a silly question

[picolo]

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hi there ,

I have a silly question ....can anyone tell me who are the main patient population in inpatient PM&R rotations ? and when you are on call what are the emergencies ?

 

[zwasfeli]

hi there ,

I have a silly question ....can anyone tell me who are the main patient population in inpatient PM&R rotations ? and when you are on call what are the emergencies ?

The power of google:
http://www.nrhrehab.org/Patient+Care/Conditions/default.aspx
but in short probably sci injury, neuro-rehab/stroke/tbi, amputees/ortho are large constituencies.
Also saw some cancer rehab and burns.

Emergencies:
I think the key for this is realizing when someone is "sick." "Sick" people need to go to the acute medicine floor via transfer (if your unit is attached like say at UW) or via ambulance (if you are at a free standing hospital like RIC). "Smelling" when someone is sick is what intern year is for, I suppose - your 95 year old woman with pneumosepsis, for example.

 

[lobelsteve]

The power of google:
http://www.nrhrehab.org/Patient+Care/Conditions/default.aspx
but in short probably sci injury, neuro-rehab/stroke/tbi, amputees/ortho are large constituencies.
Also saw some cancer rehab and burns.

Emergencies:
I think the key for this is realizing when someone is "sick." "Sick" people need to go to the acute medicine floor via transfer (if your unit is attached like say at UW) or via ambulance (if you are at a free standing hospital like RIC). "Smelling" when someone is sick is what intern year is for, I suppose - your 95 year old woman with pneumosepsis, for example.

Exceptions abound: While where I trained, we did not treat or try to rehab acutely ill people, there ar eprograms that run vent rehab units, do cardiac telemetry on the rehab, etc.

Not my idea of 2-3 hrs of multidisciplinary therapy when they are vent dependent or are with UA.

 

[rehab_sports_dr]

when I was a resident, the vast majority of my pages on call were for the same kinds of things that I was paged for as a medical intern- sleep medication, pain, random rashes, discrepencies in what medications that patients were supposed to take, etc.

The main difference was that I was less likely to give a phone order on the rehab ward, since the underlying impairments of the patients on the rehab ward meant that a seemingly simple thing like insomnia or tachycardia could be a precursor of something more serious.

As for the more serious on call issues, autonomic dysreflexia was the most common. And since you were dealing with patients who have baseline sickness (e.g., most stroke patients have multiple comorbidities), you would have the occasional heart attack, pneumonia, etc.

The final issue was late admissions. You wouldn't have admissions at 3am from the ER like you would as a medical intern, but you would have patients transferred late from far away hospitals.

Overall, it was clearly an easier and less stressful experience than medical internship, but there were also some legitimate medical issues.

 

[zwasfeli]

phone order

thank goodness for cpoe!

 

[SSdoc33]

I'm not sure I'd listen to anything NRH has to say....