describe the history of lung transplants
candidates - general indicaition for lung transplants
candidates - absolute contraindications for lung transplants
candidates - relative contraindications for lung transplants
describe the evaluation process for lung transplants
describe what the initial Pt assessment does
Explanations of the LT/HLT process from physio perspective (pre, post, out-patient)
Information about current and past levels of physical activity limitations
Clinical impression of patient’s candidature
what are the factors affecting the wait times for lungs?
what would allow a pt to go on the emergency transplant list?
what is the organ donor per million people died in canada compared to other countries?
what are top causes of death of donor organs and reasons of refusal
describe the PHYSIOTHERAPY FOLLOW-UP DURING WAITING TIME
describe the surgery - frequency and duration
describe the lung transplant
describe the heart-lung transplant
scars from transplants
intensive care - how long do you stay there, PT intervention, extubation
what is the post-op meds like?
what are specific post-op complications for lung transplants?
what are other complications for lung transplants?
what are the sectors, what is the frequency, duration, and intensity?
describe physio in intensive care
- From medical stabilization
- Without a prescription
- Discussion with the medical team in doubt
- Fields of treatment (Ventilation, Secretions, Mobility)
- Pt on mechanical ventilation (VS or VAC mode) (Deep breathing)
- Once extubated:
¤ Incentive inspirometer (5 min/hour)
¤ Coughing with splinting
¤ Active mobilisations UE’s and LE’s
¤ Sitting in bed -> on the edge of the bed -> in the chair
¤ Walking with rolling walker (Equipment management)
describe when the pt transfers to the transplant unit from intensive care
describe transplant unit interventions
- Increase walking endurance
- Progressive weaning of walking aid ̈ Stationary bike and/or treadmill
- Weight training LE’s and UE’s
- Stretching UE’s / neck / trunk
- Stairs training
- *** Focus on self-management ***
- Communication with team
describe the discharge preparation process
what are physical restrictions for pts? (as part of the discharge planning)
look over the long temr medication list
¤ Vitamine D
¤ Biphosphonate (Actonel, Fosamax)
¤ Bone formation agent (Fortéo)
¤ Anti-Nausea (Gravol)
¤ Pain killers (Tylenol, Dilaudid, Empracet, MS Contin, Fentanyl patch) ¤ Gastric (Motilium, Pantoloc)
¤ Constipation (Lactulose, Senekot, Colace, glycerine)
¤ Diarrhea (Imodium)
¤ Diuretics (Lasix)
describe pt follow-up immediately after hospital discharge
describe the out pt PT follow-up (frequency, goals)
what is the long-term surgical mortality rate?
describe the progression of the lung and heart-lung transplant waiting list