Reasons to Perform Medical Screening - Class 2 Flashcards
reasons to perform a medical screening
direct access
“quicker and sicker”
a signed prescription
progression of time and dz
pt/client disclosure
yellow or red flags
direct access
if we are the pt’s first contact with a HCP
we have the primary responsibility to screen for medical dzs
“quicker and sicker”
used to describe pts in today’s health care environment
quicker refers to
how health care delivery has changed in the last 10 years
how health care delivery has changed in the last 10 years
warning signs may come in the form of reported sxs or observed signs
it could also be clinical presentation that does not match the recent history
sicker refers to
fact that pts in all settings may be a significant PMH
of people w/ at least 1 chronic dz or diability
reaching epidemic proportions
according to the national institute of aging
79% of adults over 70 have at least one of the 7 disabling chronic conditions
7 disabling chronic conditions
arthritis
hypertension
heart dx
DM
respiratory dz
stroke
cancer
what kind of pts are d/c fater
hospital
out pt surgery is more common w/
same day d/c for procedures that in the past would have required 7-10 day hospital admission
when should PTs have an alert for red flags
pts d/c from hospital early
signed prescription
from a physician or other HCP
what do we have to keep in mind with a signed prescription
that may not have actually seen or been examined by the physician
medical specialization
d/t increasing specialization of medicine
d/t increasing specialization of medicine
pts may be evaluated by a medical specialist who doesn’t immediately recognize the underlying systemic dz
or
specialist may assume PCP has ruled out other causes
progression of time and dz –> in some cases
early S&S of systemic dz maybe difficult or impossible to recognize
when may S&S of system dz be noticable
dz has progressed enough to create distressing or noticeable sxs
how pts present to the physician may be
very different from what the therapist observes when days, weeks, or longer separates the 2 appointments
we must ask –> progression
did you have this when you saw the dr
as a PT –> progression
we must know what questions to ask
what medical conditions that could cause shoulder, back, thorax, pelvic, hip, sacroiliac and groin pain
what do we have to be familiar with –> progression
RF of various dzs, illnesses and conditions
RF of various dzs, illnesses and conditions
important tool for early recognition in the screening process
pt/client disclosure
pt may tell the PT things about their current health status and social history unknown or unreported to the physician
what might this new info be important –> disclosure
clues that point out a systemic illness or viscogenis cause of MS or NM impairment
why might a pt tell a physician something
forgetfulness
fear
embarrassment
identifying yellow or red flags
large and important part of the screening process
yellow flag
cautionary symptom
signals “slow down” and thing about the need for screening
red flag
required immediate attention
to pursue further screening questions
+/or
tests or to make an appropriate referral
how must the pt be views
context of a whole person
what should be given by the pt
age
gender
PMH
known RF
medication use
current clinical presentation
presence of one yellow or red flag
not usually cause for immediate medical attention
what should the PT consider when making a treatment v. referral decision
the history
presenting pain pattern
possible associated S&S
results of the objective examination
medical conditions can cause
pain
dysfxn
impairments
pain, dysfxn, impairments of the
back/neck
shoulder
chest/breast/rib
hip/groin
SI/sacrum? pelvis
what should always raise suspicion
bilateral pain –> systemic problem
require further investigation
primary areas of referred viscerogenic pain
back and shoulder
