Future Medical Cost Projections Module 7 Common Conditions, Part 2
Common Injuries and Conditions Overview Discusses common medical conditions and typical treatment protocol for catastrophic conditions and uncommon injuries Objectives Understand basic complexities of spinal cord injury Understand basic complexities of significant brain injury Understand basic complexities of amputations Copyright InSitu Academy
Copyright InSitu Academy Common Conditions Traumatic brain injury Spinal cord injury Amputation Burns Chronic pain Copyright InSitu Academy
Traumatic brain injury Mild TBI Physician evaluations dependent on medications prescribed Monthly prescriptions dependent on individual formulary At least one neuropsychological evaluation in lifetime Limited sessions of behavioral/cognitive therapy Medical mileage reimbursement if worker’s compensation coverage Significant TBI May impact function, loss of motor and sensory nerve pathways Treatment plan in response to functional limitations Includes medications, physician visits, diagnostics, behavioral counseling Could include in-patient rehabilitation Could involve cortical blindness and hearing loss Requires periodic neuropsychological evaluations May require home attendant care, equipment, home modifications Significant co-morbidities: facial and/or cervical fractures Typically requires ongoing physical, occupational, and speech therapies Copyright InSitu Academy
Copyright InSitu Academy Spinal Cord Injury Comprehensive, interdisciplinary team approach needed Regular, periodic evaluations by several specialty physicians Ongoing, lifelong therapy cornerstone of treatment Major issues: skin breakdown, infection (bladder and lung), contractures, autonomic dysreflexia Home renovations, accessibility issues, transportation, equipment, medications, injections, bracing, home attendant care Needs life care planner expertise involvement: especially in personal injury cases Worker’s compensation cases typically do not settle medical on these catastrophic cases Copyright InSitu Academy
Amputation Lower Extremity Below the knee, above the knee Significant potential complications and secondary conditions Treatment Bi-annual diagnostics to monitor status of orthopedic condition Bi-annual liver and kidney function studies due to chronic use of medications Periodic urine drug screening if narcotics prescribed Monthly physician evaluations for medication management Monthly prescriptions depending on individual formulary Regular physical therapy for flare up of condition, monitor skin and contractures Periodic replacement of prosthetics Standard equipment needs, including wheelchair, transportation, commode, and other assistive devices May need home modifications Copyright InSitu Academy
Amputation Upper Extremity Wrist, hand, fingers Arm, below or above elbow Treatment Bi-annual diagnostics to monitor status of orthopedic condition Bi-annual liver and kidney function studies due to chronic use of medications Periodic urine drug screening if narcotics prescribed Monthly physician evaluations for medication management Monthly prescriptions depending on individual formulary Regular physical therapy for flare up of condition, monitor skin and contractures Periodic replacement of prosthetics Standard equipment needs for assistive devices May need home modifications Copyright InSitu Academy
Copyright InSitu Academy Burns Electrical Thermal Chemical Solar DIC Copyright InSitu Academy
Copyright InSitu Academy Electrical Burns Entrance and exit wounds Be mindful of internal impact Brain Heart Copyright InSitu Academy
Copyright InSitu Academy Chemical Burns Skin Nasal passages Respiratory tract Multiple agents Treatment Dermatology ENT Neurology Pulmonology Neuropsychology Copyright InSitu Academy
Copyright InSitu Academy DIC Disseminated intravascular coagulation Significant internal injuries Brain Kidneys Lungs Hot weather danger Cars and environment Treatment Physician conferences Multi-factoral Copyright InSitu Academy
Copyright InSitu Academy Chronic Pain Types Nociceptive Neuropathic CRPS Treatment Medication Injections TNS unit Therapy Spinal cord stimulator Pain pump Diagnostics and laboratory, drug screening Physician evaluation counseling Copyright InSitu Academy
Copyright InSitu Academy Uncommon Conditions Environmental toxic exposure Hearing/vision loss Brachial plexus ED PTSD Addiction Copyright InSitu Academy
Copyright InSitu Academy Hearing loss Common Industrial accident ENT specialist Audiologist Hearing aids Supplies Copyright InSitu Academy
Copyright InSitu Academy Dental Injuries Common in MVA and falls Concurrent facial injuries Concurrent head injuries Treatment Can usually obtain estimate from treating dental team Copyright InSitu Academy
Brachial Plexus Injuries Traumatic Often missed Motorcycle/bicycle accidents Hanging/shoulder accidents Chronic pain issues Limited use of affected arm and hand Obstetrical Malpractice case Life Care Planning Copyright InSitu Academy
Copyright InSitu Academy PTSD Diagnoses sometimes difficult Need psychology, psychiatry evaluations Co-morbid conditions Drug abuse Alcohol abuse Verbal, physical abuse Treatment Medications Cognitive-behavioral therapy Inpatient rehabilitation Desensitization Copyright InSitu Academy
Copyright InSitu Academy ED Common condition found with significant back injuries Crush injuries Effect of medications for other conditions Psychological conditions Treatment Urologist Sex education specialist, counseling Medications Penile Pump Injections Penile implant Copyright InSitu Academy
Copyright InSitu Academy Homework Research brain injury rehabilitation services in your local area Contact local occupational therapist and discuss home modification evaluation, driving evaluation, and other services available for spinal cord injured clients Research and download these: Glasgow coma scale, revised trauma scale, global assessment of functioning scale, Asia spinal cord injury scale---retain in records Contact local ED specialist and discuss various treatment options for ED: pump, injections, implant, retain in records Copyright InSitu Academy
Copyright InSitu Academy Contact Information info@insitutraining.com Copyright InSitu Academy