Case Study Presentation Notes

"CT" is used to provide the patient with confidentiality abiding with___() . As a "student practioner, it is especially vital to align with CSP values demanding ___ and ___ within the ___ ().

Present Condition: Major Trauma (fall), #ribs 5- 10 Right, 7 Left, Small pneumothorax Right, Chronic Pancreatis, HAP, Delirium, Aspiration.

Previous Medical History: AF, Hypothyroidism, Vitamin B12 Deficiency, Pancreatis, Perpheal neuropathy, History of Falls.

Social History: Lives alone, anxiety, Alcohol Excess, Depression, Bilateral Deafness.

Drug History:

Additional Details: *DNACPR*

Initial Problem List

1. pain

2. cognition

3. mobility

4. Sudden onset of chest pain ^[1]

5. Dyspnoea - shortness of breath, Tachycardia - increased heart rate, Tachypnoea - increased respiration rate

6. Dry cough, Sputum Retention, Diminished Air Entry

7. Fatigue

8. anxiety, use of accessory muscles

9. Hypotension

10. Risk of Subcutaneous emphysema

11. Risk of falls

12. Risk of deterioration (due to thoracic complications)

Deterioration and Hospital Acquired Pathologies

1. Increased WCC, CRP

2. Delirium

3. Aspirations recognised during clinical exchange (cough on swallow)

4. HAP

Assessments

1. Subjective Assessment: Experience, Pain, Sleep, Hydration, Mobility, Pre-trauma

2. A-E: Auscultations, Expansion, Palpation

3. Risk Assessment (Mobility, Dementia, Falls)

Interventions

4. Positioning

5. Deep Breathing Exercises (ACBT): focused on breathing control, inspiratory hold, Huffing Technique

6. Transfers (STS, Lying-to-SOEOB, SOEOB-to-stand, SOEOB to Rotunda)

7. Marching on the Spot (MOS)

8. Mini-Squats

9. Gait

Multi-disciplinary Care

1. Nursing Staff

2. Occupational Therapist

3. Ward Physician

4. Surgeon

5. Speech and Language Therapist (SALT)

Transfers

1. Offsite Care

Abbreviations:

#: Fracture

AF: Atrial Fibrillation

ARDS: Acute respiratory distress syndrome

DNACPR: Do not Attempt Cardiopulmonary Resuscitation

HAP: Hospital Acquired Pneumonia

Presentation References to move across

1. CSP: https://www.csp.org.uk/frontline/article/spotlight-physio-case-studies "case studies in the spotlight"

2. SHU: https://docs.google.com/document/d/1Rt7Z1ahrxsRC9Nnr4qaCFXHZuKu1ow_ZynclB5sQl2U/edit "Mark Scheme"

3. ACBT: The Active Cycle of Breathing Techniques. Association of Chartered Physiotherapists in Respiratory Care. Leaflet no.GL-05.Available at http://www.acprc.org.uk/dmdocuments/GL-05%20ACBT.pdf↑ ^{Jump up to:8.0 8.1 8.2 8.3 8.4}