Beyond the AMU

This week my preceptor arranged for me to visit other areas in the hospital.

BPTU = Burns, Plastics and Multiple Trauma Unit
Wednesday Morning
 As the name suggests they handle the burns, plastic surgery patients and those who have experienced multiple traumas. And sometimes a patient may have a burn and a multiple trauma and requires plastic surgery to graft skin to their burn sites.
This is a really awesome unit. Maybe just because its something totally different then what I have been seeing for the past couple of weeks.

The physios are responsible for getting the patients up and out of bed and making sure they maintain their mobility like they do on the floor I am currently on. In addition they also get to do a bit of wound care and wound education. I got to see a couple of burn patients with pretty significant 3rd degree burns and a faciaotomies (when they cut open the fascia (the connective tissue that wraps the skin and the muscle together) to let the pressure off from all of the swelling. So it was pretty awesome to see people's muscles moving around (not awesome for them because this means they have lost a ton of skin) and to see the new skin grafts starting to grow where they had been placed.So we bandaged a few people up and took them for a walk and one patient we just did some passive range of motion (read: we moved his arms and legs around for him while he lay there in pain and agony) to make sure that when the sores healed that the skin wouldn't be tight and constrictive like Freddy Kruger and limit their future potential for range of motion.

Also the BPTU patients have the most interesting HPI's (history of present illness). Just sayin'. I was reading some of the charts and the scenes were playing out in my mind of how they managed that. The people that end up in this ward also end up in the headlines a lot of the time because of their crazy stories. (Note: nobody that I saw that day was in the news)


ICU
Wednesday Afternoon
I think a lot of people are familiar with ICU = intensive care unit. This place was how I used to imagine hospitals to be like. It looks like what hospitals on TV are made out to be in terms of how many doctors and nurses and other staff are involved in their care and how many machines are in the room and the general hustle and bustle and beeping and other noises going on. As for the patients its sort of like TV a bit in that there are some rooms that have the glass walls like in"House" and some are just curtained off. At VGH there are 27 beds in the ICU and that day they had an extra 2 ppl in the auxillary area.

The ICU is unique from the rest of the wards as most of them are on ventilators getting help with their breathing and  oxygen intake. The nursing is 1:1 because a lot of the patients require a serious amount of care as suggested by the name of the ward. A lot of the patients are also on dialysis requiring that little bit of extra help to clean out their system. A lot of them also are trached (tube in their neck to help them breathe). And a large amount have Foley catheters to drain the urine from their bladders.

Lots of people wonder what can a physio do for people in the ICU? Pretty much the same as what they can do for people in other parts of the hospital. They mobilize the relatively "healthier" and more stable patients and get them sitting up in bed or sitting at the edge of the bed. Some are even able to go for a short walk down the hall. And yes, apparently you can walk while you are on a ventilator if your conscious enough. They also do chest physio: percussions, vibrations and suctioning for those with chest pathologies.


CESEI
 Thursday Morning
I am not sure what this stands for I think something like "Centre of Excellence in Surgery and blah blah". Its not important. The important thing is that there are human robots that can be programed to react to your interventions. We weren't doing surgery but we were suctioning the robots in a few different ways. We suctioned them via  a trach tube, mouth and nasaly and we also listened to their fake breath sounds and we bagged them too. (Bagging is getting that air bag thingy like on tv and pushing some extra air into their lungs to help dislodge a mucous plug, thats the hope anyways.)

This was done with several of my classmates. It was good to see some of them again and talk about our experiences. Of course the conversation came down to the grossest stories, and I am glad to say that I didn't win that one. Lets just say I haven't been pooped in yet... yet. They day will come I am sure. knock on wood.

Pulmonary Rehab Lab
Thursday Afternoon
I spent an hour in a Pulmonary rehab class. People with COPD (emphysema, chronic bronchitis etc.) or who have recently undergone transplants come here. A physio teaches the class which consists of strength exercises and cardio. My main job was to teach a few exercises and run around with the SpO2 monitor to take readings of peoples blood oxygen levels. I am happy to report I have a great SpO2 baseline!

The class was really fun. It was nice to be in the rehab setting and see people who are committed and motivated to making their lung function better. The instructor was also hilarious and had a great rapport with the patients. That was really good to see for me because sometimes on the ward I think I get a little to serious.


All in all it was a great week getting to explore the other bits of the hospital somewhat. I think that my preceptor was sucessful in proving her point that even if you don't want to work in internal medicine there is a lot more you can do as a physio in the hospital!