Acute Medical Unit

So what actually do physios do in the hospital on the AMU?

Miracles.

Just kidding. We leave those to the doctors and nurses.

Basically when a new patient comes to the unit they come with a medical chart. The physio on that unit will look over their chart and gather what is called a “Database”.

This includes:

Diagnosis

-what the Docs have decided that they have in term of illness

Relevant Information

-usually looking for Dr’s orders for either ‘Bedrest’ or AAT (activity as tolerated)

HPI (Hisotry of Present Complaint)

-a lot of the time the patients on the AMU come through the ER and so we get things like “Head ache for the past 3 days accompanied by shortness of breath and fever. Patient also complains of blah blah blah…..”

PMHx (Past Medical History)

- this includes things like if they have had surgery before, if they have been hospitalized before, hypertension, heart disease, stroke, diabetes, spinal cord injures

SHx (Social History)

-who they live with, where they live etc.

Once that is all gleamed from the patients chart its time to actually meet the patient. Sometimes you have to get all dressed up to go see a patient. This includes putting on blue gloves and a yellow gown. This is done for patients with diarrhoea or something infectious. If they are coughing and infections you get to put on surgical mask with a shield. The shield is also handy if you are doing some suctioning.

 

Less like this

more like this

Then you go in and have a chat with the patient while taking blood pressure and measuring their oxygen saturation levels. You find out how many stairs they have to get to inside their house and if they have any within their house and if they live alone. You also want to know if they used a cane or a walker prior to admission and how far they can usually get around on their own.

After that you might assess their range of motion and strength based on their previous level of mobility and the state they appear to be in now.

Then after that you get them sitting at the edge of the bed if they are able. Then standing then maybe transfer them to a wheelchair for some sitting upright time or go for a little walk for some exercise.            

Sounds pretty easy but there is actually a lot of clinical reasoning involved in knowing what exactly to do with the client. Should this person just sit at the edge of the bed or should you get this person up and out for a walk and if so what sort of equipment are you going to use if you do want to move them.

Then there are the “chest” patients. With these ones are tops priority. They may require suctioning. This is when you stick a tube with suctioning power down their trachea via trach tube or nose or mouth to get the gunk out of their lungs that they cannot cough out themselves. Its really awesome to see someone do better and breath better after a good suction, but man does it look uncomfortable then its going on. 

 <--This guy looks a little more comfortable than my patients

There is also the percussions. Which is the drumming on the chest of a person who has secretions in their chest and this helps to loosen the mucous from the small airways and get it out. The percussions are sometimes followed up by suctioning to get the gloop out.

percussions

Now I can say that I am fairly proficient in describing the gunk that comes out of the lungs. I can describe texture, color and amount. Also its important to note if it appears to be bloody or infected. This week alone I have seen several types of mucus, including an entire mouthful of yellow thick mucus into my (gloved) hand.