Clinic management

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• Who should assess the wound


  Any practitioner who cares for a patient with a wound must possess the necessary skills to accurately assess and understand the results of those assessments, allowing development of an appropriate, evidence-based treatment plan
• Ousey, 2012: 'Any practitioner who cares for a patient with a wound must possess the necessary skills to accurately assess and understand the results of those assessments, allowing development of an appropriate, evidence-based treatment plan'
• Leading causes of death in the US


  • Heart disease
  • Cancer
  • COVID-19
  • Accidents
  • Stroke
  • Chronic Lower Respiratory Disease

  
• Leading causes of death in the US (2019)


  • Heart disease
  • Cancer
  • Accidents
  • Chronic Lower Respiratory Disease (lung disease)
  • Stroke
  • Alzheimer Disease

  
• Hypertension (HTN)


  High blood pressure 140/90 or higher
• HTN increases risk of


  Coronary artery disease (CAD), Myocardial infarct (MI), and Cerebral Vascular Accident (CVA)

  
• Atherosclerosis


  Progressive disease, arterial thickening and hardening, caused by Hypertension, high cholesterol, tobacco use, diabetes, obesity
• Arteriosclerosis


  Increased lipids, cholesterol that restricts blood flow
• Stable and unstable Angina


  Immediate medical attention is imperative if this lasts longer than 15 minutes or medicine is not effective
• Electrocardiography (EKG)


  Test to measures the heart's electrical activity

  
• Signs of a heart attack (MI)


  • Some people are asymptomatic
  • Chest pain and pressure or squeezing
  • Radiating into the jaw, shoulders, left arm, or upper back
  • Dyspnea, diaphoresis, nausea, syncope and impaired cognition

  
• Differences between men and women in signs of heart attack

  • Women are more likely to report SOB, nausea, vomiting, back pain, jaw pain, cough and fatigue
  • Men more likely to report chest pain and sweating

  
• Cardiac Rehabilitation Treatment


  1. Acute- 1-3 days post MI, working to medically stabilize the client

  2. Phase 1

  3. Phase 2, Inpatient cardiac rehabilitation, Monitored low-level physical activity (Self-care), energy conservation techniques

  4. Phase 3, Outpatient cardiac rehabilitation, Physician-directed, exercise-based program, lifestyle modification, medical therapy
• Borg Rate of Perceived Exertion Scale


  A way to measure the intensity of activity based on how the client feels

  
• Sternal precautions


  • Do not lift more than 8 #
  • Do not bring elbows above shoulders
  • Do not push or pull with your arms
  • Avoid twisting or deep bending
  • Hug a pillow when you cough
  • REPORT CLICKING OR POPPING NOISES TO THE CARDIOLOGIST
• Congestive Heart Failure (CHF)


  • The inability of the heart to pump blood due to impaired structures or function of the ventricles
  • CHF can be acute or become chronic
  • This disease decreases activity and mobility which then progresses the disease and contributes to other health issues

  
• MET Values


  The amount of O2 required for a given activity
• Orthostatic hypotension


  A drop in systolic blood pressure and hypotension of treater then 10 mmHg with a change in position from supine to sitting or sitting to standing
• Dyspnea


  Shortness of breath
• Hypoxemia


  Abnormal low O2 in the blood
• Oxygen saturation


  Blood O2 levels, normal is 95%
• Pulmonary function test


  Assess gas exchange
• Emphysema


  A medical condition in which the alveoli are gradually damaged
• Chronic Bronchitis


  The bronchial airway becomes inflamed, leading to increased mucus production, cough and airway obstructions
• Chronic diseases linked to smoking


  • Stroke
  • Aortic aneurysm
  • CHD
  • APAD
  • COPD
  • Pneumonia
  • Cataracts
  • Reproductive effects in women
  • Early abnormal aortic atherosclerosis
  • Diabetes
  • Erectile dysfunction
  • Rheumatoid Arthritis
  • Immune function
• Smoking is on the decline in the U.S. but there are disparities in smoking based on race, geographic area, socioeconomic status, mental health
• People with insurance are more likely to have smoking cessation counseling than uninsured, Hispanic

  
• Chronic Obstructive Pulmonary Disease (COPD)


  • Causes irreparable lung damage, irreversible airflow obstruction decreasing gas exchange
  • Umbrella term for progressive lung disease
  • Includes emphysema, chronic bronchitis
  • They tend to have higher rates of depression

  
• The Borg Rate of Perceived Exertion Scale


  A way to measure the intensity of activity based on how the client feels

  
• METS and Borg do not really correlate
• OTs role with cardio and pulmonary clients


  • Prevention
  • Cognitive interventions
  • Rehabilitation
  • Maintenance
  • Adaptation
  • Modification
• I have the following relevant relationships in the products or services described, reviewed, evaluated or compared in this presentation.
• Continuing Education


  • Nationwide Events
  • Online Learning
• Our nationwide continuing education program allows you to pick and choose the courses that work best for you–anytime, anywhere.
• Continuing Education Program


  • Evidence-based courses
  • Expert instructors
  • Collaborative learning
• Improving patient outcomes through collaborative learning for professionals who care for O&P patients.
• We host a variety of professional events that provide extensive, in-depth, and hands-on training to learners across the country.
• Healthcare professionals are invited to learn alongside our expert clinicians and to take part in education focused on advancing their understanding of the world of O&P and how we can improve patient outcomes together.
• With several live and recorded webinar options, we're able to offer continuing education credits for many types of healthcare and medical professionals, including, physicians, therapists, and O&P clinicians.