Physical Therapy PT Occupational Therapy OT Protocol

PLACE LABEL HERE PHYSICAL THERAPY (PT) / OCCUPATIONAL THERAPY (OT) PROTOCOL

The following orders will be implemented per physician order of PT or OT Consult. Orders with a “” are indicator choices and are NOT implemented unless checked. 1. Consult Physical Therapy (PT) if:

 Patient has had a substantial decrease from baseline function which interferes with ability to ambulate, transfer between bed and chair that is unlikely to resolve within 48 hours with treatment of an acute medical problem.

 Patient needs placement and disposition; notify physician and Case Manager of DME and discharge needs as soon as possible.

 PT may consult OT if indicated.

2. Consult Occupational Therapy (OT) if:

 Patient has had a decrease from baseline function in upper extremity strength or function which interferes with activities of daily living such as dressing or feeding self that is unlikely to resolve within 48 hours with treatment of an acute medical problem.

 Patient needs placement and disposition

 OT may consult PT if indicated .

3. Hold PT / OT for:

 New onset DVT or PE until anticoagulated for 24 hours.

 Unstable extremity due to fracture, recent surgery or vascular compromise (such as arterial insufficiency or DVT with ischemia evidence by cyanosis or pallor of the extremity)

 Unstable vital signs (BP < 90 systolic, pulse > 110 at rest) without physician approval

 Hypoxia (O2 saturation < 90% at rest or 88% with exercise) with supplemental oxygen unless approved by physician

 Oxygen supplementation with > 50% fiO2 (50% ventimask or higher)

 Troponin or other cardiac enzyme elevation that is being actively worked up or is thought due to a recent myocardial infarction (within 24 hours or active symptoms) without physician approval.

 New or unexplained chest pain or dyspnea

 Severe confusion or agitation which, in the therapist’s opinion, would be a significant risk to the patient or staff’s safety

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PLACE LABEL HERE PHYSICAL THERAPY (PT) / OCCUPATIONAL THERAPY (OT) PROTOCOL

 Other conditions based on the therapists or staff’s clinical judgement unless approved by physician

4. Resume PT / OT if:

 DVT or PE in patient with stable vital signs and O2 saturation and no evidence of limb ischemia (such as cyanosis or pallor), anticoagulated for > 24 hours

 Suspected DVT with technician confirmed negative venous study (ultrasound, etc.), unless evidence of limb ischemia

 Elevated troponin after approved by physician

 Other questions to be addressed by physician

______Date Time Physician Signature PID Number

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