Archive for December, 2007

Why do occupational therapists splint?

The above title was used as a search engine query to get to this blog.  I think that this is a good question.  Why do we splint?  Why not PT’s?  Or orthopedic technicians?

The obvious answer is that we make splints for functional purposes, whether it is an extension splint for a below knee amputation (I made my second one last week!), or a resting hand splint to prevent hand contractures. But this is not always consistent, as I’ve seen only PT’s making referrals for certain types of splints, such as multi-podus boots to prevent foot drop. The good thing is that when it comes to splinting, the occupational therapists are the ones that get called for the most part.

I enjoy splinting.  Back when I was a student, I made tens of foot-plates.  We had patients who had external fixators attached to their legs, and we would make foot-plates to prevent foot drop (multi-podus boots wouldn’t work as the ex-fix got in the way, see picture for example).  As my experience grows in acute care, I’d like to see my experience in splinting grow as well.  I am even considering specializing in splinting.

December 16, 2007 at 10:49 pm 8 comments

Working with comatose patients

Luckily, I don’t work with too many patients who are comatose, but I’ve had weeks where I will suddenly see 3 or 4 patients in one week who are comatose. This usually happens because the patient is for the most part medically stable, and they now need placement. Most facilities won’t accept patients without having some sort of level of care, so they call upon the therapists to determine what the patients can and cannot do.

What I find interesting is that for the most part, the exact same evaluation will take place from OT, PT, and SLP. My hospital seems to favor the JFK Coma Recovery Scale, and both the OTs and PTs use the scale as their evaluation. What ends up happening is that we both do the exact same thing based on the exact same scale, yet bill differently. And Medicare accepts this. If the patient was not comatose, Medicare would never pay for two disciplines to do the exact same thing. Go figure.

When the patient is comatose, it is obviously hard to complete ADLs, but we end up usually seeing what stimuli work to arouse the patient. Can the patient follow a 1-step command consistently (i.e. give a thumbs up)? Do they respond to pain? The link to the scale is here (pdf) and is for the most part self-explanatory, should you want to know more information.

December 16, 2007 at 10:30 pm Leave a comment

Blog neglect

I know, shame on me.  I have neglected this blog for more than two months.  I have a few ideas that I’ve been meaning to write about, so I hope to put them on the blog soon.  If I have any readers left, sorry for neglecting the blog!

December 16, 2007 at 10:29 pm Leave a comment


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