2001 OPEN FORUM Abstracts
INTERDISCIPLINARYCO-TREATMENTS OVERCOME OBSTACLES TO PATIENT RECOVERY
Nancy Nathenson, RRT, MadonnaRehabilitation Hospital, 5401 South Street, Lincoln, NE 68506 Jackie Kiritsy, BFA in Ed., RRT, MadonnaRehabilitation Hospital, 5401 South Street, Lincoln, NE 68506
Approving Physician: Kenneth J.Cheloha, Jr., M.D., Lincoln Internal Medicine Associates, 2222 South 16thStreet, Suite A-300, Lincoln, NE 68502
This case involves a 51-year oldfemale with a history of chronic medical problems experiencing a rapid exacerbationof symptoms with severe functional decline. She was sent to both universityhospital and diagnostic hospital settings, but a definitive diagnosis couldnot be made. Some provisional diagnoses were polymyositis, dermatomyositis andciliac sprue. This is an unusual case because the patient presented at MadonnaRehabilitation Hospital in a completely dependent condition of an unknown etiology.Her lack of bed mobility was so severe she needed assistance to simply moveher head. She was in pain and totally dependent on the ventilator. In spiteof her poor functional status, she was alert, concerned, and frustrated withthe lack of progress she made through several hospitalizations. This case studyis important because it illustrates how an interdisciplinary approach can overcomeeven the most dramatic obstacles to patient recovery. Respiratory therapy (RT)took a leadership role with the team members by implementing co-treatment approacheswith physical therapy (PT), occupational therapy (OT), speech-language pathology(SLP), and neuropsychology. The respiratory therapist instructed the team memberson how to monitor oxygen saturations and respiratory status so they could safelyprogress therapies. Co-treatments were often scheduled with team members andthroughout many PT and OT sessions, RT?s monitored ETCO2, work ofbreathing, and O2 saturations. The neuropsychologist would also co-treatto help reduce patient anxiety as new interventions were introduced. The RTand SLP scheduled co-treatments to work on oral motor and laryngeal exercisesand interventions with a speaking valve to enable the patient to communicatemore easily. The rehabilitation literature indicates that co-treatments providean efficient means of treatment. In this case study, team members found thatco-treating and use of an interdisciplinary approach were the keys in solvingrecovery obstacles that could not be overcome by a traditional medical approach.The patient has fully recovered and returned to the community, driving her carand engaging in community activities.