Decision Making Flashcards
5 things to consider when trying to figure out a diagnosis
- Does this pt belong in PT
- Common conditions present atypically more often than uncommon conditions prestent at all
- Dx and assessment should not stop after the initial eval
- monitor response to ongoing rx
- Know when to progress/regress your treatments
Case Study: 25 yr old patient w/ PFP.
What factors should you consider when developing a treatment plan for this pt
Hx and PE
- Dx
- Prognosis
- Comorbidities
- Phases of Healing
- Stage of injury
- irritability estimate
What is a Dx
Process and result of evaluation info from the Hx and PE
What does the Dx typically drive
The hypothesis, treatment plan, and outcomes assessment, but all other factors are considered bc not all pts w/ the same dx are the same
Case Study: 25 yr old F with knee pain and your dx is PFP
What else do you need to know
Eval findings –> to develop hypothesis
What are ICD-10 codes
Guide that lists corresponding codes for dx impairments
What is the goals of an ICD-10 code
To select the code that describes treatment dx and not the medical dx
What is prognosis
Determining the level of optimal improvement that might be attained, and the amount of time requried
Case Study: 25 yo F with PFP
Consider these 2 scenarios:
- PMH: experienced runner, first episode of pain, onset of pain 2 wks ago
- PMH: Trying to get back into running, previous lateral release (surgery to lateral retinaculum) continued pain since, but most recently worsened over the past 2 wkss
Would your prognosis be the same?
- with PT rx
- without PT rx
The prognosis would not be the same because the patient that is an expereinced runner would most likely have a much shorter prognosis
What effect can comorbidities have
They can directly affect the severity of the diagnosis, thereby altering the prognosis
Case Study: 25 yo w/ PFP
Consider 2 scenarios
- PMH: runs 2-3x wk
- PMH: smoking 1 pack a day x 5 years, no regular excursive, 30lbs overweight
Would your treatment differ for these 2 people given the comorbidities
The treatment would differ because the pt that has the substantial comorbities would not be able to handle the same workload as the pt the has no comorbities
What is the first phase of healing
Inflammatory
Describe the Inflammatory phase
- 0-5 days
- Exudative phase
- Generic process that occurs - applies to any and all tissues
- qualitatively always the same
- Quantitatively variable based on extent of the injury and the ability of the body/tissue to respond
- critical first step of repair
What is the second phase of healing
Fibroplasia
Describe the fibroplasia phase
- 3-(21-28) days
- proliferative or repair phase
- new vessel formatino
- Collagen synthesis/lysis
- immature and weak cross links
- Random fiber orientation
- Gradual increase in tensile strength
- predominantly type III collagen