Posts filed under ‘PT’

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


This is a funny story about people who are absolutely clueless as to the role of occupational and physical therapy. Often, when orders are made for OT in acute care, PT is also requested as part of the consult. It doesn’t mean the patient even needs one or the other, but sometimes doctors just check it off as they go down the list of orders on the computer. Also, before some patients can go home, they need to be consulted by OT and PT.

Anyway, a fellow OT co-worker of mine was getting ready to see a patient who was awaiting approval from OT to be able to be discharged home when the nurse saw her coming. She got all excited and said, “OT/PT is here!” Mind you, it was just the OT that was there, but this nurse saw so many patients being treated by both OT and PT, they somehow all got rubbed into one word: OTPT!

August 28, 2007 at 9:03 pm 3 comments


Going along with the theme from the previous post, here are two of the most frequently asked questions that I (and I think most other OT’s) have been asked:

  • Is occupational therapy like physical therapy? (Variations: How is OT different than PT? OT is just another name for PT, right?)
  • So you help people find jobs?

No, we don’t help people find jobs (although some OT’s do work in vocational centers). I think that the best way to describe the difference between OT and PT is in the following quote I once saw:

“A Physical Therapist will teach you how to walk. An Occupational Therapist will help you get a date and enjoy the dance”

In other words, we take the basic skill of walking, and make it into something meaningful to the client.

March 20, 2007 at 11:02 pm 1 comment

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