medical_student:pt_ot_restrictions
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| medical_student:pt_ot_restrictions [2019/07/01 17:46] – [DIEP flaps] matt | medical_student:pt_ot_restrictions [2020/12/29 22:08] (current) – [Pedicled Gracilis Flap] jonathan | ||
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| * Once completed, copy and paste this information into a nursing communication “Activity Order” in Epic.\\ | * Once completed, copy and paste this information into a nursing communication “Activity Order” in Epic.\\ | ||
| * If a splint is required for your patient, enter a separate nursing communication order to specify type of splint requested and additional details (see Splint information below).\\ | * If a splint is required for your patient, enter a separate nursing communication order to specify type of splint requested and additional details (see Splint information below).\\ | ||
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| * Included on this page are the restrictions of the most common plastic surgery operations, as well as an inclusive list of all information that may be required.\\ | * Included on this page are the restrictions of the most common plastic surgery operations, as well as an inclusive list of all information that may be required.\\ | ||
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| * NWB: Non-weight bearing\\ | * NWB: Non-weight bearing\\ | ||
| - | ROM: Range of motion for specific extremity, plane or digit.\\ | ||
| - | ====Complete List of Information Options==== | + | ====Complete List of Possible Restrictions/ |
| - | * Range of Motion: [enter extremity(ies) | + | * Range of Motion: [enter extremity(ies), |
| * Weight-bearing: | * Weight-bearing: | ||
| * Elevation and Dangle: If continuous elevation required, state here. If dangle allowed (limb in gravity-dependent position), state [duration of time dangle allowed + number of times per day]\\ | * Elevation and Dangle: If continuous elevation required, state here. If dangle allowed (limb in gravity-dependent position), state [duration of time dangle allowed + number of times per day]\\ | ||
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| ====DIEP flaps==== | ====DIEP flaps==== | ||
| - | * Range of Motion: | + | * Range of Motion: |
| * Weight-bearing: | * Weight-bearing: | ||
| - | * Venous Flow Coupler: may be disconnected for no more than 10 minutes at a time.\\ | + | * Venous Flow Coupler: may be disconnected for no more than 10 minutes at a time\\ |
| * Walker use allowed: Yes, may rest hands gently on walker\\ | * Walker use allowed: Yes, may rest hands gently on walker\\ | ||
| * Additional Restrictions: | * Additional Restrictions: | ||
| Line 41: | Line 39: | ||
| ====Gynecomastia mastectomy==== | ====Gynecomastia mastectomy==== | ||
| - | No weight bearing greater than 10 lbs. No pushing or pulling. | + | * Range of Motion: |
| + | * Weight-bearing: | ||
| + | * Additional Restrictions: | ||
| ====Latissimus Pedicled Flap==== | ====Latissimus Pedicled Flap==== | ||
| - | Restrictions: | + | * Weight-bearing: |
| + | * Additional restrictions: | ||
| + | |||
| + | |||
| + | ====Pedicled Gracilis Flap==== | ||
| + | * Weight-bearing: | ||
| + | * Walker use allowed: Yes, if needed\\ | ||
| + | * Additional | ||
| + | * Post-operative activity pathway = POD 0: Bedrest; POD 1: Activity as tolerated\\ | ||
| - | ====Pedicle Gracilis Flap==== | ||
| - | Bedrest POD#0: | ||
| - | POD#1: Okay to begin working with PT/OT. Weight bearing as tolerated BLE. Must walk with legs shoulder width apart and not have thighs rubbing. Abduction pillow while in bed. No Abduction of surgical extremity. Keep surgical sites dry. Okay to use walker if needed. | ||
| ====Iorio Lower Extremity==== | ====Iorio Lower Extremity==== | ||
| Line 54: | Line 60: | ||
| Pain/ | Pain/ | ||
| - | ===Free ALT flap=== | + | ====Free ALT flap==== |
| - | Start dangles | + | * Dangles (limb in gravity-dependent position): Begin on day 2, unless in frame - further information pending\\ |
| + | * Additional Restrictions: | ||
| + | * Splint: Posterior splint required if no frame.\\ | ||
| + | * Post-operative activity pathway: pending\\ | ||
| - | ===Free muscle flaps=== | + | ====Free muscle flaps==== |
| - | PT/OT: Keep RLE elevated, NWB, POD#4 okay for bedside commode and chair. POD#6 okay for 5 minute dangles and advance. If no frame, | + | * Weight-bearing: |
| + | * Elevation and Dangles (limb in gravity-dependent position): Keep (involved extremity(ies) | ||
| + | * Splint: | ||
| + | * Post-operative activity pathway: POD 0-3: Bedrest, POD 4-5: out of bed to chair and commode with (involved extremity) elevated at all times, POD 6: Begin dangle protocol per above.\\ | ||
| - | ===Splints=== | + | ====Splints==== |
| - | we will put the splints | + | * If a patient requires a splint, an order set exists in Epic that will prompt you to enter necessary information needed by PT/OT before a splint can be fabricated. Follow instructions below to place appropriate order. Splints can often be complex, so usually at least one brief phone call in addition to placing Epic order will be required, however, entering this order will give PT/OT helpful initial information to get started.\\ |
| + | * For upper extremity splints: | ||
| + | * In Epic, go to patient' | ||
| + | * For lower extremity | ||
| + | * In Epic, go to patient' | ||
medical_student/pt_ot_restrictions.1562017600.txt.gz · Last modified: 2019/07/01 17:46 by matt