RE: day of surgery, TKR and THR

[Guest guest]

Most of the newer aggressive surgeons in our area want them out of bed same

day and either partial or full weight bearing.

Bubba Klostermann OT, CVE, CEAS

CEO, WORK & REHAB

4546 South 14 th

Abilene, Texas 79605

phone:

fax:

email: bubklo@...

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[Guest guest]

Eileen,

We are getting some of our total joints started day of surgery. Usually

these are first cases and each of our docs are different. We do start

all of them am of post op day 1.

Mandy Volk, MPT

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

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[Guest guest]

Nursing gets our patients up to side of bed, sometimes to the chair.

Since we use general anesthesia, our surgeons are in agreement that the

patients could not tolerate more activity on the day of surgery (due to

nausea etc.)

Irene Bartlett, Rehab Director

Mercy-Des Moines

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

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_______________________________________________________________

[Guest guest]

We actually just met on this today. Our new recommended protocol is for OOB on

day of surgery.

Redge L MS OTR/L

Director of Rehabilitation Services

on Medical Center

Bremerton, WA 98310

Administrative Assistant:

Wanda Kotte: wandakotte@...

on Medical Center

We make a positive difference in people's lives through exceptional medical care

>>> ecasey@... 5/12/2006 8:12 AM >>>

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

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company accepts no liability for any damage caused, directly or indirectly, by

any virus transmitted in this email.

_______________________________________________________________

[Guest guest]

We are getting our minimally invasive knees and hips up with PT

evaluation the day of surgery, but it is not a blanket order. The

physician chooses which day to start. If the surgery goes well and the

patient is relatively stable, he usually orders OOB same day.

Proffitt, PT

Aultman West Therapy Services

Massillon, OH

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

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company accepts no liability for any damage caused, directly or

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_______________________________________________________________

[Guest guest]

Eileen,

We have a Total Joint Center and the patients are assisted to stand on the

evening of the surgery. Due to the time of surgery some patients are not ready

to stand until 8,9,or even 11pm. For this reason we presently have nursing stand

the patient up. The procedure is mainly to get them up on their feet and maybe

go the bathroom. Not really for gait training at that time. We then start the

next am.

Gerald Appelhans

Rehab Services

Stormont-Vail Healthcare.

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

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should check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or indirectly, by

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_______________________________________________________________

[Guest guest]

We make every attempt. It's part of our pathway to do so but depending

on the time of day (patient's are recovered before we leave) and how the

patient feels (usually nauseous) sometimes we don't succeed.

Lori Stoddart, OTR

Inpatient Rehab Services

Henry Ford Wyandotte Hospital

MI

Lori

>>> ecasey@... 5/12/2006 11:12 AM >>>

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our

care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

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confidential information and is intended solely for the use of the

individual or entity to whom it is addressed and may be subject to legal

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not necessarily represent those of the company. The recipient should

check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or

indirectly, by any virus transmitted in this email.

_______________________________________________________________

[Guest guest]

Typically not however we have one MD who always writes the order. We find

the biggest difficulty is the spinal blocks making the patients leg(s) numb

-- they simply cannot feel their legs to be able to perform mobility the day

of surgery. We begin the morning after surgery.

Leonard, PT

Clinical Mgr PT/OT

St ph Medical Center

KC, MO

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

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confidential information and is intended solely for the use of the

individual or entity to whom it is addressed and may be subject to legal

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notify your system manager. Please do not copy it for any purpose, or

disclose its contents to any other person. The views or opinions presented

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any attachments for the presence of viruses. The company accepts no

liability for any damage caused, directly or indirectly, by any virus

transmitted in this email.

_______________________________________________________________

[Guest guest]

One physician's TKR (quad sparing procedure) patients walk up to 150' with

standard cane same day of surgery.

Carol Rehder, PT

Manager, Physical Therapy

Genesis Medical Center

rehder@genesis@...

>>> ecasey@... 5/12/2006 10:12 AM >>>

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the individual or

entity to whom it is addressed and may be subject to legal privilege. If you

have received this e-mail in error you should notify the sender immediately by

reply e-mail, delete the message from your system and notify your system

manager. Please do not copy it for any purpose, or disclose its contents to any

other person. The views or opinions presented in this e-mail are solely those of

the author and do not necessarily represent those of the company. The recipient

should check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or indirectly, by

any virus transmitted in this email.

_______________________________________________________________

[Guest guest]

Most of our TKR and THR patients have epidural catheters for 48 hours after

surgery. We do not attempt to get these patients out of bed until the

epidural is removed. Consequently it is post-op day 2 before our patients

get up.

Jerel West

Natchez Regional Medical Center

Natchez, MS

day of surgery, TKR and THR

> For those of you in acute care, does anyone get their TKR and THR

> patients OOB the day of surgery? We are in process of updating our care

> plans and the Orthopods are pushing for OOB immediately after surgery.

> Just wondering what other facilities are doing. Thanks in advance.

>

>

>

> Eileen Casey, PT

>

> Dir. Rehab Services

>

> Brattleboro Memorial Hospital

>

> Tel:

>

> Fax:

>

>

>

>

>

>

> _______________________________________________________________

>

> The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the

individual or entity to whom it is addressed and may be subject to legal

privilege. If you have received this e-mail in error you should notify the

sender immediately by reply e-mail, delete the message from your system and

notify your system manager. Please do not copy it for any purpose, or

disclose its contents to any other person. The views or opinions presented

in this e-mail are solely those of the author and do not necessarily

represent those of the company. The recipient should check this e-mail and

any attachments for the presence of viruses. The company accepts no

liability for any damage caused, directly or indirectly, by any virus

transmitted in this email.

> _______________________________________________________________

>

>

>

>

[Guest guest]

TKR and THR are up on POD #1, or day after surgery. Occasionally we will have a

manipulation under anesthesia, or ACL reconstruction done in morning and they

will order PM PT for OOB.

Sherri Welch, PT

McAlester Regional

McAlester, OK

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the individual or

entity to whom it is addressed and may be subject to legal privilege. If you

have received this e-mail in error you should notify the sender immediately by

reply e-mail, delete the message from your system and notify your system

manager. Please do not copy it for any purpose, or disclose its contents to any

other person. The views or opinions presented in this e-mail are solely those of

the author and do not necessarily represent those of the company. The recipient

should check this e-mail and any attachments for the presence of viruses. The

company accepts no liability for any damage caused, directly or indirectly, by

any virus transmitted in this email.

_______________________________________________________________

[Guest guest]

TKR's are up post op day (in the afternoon), but not all the orthos follow

this protocol. New for us in the last 6 months

Ron Barbato PT

Corporate Director, Rehabilitation Services

Ephraim McDowell Health

Voice:

Fax:

rbarbato@...

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the

individual or entity to whom it is addressed and may be subject to legal

privilege. If you have received this e-mail in error you should notify the

sender immediately by reply e-mail, delete the message from your system and

notify your system manager. Please do not copy it for any purpose, or

disclose its contents to any other person. The views or opinions presented

in this e-mail are solely those of the author and do not necessarily

represent those of the company. The recipient should check this e-mail and

any attachments for the presence of viruses. The company accepts no

liability for any damage caused, directly or indirectly, by any virus

transmitted in this email.

_______________________________________________________________

[Guest guest]

I guess my question would be what is the length of stay on those patients who do

mobilize same day? Does it impact or shorten their length of stay?

Melisssa Berry

Salem Oregon

>>> bubklo@... >>>

Most of the newer aggressive surgeons in our area want them out of bed same

day and either partial or full weight bearing.

Bubba Klostermann OT, CVE, CEAS

CEO, WORK & REHAB

4546 South 14 th

Abilene, Texas 79605

phone:

fax:

email: bubklo@...

This e-mail and any files transmitted with it are the property of WORK &

REHAB, are confidential, and are intended solely for the use of the

individual or entity to whom this e-mail is addressed. If you are not

one of the named recipient(s) or otherwise have reason to believe that

you have received this message in error, please notify the sender and

delete this message immediately from your computer. Any other use,

retention, dissemination, forwarding, printing, or copying of this

e-mail is strictly prohibited.

[Guest guest]

I have been following this thread and while I fully understand the desire to

wonder what other therapists are doing in terms of treatment protocol, I

find it curious that no one has established or asked what the evidence is

regarding immediate post op TKR protocols. Is anyone aware of any

established evidence regarding the change in outcome or efficacy in getting

TKR patients out of bed the day of surgery? It seems to me that is where

our clinical conversations should be centered, not necessarily on what other

people are doing.

My 2 cents,

Mark F. Schwall, PT

www.futurephysicaltherapy.com

day of surgery, TKR and THR

For those of you in acute care, does anyone get their TKR and THR

patients OOB the day of surgery? We are in process of updating our care

plans and the Orthopods are pushing for OOB immediately after surgery.

Just wondering what other facilities are doing. Thanks in advance.

Eileen Casey, PT

Dir. Rehab Services

Brattleboro Memorial Hospital

Tel:

Fax:

_______________________________________________________________

The information contained in, or attached to, this e-mail, may contain

confidential information and is intended solely for the use of the

individual or entity to whom it is addressed and may be subject to legal

privilege. If you have received this e-mail in error you should notify the

sender immediately by reply e-mail, delete the message from your system and

notify your system manager. Please do not copy it for any purpose, or

disclose its contents to any other person. The views or opinions presented

in this e-mail are solely those of the author and do not necessarily

represent those of the company. The recipient should check this e-mail and

any attachments for the presence of viruses. The company accepts no

liability for any damage caused, directly or indirectly, by any virus

transmitted in this email.

_______________________________________________________________