Week 5

S: 44 year old indigenous male 3 weeks post collapse with left and right intraventricular bleeds and associated left sided hemiplegia. Past medical history included diabetes, obesity, hypertension, alcohol abuse, and smoking. The patient (pt) has no fixed address, occasionally stays with brother, pt unemployed. Current Glasgow coma scale score (GCS) of 3/15 trache in situ and oxygen saturation 98% on 2L of oxygen via swedish nose.

T: Perform appropriate assessment and treatment session for the patient.

A: I performed relevant assessments needed such as GCS, chest, passive range and tone assessment to direct my treatment. As the patient was in a stuperosed state, I was able to perform suctioning via trache, passive range to provide some proprioceptive input and stretching to avoid contractures due to abnormal tone. I then did rolling to provide vestibular stimulation as the patient was unable to be sat out of bed due to continual opening of bowels.

R: The treatment session was effective overall. I was able to clear secretions via suctioning allowing increased breath sounds throughout upon reausculatation.

E: I struggled with passive range exercises as the patient was obese, and also particularly because the patient was in a stuperosed state and had no voluntary control of any limbs, I found it physically demanding. I struggled to find an appropriate position to perform these exercises in without placing my back at risk.

S: I seeked help from the supervising physio. He was able to show me different ways of handling the patients limbs. However, it also was suggested by the physio that if it was too physically demanding, I would not be able to continue to see the patient. I was able to utilise these different positions effectively and safely and was able to continue to see the patient.