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medical_student:pt_ot_restrictions [2019/07/01 21:29] – [Free muscle flaps] mattmedical_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 Possible Restrictions/Precautions==== ====Complete List of Possible Restrictions/Precautions====
-  * Range of Motion: [enter extremity(ies) affected, degrees of motion allowed]\\+  * Range of Motion: [enter extremity(ies), digits affected; degrees of motion allowed for each digit in each plane]\\
   * Weight-bearing: [enter extremity(ies) affected, weight-bearing status of specified extremity(ies)]\\   * Weight-bearing: [enter extremity(ies) affected, weight-bearing status of specified extremity(ies)]\\
   * 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: No greater than 45 degrees in all planes of motion in bilateral shoulders\\+  * Range of Motion: Bilateral shoulder ROM no greater than 45 degrees in all planes, hips to remain flexed to at least 30 degrees at all times\\
   * Weight-bearing: BUE NWB\\   * Weight-bearing: BUE NWB\\
-  * 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: No lifting greater than 5lbs, no pushing, no pulling\\    * Additional Restrictions: No lifting greater than 5lbs, no pushing, no pulling\\ 
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-====Pedicle Gracilis Flap====+====Pedicled Gracilis Flap====
   * Weight-bearing: BLE WBAT\\    * Weight-bearing: BLE WBAT\\ 
   * Walker use allowed: Yes, if needed\\   * Walker use allowed: Yes, if needed\\
-  * Additional Restrictions: Must ambulate with with legs shoulder-width apart (no thigh to thigh contact), abduction pillow while in bed, no active abduction of surgical (involved) extremity, keep surgical sites dry.\\+  * Additional Restrictions: Must ambulate with with legs shoulder-width apart (no thigh to thigh contact), shuffle gait, abduction pillow while in bed, no active abduction of surgical (involved) extremity, keep surgical sites dry.\\
   * Post-operative activity pathway = POD 0: Bedrest; POD 1: Activity as tolerated\\   * Post-operative activity pathway = POD 0: Bedrest; POD 1: Activity as tolerated\\
  
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 ====Free ALT flap==== ====Free ALT flap====
-Start dangles on POD#2, unless in frame???? If no frame, patient needs OT for posterior splint to prevent equinis+  * Dangles (limb in gravity-dependent position): Begin on day 2, unless in frame - further information pending\\ 
 +  * Additional Restrictions: pending\\ 
 +  * Splint: Posterior splint required if no frame.\\ 
 +  * Post-operative activity pathway: pending\\
  
 ====Free muscle flaps==== ====Free muscle flaps====
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 ====Splints==== ====Splints====
  
-we will put the splints here+  * 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's chart > Manage Orders > in search bar, enter "UPPER EXTREMITY SPLINT FABRICATION/PROVISION" > fill out additional information > sign.\\ 
 +  * For lower extremity splints:\\ 
 +      * In Epic, go to patient's chart > Manage Orders > in search bar, enter "LOWER EXTREMITY SPLINT FABRICATION/PROVISION" > fill out additional information > sign.\\
medical_student/pt_ot_restrictions.1562030965.txt.gz · Last modified: 2019/07/01 21:29 by matt

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