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Young Adult - Comp Exam > Specialty Seating > Flashcards

Specialty Seating Flashcards

1
Q

Appropriate Seating

A

Improves QOL

facilitates community integration

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2
Q

Inappropriate Seating

A

Contributes to disability

barriers to independence, mobility

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3
Q

what is specialty seating

A

WC base
cushion
backrest
casters and rear wheels
armrests
drive mechanisms (power)
accessories

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4
Q

WC base - Manual

A

K1-4 are not meant for everyday use - not long term or customizable

K5 (ultralite) and above is meant for everyday, community ambulation

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5
Q

WC base frames

A

folding frame vs rigid frame

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6
Q

WC base - power mobility

A

not a scooter or basic electric wheelchair

power tilt and/or recline options

rear, front, midwheel drive

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7
Q

power recline is not for

A

pressure relief

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8
Q

power recline is for

A

people who self-dress and self-catheterize

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9
Q

common pressure areas

A

occiput - head support

scapula and spinous processes - back support

elbow - UE supports

greater trochanter, sacrum, coccyx, and ischial tuberosity - seat support along with back support to maintain proper positioning of the trunk and pelvis

heels - LE supports

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10
Q

pressure mapping

A

looking for hot spots to make adjustments via pressure relieving cushions

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11
Q

caster size determines

A

resistance, terrain considerations

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12
Q

steps in seating process

A
  1. identify need
  2. medical referral
  3. physical exam
  4. WC eval
  5. equipment recommendations/selection
  6. medical necessity justification/funding
  7. product delivery, fitting
  8. follow-up maintenance and repairs
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13
Q

seating steps 4-7 takes about how long

A

3 months

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14
Q

MD role in seating process

A

documents dx

face-to-face eval

makes referral for specialty seating

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15
Q

PT/OT role in specialty seating

A

identify need (NSG)

complete physical assessment

work with ATP

document medical necessity

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16
Q

ATP role in specialty seating

A

assistive technology professional

works with PT in WC eval

identifies appropriate equipment components

guides process

17
Q

Pt/Family role in seating selection

A

input on needs, preferences, resources

18
Q

New WC user needs

A
  1. non ambulatory
  2. ambulation non-functional or poses risks
    - decreased safety, increased fall risk
    - requires assistance
    - unable to consistently ambulate (look at 24hrs)
    - endurance limits ambulation
19
Q

current WC user needs

A

wc > 5yrs old

doesnt meet needs

in disrepair

change in function

20
Q

obtaining specialty seating referral

A

MUST have MD specialty seating referral for WC eval to proceed

secondary face-to-face session
- IPR: daily rounds
- OP must visit MD (psychiatrist)

make medical dx

qualifying dx (ICD10 code) necessary but not sufficient for WC payment

21
Q

physical exam for specialty seating

A

often interdisciplinary - NSG, PT, OT, RT

what do we need to examine?
- medical dx/chief complaint
- PMH
- family/social support
- home setup: steps, multiple levels, doorway width, floor materials, outdoor terrian
- transportation
- cognition

if existing WC user - current equipment assessment
- what works/doesn’t work
- patterns of wear

functional assessment - transfers, ambulatory status, ADLs, pressure relief

ambulatory pt’s can qualify for WC - must demonstrate need

22
Q

performance on WC trial - show two things:

A

pt CANT function with LESS than you’re asking for

pt CAN function with what you’re asking for

23
Q

physical exam eval

A

sensation
skin integrity
pain
posture/alignment
balance
strength
ROM
NM status - tone, reflexes, motor control

24
Q

flexible postural deficits

A

correct with seating

25
Q

fixed postural deficits

A

accommodate with seating

26
Q

what role does our documentation play

A

present eval findings

ID pt problems and potentials

specify goals of positioning/mobility intervention

specify recommend tech features

provide medical rationale for each feature

27
Q

WC eval and recommendations

A

seating clinics vs general clinic setting

need 3 parties: ATP, PT, patient/family

28
Q

must have these measurements for specialty seating

A

shoulder width
chest width
hip width
top of shoulder
inferior angle of scapula
upper leg length
lower leg length

29
Q

the WC eval

A

APT measures pt on mat
- body segment lengths
- ROM
- sitting balance
- postural deviations - fixed or flexible

PT +/- OT discuss clinical findings

discussions with pt/family

recommendations made per clinical findings and pt/family preferences

30
Q

justifications, medical necessity

A

APT makes recommendations, but seating eval documentation must be completed by licensed therapist

must justify all seating components relevant to pt

our documentation forms the bulk of this process

seating request reviewed by panel of HCPs
- MD, nurses, PTs

31
Q

product delivery/fitting

A

pt discharges with loaner chair

APT responsible for these steps

32
Q

maintenance/upkeep

A

WCs require maintenance - through APT

pr qualifies for new equipment:
- every 5 years
- with a documented change in function

33
Q

C4 and above SCI WC prescription

A

power WC

+ independent mobility, pressure relief

  • heavy, transportation/space requirements
34
Q

C5/6 SCI WC prescription

A

power-assist manual WC vs power

may propel but strength/endurance limits

35
Q

C7 and below SCI WC prescription

A

manual ultra-lightweight WC

folding vs rigid frame, minimize weight

36
Q

L3/4 SCI WC prescription

A

may use ultralight WC for daily use

para walking with equipment - EE, speed, safety issues

37
Q

pressure relief time recommendations

A

1 min per 15-30 min in WC

38
Q

Pressure Relief in WC

A

cushions help but pressure relief is critical

C5 and above - power tilt

C5-6 - lateral/front lean

C7 and below - lateral front lean or pushup
- encourage other pressure relief techniques, especially in strong patients

Young Adult - Comp Exam (10 decks)

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