40sec Balance Test
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This document outlines a 4-stage balance test to assess static balance. It describes each of the 4 stages or positions with increasing difficulty, such as standing with feet side by side, then heel to toe, and finally standing on one foot. For each stage, the patient is instructed to hold the position for 10 seconds without moving their feet while being timed. An older adult unable to hold the tandem stance for 10 seconds is considered at increased risk for falls.
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4 stage balance test
The document describes a 4-stage balance test to assess static balance in older adults. It involves having the patient stand in 4 progressively difficult positions for 10 seconds each without moving their feet or needing support. The positions are side-by-side, heel-toe, tandem stand, and standing on one foot. An older adult unable to hold the tandem stand for 10 seconds is at increased risk of falling and should be referred to physical therapy or an evidence-based fall prevention program.
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The document provides instructions for safely transferring an individual from a wheelchair to a car and back. It outlines 11 steps for the transfer to the car, which include positioning the wheelchair next to the car, removing the footrests, lifting the person and slowly lowering them into the seat while keeping their back straight. The return transfer involves 9 steps, such as positioning the wheelchair, lifting the person out of the car while supporting their back and head, and slowly lowering them back into the wheelchair. The goal is to complete the transfers safely and communicate with the individual throughout the process.
Bedsore & moving and lifting
Moving and lifting patients involves transferring them between locations using devices like wheelchairs and stretchers for those unable to move themselves. Common devices are wheelchairs, wheel beds, and stretchers. Assisting a patient from bed to chair maintains good body mechanics and enables position changes without injury, especially for pre-operative, anemic, old, or other indicated patients. Proper wound cleansing and sterile dressing application protects wounds from contamination and promotes healing by maintaining a clean, humid environment. Key steps include assessing the wound, preparing materials aseptically, informing the patient, cleansing and applying the dressing, and documenting properly.
Lifting and moving patient from bed
MOVING TO THE SIDE OF THE BED,
HELPING THE PATIENT TURN ON HIS SIDE,
RAISING SHOULDERS OF THE HELPLESS PATIENT,
RAISING THE SHOULDERS OF TH SEMI HELPLESS PATIENT,
MOVING THE HELPLESS PATIENT UP IN BED,
MOVING THE SEMI HELPLESS PATIENT UP IN BED,
HELPING THE SEMI HELPLESS: PATIENT RAISE HIS BUTTOCKS,
ASSISTING THE PATIENT TO A SITING POSITION ON THE SIDE OF THE BED,
ASSISTING THE PATIENT TO GET OF BED AND INTO A CHAIR,
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The four steps of first aid are: 1) assess the situation and any dangers, 2) diagnose what is wrong with the patient, 3) provide immediate treatment, and 4) arrange appropriate transport. When assessing a patient, check for response, send for help if needed, ensure their airway is clear, check their breathing and circulation, and use defibrillation if needed. The level of consciousness is assessed on a scale of alert, responding to voice, responding to pain, or unresponsive.
4 stage balance-test-print
The document describes a 4-stage balance test to assess static balance in older adults. It involves having the patient stand in 4 progressively difficult positions for 10 seconds each without moving their feet or needing support. The positions are: 1) feet side by side, 2) one foot touching the big toe of the other, 3) heel of one foot touching toe of the other (tandem stand), and 4) standing on one foot. An older adult unable to hold the tandem stand for 10 seconds is at increased risk of falling and should be referred to physical therapy or an evidence-based fall prevention program.
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The short physical performance battery (SPPB) assesses lower extremity function in older adults through tests of balance, chair stands, and gait speed. It involves timing participants as they perform repeated chair stands, balance in progressively more challenging positions, and walk 8 feet, with scores ranging from 0 to 12. The SPPB has been shown to predict disability, nursing home admission, and mortality risk in older populations. The document provides detailed instructions for administering each component of the SPPB assessment.
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4 stage balance test
The document describes a 4-stage balance test to assess static balance in older adults. It involves having the patient stand in 4 progressively difficult positions for 10 seconds each without moving their feet or needing support. The positions are side-by-side, heel-toe, tandem stand, and standing on one foot. An older adult unable to hold the tandem stand for 10 seconds is at increased risk of falling and should be referred to physical therapy or an evidence-based fall prevention program.
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This document provides instructions for performing a supine chest x-ray on a patient lying on a stretcher. It describes adjusting the patient's position, placing the x-ray cassette and grid behind their back, positioning the x-ray tube, giving exposure instructions, and completing the exam by returning the patient to a comfortable position and cleaning the equipment. Key steps include adjusting the patient by pulling them toward you while gripping the sheet, placing a lead shield on the patient before returning to the control panel, and exposing at 115 kVp and 12.5 mAs for a sthenic or average body type.
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Bedsore & moving and lifting
Moving and lifting patients involves transferring them between locations using devices like wheelchairs and stretchers for those unable to move themselves. Common devices are wheelchairs, wheel beds, and stretchers. Assisting a patient from bed to chair maintains good body mechanics and enables position changes without injury, especially for pre-operative, anemic, old, or other indicated patients. Proper wound cleansing and sterile dressing application protects wounds from contamination and promotes healing by maintaining a clean, humid environment. Key steps include assessing the wound, preparing materials aseptically, informing the patient, cleansing and applying the dressing, and documenting properly.
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MOVING TO THE SIDE OF THE BED,
HELPING THE PATIENT TURN ON HIS SIDE,
RAISING SHOULDERS OF THE HELPLESS PATIENT,
RAISING THE SHOULDERS OF TH SEMI HELPLESS PATIENT,
MOVING THE HELPLESS PATIENT UP IN BED,
MOVING THE SEMI HELPLESS PATIENT UP IN BED,
HELPING THE SEMI HELPLESS: PATIENT RAISE HIS BUTTOCKS,
ASSISTING THE PATIENT TO A SITING POSITION ON THE SIDE OF THE BED,
ASSISTING THE PATIENT TO GET OF BED AND INTO A CHAIR,
FIRST AID: ASSESSMENT
The four steps of first aid are: 1) assess the situation and any dangers, 2) diagnose what is wrong with the patient, 3) provide immediate treatment, and 4) arrange appropriate transport. When assessing a patient, check for response, send for help if needed, ensure their airway is clear, check their breathing and circulation, and use defibrillation if needed. The level of consciousness is assessed on a scale of alert, responding to voice, responding to pain, or unresponsive.
4 stage balance-test-print
The document describes a 4-stage balance test to assess static balance in older adults. It involves having the patient stand in 4 progressively difficult positions for 10 seconds each without moving their feet or needing support. The positions are: 1) feet side by side, 2) one foot touching the big toe of the other, 3) heel of one foot touching toe of the other (tandem stand), and 4) standing on one foot. An older adult unable to hold the tandem stand for 10 seconds is at increased risk of falling and should be referred to physical therapy or an evidence-based fall prevention program.
SPPB_Protocol.pdf
The short physical performance battery (SPPB) assesses lower extremity function in older adults through tests of balance, chair stands, and gait speed. It involves timing participants as they perform repeated chair stands, balance in progressively more challenging positions, and walk 8 feet, with scores ranging from 0 to 12. The SPPB has been shown to predict disability, nursing home admission, and mortality risk in older populations. The document provides detailed instructions for administering each component of the SPPB assessment.
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3. Specific techniques for standing, sitting, and rolling patients on beds, as well as transferring patients to and from wheelchairs.
4. Tips for lifting objects like getting help for heavy loads, pushing instead of pulling, and using lifting aids for large items.
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- Primary care specialties (family practice, internal medicine, general practice) accounted for nearly half of all dispensed opioid prescriptions in 2012.
- Specialties treating pain conditions like pain medicine, surgery, and physical medicine had the highest rates of opioid prescribing.
- Overall opioid prescribing rates increased from 2007-2010 but stabilized from 2010-2012 as most specialties reduced rates.
- The greatest increase in opioid prescribing was among physical medicine specialists, while the largest decreases were in emergency medicine and dentistry.
The place-of-antipsychotics-in-the-therapy-of-anxiety-disorders-and-obsessive...
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Structured opioid refill clinic epic smartphrases
#*** I explained to the patient the risks of combining opioids and benzodiazepines based on medical literature. We agreed to slowly taper the patient off benzodiazepines and trial safer alternatives for sleep and anxiety issues.
#*** I showed the patient their fibromyalgia screening questionnaire results, which were consistent with a fibromyalgia diagnosis. Fibromyalgia can amplify other painful conditions and is often the primary source of morbidity when present with other chronic pain diagnoses.
#*** We discussed the patient's high risk opioid regimen based on their dose exceeding CDC guidelines. While willing to work on a harm reduction plan, it will require a taper or switching to buprenorphine due to safety concerns.
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This document summarizes the key issues regarding the use of opioids for chronic pain treatment:
1) An overreliance on opioids to treat chronic pain has contributed to the prescription opioid abuse epidemic in the US, as outpatient use allows for abuse and diversion of these addictive drugs.
2) While clinical trials show opioids effectively treat acute pain and are initially effective for chronic pain, real-world use reveals increased risks of abuse, addiction, and poor functional outcomes over the long-term.
3) The evidence supporting chronic opioid therapy was limited and observational in nature, yet convinced the medical community until larger population studies showed increased abuse rates contrary to initial assumptions.
The potential adverse influence of physicians’ words.
The physician's words can inadvertently amplify patients' symptoms and increase somatic distress if not carefully considered. Learning about potential side effects from medications, procedures, or test results can lead patients to experience and report those effects more frequently through psychological mechanisms like misattribution and increased attention to bodily sensations. Discussing concepts like nocebo and viscerosomatic amplification with patients can help provide reassuring explanations for symptoms and make them feel less intrusive. Physicians should thoughtfully consider their word choices and focus on benefits as well as side effects to minimize undue distress.
Ctaf chronic pain__evidence_report_100417
This document is an evidence report published by the Institute for Clinical and Economic Review (ICER) that evaluates the comparative clinical effectiveness and value of cognitive and mind-body therapies for chronic low back and neck pain. It was authored by Jeffrey Tice and others from ICER. The report assesses the clinical evidence on therapies such as cognitive behavioral therapy and mindfulness-based stress reduction and presents economic analyses of the long-term cost-effectiveness and potential budget impact of these therapies. It also incorporates input from clinical experts and stakeholders.
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40sec Balance Test
- 1. Patient: Date: Time: AM/PM The 4-Stage Balance Test Purpose: To assess static balance Equipment: A stopwatch Directions: There are four progressively more challenging positions. Patients should not use an assistive device (cane or walker) and keep their eyes open. Describe and demonstrate each position. Stand next to the patient, hold his/her arm and help them assume the correct foot position. When the patient is steady, let go, but remain ready to catch the patient if he/she should lose their balance. If the patient can hold a position for 10 seconds without moving his/her feet or needing support, go on to the next position. If not, stop the test. Instructions to the patient: I’m going to show you four positions. Try to stand in each position for 10 seconds. You can hold your arms out or move your body to help keep your balance but don’t move your feet. Hold this position until I tell you to stop. For each stage, say “Ready, begin” and begin timing. After 10 seconds, say “Stop.” See next page for detailed patient instructions and illustrations of the four positions. For relevant articles, go to: www.cdc.gov/injury/STEADI Centers for Disease Control and Prevention National Center for Injury Prevention and Control
- 2. Instructions to the patient: 1. Stand with your feet side by side. Time: __________ seconds 2. Place the instep of one foot so it is touching the big toe of the other foot. Time: __________ seconds 3. Place one foot in front of the other, heel touching toe. Time: __________ seconds 4. Stand on one foot. Time: __________ seconds An older adult who cannot hold the tandem stance for at least 10 seconds is at increased risk of falling. Notes: