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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Every Therapist's Nightmare

Published April 8, 2011 10:48 AM by Jon Bassett
Fascinating article today in the Reading (PA) Eagle. Physical therapist Kai Pedersen, who owns South Mountain Physical Therapy in Reading, was going about his day when a patient began to show symptoms of distress.

Rosie Schucker, 74, fit the profile of a typical patient in outpatient therapy. Schucker had undergone a total knee replacement, was otherwise healthy, and had been a patient of Pedersen's for several visits. She was progressing well.

That is, until one visit in January, when she didn't appear well.

"She came in that day looking real tired," Pedersen told his hometown newspaper. "She wasn't herself, and she said she had fallen at home. She was complaining of some shortness of breath and some dizziness."

Responding coolly but swiftly, Pedersen assessed her vitals -- Schucker's blood pressure and pulse were high enough for Pedersen to alert Schucker's family physician by phone, who instructed Pedersen to call for an ambulance.

At Reading Hospital, testing revealed deadly time bombs -- embolisms in both Schucker's heart and lung.

"She was close to dying," Pedersen said.

Apart from the admiration for Pedersen's quick action, I'm struck by another thought. Physical therapists in outpatient community settings work with a high percentage of patients who have undergone invasive medical procedures, many of whom are on medication and in differing progressions of disease states. Part of me is surprised that we don't hear stories like this more often.

For the outpatient PTs out there, have you ever had a patient emergency, and how did you respond? Does PT school, mentoring and/or facility-based training opportunities adequately prepare you for such an unforeseen event? And does your facility have a policy in place for things like portable defibrillators and what to do in an emergency?

2 comments

Although we work inpatient - we are seeing more and more PEs and DVTs in all populations not just ortho. As a therapist you always have to see the whole picture. Kudos! Donna (PTA)

donna nehrenz April 11, 2011 12:17 PM

Partial reason for not hearing more stories like this is because the aides are treating patients in outpatient facilites.  If the PT or PTA rarely sees the patient then they are not being assessed.  

The other reason may be because of the increased demand to see more patients in that setting.  We don't take the time for observations like this if we are seeing 4-6 people an hour.  

Most observations like this comes from acute care therapists who have the knowledge and experience to recognize a patients distress.  Imagine if an acute care therapists was in the paper for everytime a DVT was found or an MI, CVA, etc. was initally seen and reported.

Karen April 10, 2011 6:00 PM

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