Rehabilitation After Traumatic Injury

Rehabilitation after traumatic injury Initial assessment and goal setting: Comprehensive evaluation: Assessment by a team of health professionals E.g. occupational therapists, speech therapists, psychologists etc. Helps assess and identify the patient’s specific needs, limitations and goals. Physical rehabilitation. Physical motion exercises: Maintain and improve joint motility. Strength exercises rebuild muscle strength -> especially after immobilisation or bed rest. Gait training For patients with lower extremity injuries, cerebral diseases, cerebellum diseases. Pain management Medications, heat, cold, electrical stimulations and manual therapy -> manage pain and reduce inflammation. Occupational therapy Helps patients regain ability to perform daily activities. E.g. dressing, bathing, cooking etc. Includes techniques such as: Adaptive techniques -> teaching patients how to modify tasks or use assistive devices to increase independence. Fine motor skill training -> injuries affecting hands and upper limbs and exercising focusing on improving anxiety and coordination. Home and workplace modifications. Speech and language therapy Patients with traumatic brain injury or injuries effecting speech and swallowing, therapy focuses on communication skills and safe swallowing techniques. Psychological and emotional support Psychological counselling Cognitive behavioural therapy Addresses negative thought patterns and behaviours that may hinder recovery. Support groups Pain management Medications such as: NSAIDS Opioids Muscle relaxants Nonpharmacological approaches. Techniques such as: Acupuncture Relaxation exercises Mindfulness Biofeedback Can be used alongside medications Rehabilitation for specific things Traumatic brain injury Need speech therapy Need cognitive rehabilitation, which may include: Memory tasks Problem solving tasks Strategies to improve concentration and attention. SCI Mobility support Management of spasticity Prevention of complications such as pressure sores. Assistive devices. Wheelchair training Adaptive techniques for daily tasks. Orthopaedic injuries Rehab focusing on restoring range of motion, strength and function in the affected areas. Depending on the injury: Immobilization may be initially needed followed by progressive exercises to regain function. Amputation Physical therapy to improve strength and balance. Prosthetic fitting and training Psychological support Home and community-based rehabilitation Home excise programs Tele-rehabilitation Virtual sessions Community reintegration Family and caregiver support Education and training Caregiver support Ongoing monitoring and adjustments Regular follow ups Long term rehabilitation Prevention of further injuries Education on risk factors Lifestyle modifications. Transportation of Trauma Patients Must be done ASAP and avoid delay. Must be accompanied by at least two healthcare professionals. At least one must be skilled in cardiopulmonary resuscitation and advanced airway management. Most patients are transported via an ambulatory care Monitoring during transportation Ventilators must be present Monitoring equipment Atrial oxygen saturation by pulse oxymnetry Respiration rate Heart rate ECG Non-invasive blood pressure monitoring Temperature U/S as indicated BSL ABG In an intubated patient -> end tidal CO partial pressure and ventilation parameters. Invasive haemodynamic monitoring is often used during intensive care transport. Syringe drivers