Physical Therapy in the Medical Setting

Question 1

What is the general role of pediatric PTs in inpatient settings, including acute care and inpatient rehab?

Answer 1

• Pediatric PTs stabilize the child medically, minimize functional loss, and support rehabilitation during inpatient care.
• Transitioning to outpatient care ensures continuity.

Question 2

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Answer 2

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Question 3

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Answer 3

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Question 4

What are the different medical settings where pediatric PTs work?

Answer 4

• acute inpatient hospital (NICU, PICU, CICU, medical units)
• inpatient rehab
• outpatient/day rehab settings

Question 5

For acute care PT, what is the primary goal of therapy?

Answer 5

• Medically stabilize the child and minimize the loss of function during the inpatient stay.
• PT is not the primary reason for admission but aids overall recovery.

Question 6

What are common diagnoses seen in pediatric acute care?

Answer 6

• cardiology (CHD, heart failure),
• infectious diseases (osteomyelitis, COVID-19)
• hematology/oncology (SCD, cancers)
• nephrology (CKD, lupus nephritis)
• neurology (epilepsy, MS)
• orthopedics (scoliosis, falls, GSW)
• pulmonology (CF, RSV, pneumonia)

Question 7

What lines and devices are common in pediatric acute care?

Answer 7

• Common lines: Peripheral IV, central lines, arterial lines, feeding tubes.
• Devices: Oxygen support (nasal cannula, CPAP, BiPAP), ventilators, tracheostomy, ECMO, VAD, dialysis machines, wound VACs, chest tubes.

Question 8

What should a pediatric PT evaluation in acute care include?

Answer 8

• history
• objective measurements
• appropriate tests
• pain assessment (e.g., Visual Analog Scale, FACES, FLACC)
• plan of care

Question 9

What interventions are typically used in pediatric acute care PT?

Answer 9

• therapeutic exercises
• developmental activities
• ROM
• gait training
• early mobilization
• bracing
• splinting
• pain management

Question 10

What considerations are needed for transitioning a pediatric patient from acute care?

Answer 10

• ensure medical stability
• determine the appropriate setting
• discharge recommendations
• assess equipment needs

Question 11

For inpatient rehab, what are the criteria for admission?

Answer 11

• must be medically stable
• has not reached full potential for independence
• can benefit from therapy services
• can participate in 3 hours of therapy a day

Question 12

What objective measures are used for pediatric patients in inpatient rehab?

Answer 12

• Coma assessment: GCS, PCS, CRS-R.
• Cognitive and behavior function: Rancho Scale, COAT.
• Balance: Pediatric Berg Balance Scale.
• Tone: Ashworth, modified Ashworth, Tardieu, and BAD scales.
• Function: PEDI, PEDI-CAT, WeeFIM.

Question 13

What are the common interventions in pediatric inpatient rehab?

Answer 13

• improving function
• caregiver education
• therapeutic exercises
• developmental activities
• functional training
• bracing/splinting/casting

Question 14

What are the common discharge criteria for pediatric inpatient rehab?

Answer 14

• child reaches full potential for independence
• no longer needs comprehensive inpatient rehab
• can be cared for at home
• can access outpatient services

Question 15

What is outpatient/day rehab, and how does it differ from inpatient rehab?

Answer 15

Outpatient/day rehab is less intensive than inpatient care, focusing on specific activity limitations for a defined episode of care.