HEENT)

●(–) Congestion, sore throat or otalgia, denies head injury with hit during the game.

Cardiovascular and pulmonary

●(–) Chest pain, palpitations, dyspnea on exertion, edema, syncope, aspiration, shortness of breath, orthopnea ●(–) Cough, congestion, wheezing, or sputum production ●Lower extremity pulses: Right: 2 + throughout Left: femoral artery, 4 + ; popliteal artery, 0; posterior tibial, 0; dorsalis pedis, 0

Gastrointestinal

●(–) Abdominal pain, hematemesis, melena, nausea, vomiting, diarrhea

Genitourinary

●(–) Dysuria, frequency, urgency, blood in urine

Musculoskeletal

Range of motion

Right

Left

Unremarkable

Limited knee flexion and extension due to pain/acuteness of injury.

Strength (manual muscle testing)

●5/5 ankle dorsiflexion ●5/5 ankle plantar flexion ●5/5 ankle inversion ●5/5 ankle eversion

●1/5 ankle dorsiflexion ●1/5 ankle plantar flexion ●1/5 ankle inversion ●1/5 ankle eversion

Other

●Special tests (including ligamentous testing) of the left lower extremity were deferred due to loss of pulses and findings from diagnostic imaging.

Neurological

Balance

●Not assessed due to lower extremity injury.

Cognition

●Alert and oriented x four.

Coordination

●Not assessed at this time.

Cranial nerves

●II–XII:...

Produkt-Details

• Erscheint lt. Verlag: 17.11.2021
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete
• Themenwelt: Medizin / Pharmazie ► Pflege
• Themenwelt: Medizin / Pharmazie ► Pharmazie
• Themenwelt: Medizin / Pharmazie ► Physiotherapie / Ergotherapie ► Rehabilitation
• Themenwelt: Medizin / Pharmazie ► Studium
• Schlagworte: Acute Care • Differential Diagnosis • Emergency Department • Inpatient • interprofessional • medically complex • Outpatient • Rehabilitation
• ISBN-10: 1-63853-692-9 / 1638536929
• ISBN-13: 978-1-63853-692-5 / 9781638536925