When to consult PM&R?

[fozzy40]

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I'm finishing up my PGY2 year in PM&R and will be starting consults. At my institution, the PM&R consult seems like a knee jerk consult with certain diagnoses i.e. spinal cord injury, traumatic brain injury, Stroke, Ortho.

I obviously know when a PM&R consult is necessary but it got me thinking. At your institution is there an algorithm or some sort of decision tree that inpatient services use to see if a PM&R consult may be necessary? If so, would you mind sharing?

Thanks again.

fozzy40

 

[BlackNDecker]

Here is a validated algorithm for evaluating a new patient with a musculoskeltal complaint. This has never failed me and I hope it helps you as much as it has helped me over the past year:

If it moves and it shouldn't --> consult Ortho
If it doesn't move and it should --> consult PM&R

 

[DrWBD]

Here is a validated algorithm for evaluating a new patient with a musculoskeltal complaint. This has never failed me and I hope it helps you as much as it has helped me over the past year:

If it moves and it shouldn't --> consult Ortho
If it doesn't move and it should --> consult PM&R

Outstanding!

 

[fozzy40]

I guess that that kind of gets at the point of my post. Is it primarily post surgical ortho patients that your institution consults PM&R for? Are there any other types of patients that you routinely consult PM&R?

Thanks for your input.

 

[angel80]

We have a nice inpatient physical rehab floor in our hospital. In order for the patient to be accepted into the rehab unit, PMR has to see them and accept the admission. I think about 90% of our consults to PMR are for that reason. As far as routine consults for things like CVAs, this isn't usually done. We get PT/OT, Speech, etc on board and usually don't need PMR (unless we want them to go to the inpatient rehab unit). We also consult them sometimes on patients that come in with intractable back pain who aren't surgical candidates, if we can't manage to get things under control. I can't speak for the surgery side of things (neuro, Ortho, etc.) because I don't admit those patients.