Y3S2W11: Old Dog, New Tricks

Fear not of old age, for physiotherapy is here to help. Older adults... or 'elders' if they're especially wise, are trainable - like old dogs, their bodies can learn new tricks. When you are struggling to open the jar of jam or need to leave 15min earlier to get to the bus stop because you're now walking slower - call a physio. We'll set you up with an exercise programme to make you buff, strong and fit. 

The 'older adult' was the theme of integrated studies this week. The first lab was self-directed and consisted of eight stations. After the lab, we were able to get a case study from the reception to present about in lab two. The older adult is likely to have multi-morbidities (many diseases / health conditions) and we're expected to help them manage these whilst improving their physical function.

Phty355 series from ACC continued... it is reasonable to assume that deciding whether a client can claim under ACC is not always a black and white process. We had another 'prep for 4th year lecture' and the key messages came from current 4th years. Most of these messages are encompassed by the phrase "fake it until you make it". 

I see you Intensive Care Unit (ICU) Syndrome is a psychological syndrome some inpatients acquire in an ICU. We were going through a different psychological syndrome (but one that's familiar to us... study stress) in our CVP lab on the role of the physio in an intensive care unit. This was an intense lab, but us per usual we had some fun. Key stations in the lab had us practising suctioning... this involved putting a catheter with a vacuum into the part of the lung where it branches into two i.e. left and right lung, to suck up secretions in an unconscious patient. For added amusement, the unconscious patient was hooked up to an ECG monitor that would 'randomly' flat-line (i.e. the patient's heart supposedly stopped), so we appropriately managed the patient's airways (put them back on the ventilator) and perform chest compressions. Good fun. We also taught self-suctioning to our patient with a tracheostomy whom had a 'Swedish nose'. 'Dressing up' in personal protective equipment (PPE) during the lab whilst suctioning was important and quite amusing too. To top off the lab, most of us had a ride on the tilt-table! Good fun! This lab also had us working on a patient with burns and another patient after a heart transplant, both in an inpatient setting.

CVP lecturer on Thursday had extensive experience as a ICU physician in New Zealand. This presenter had an immense passion and enthusiasm for intensive care. He shed light on the importance of the physio in ICU. He was excited to have worked with Margot Skinner (current lecturer at the School of Physiotherapy and current executive board member of WCPT) and J. Pryor (a graduate of Otago, world renowned CVP physio and co-author of our CVP textbook) during his time in the intensive care profession. He described the shift in medical philosophy and use of technology over his time in practice, in particular a shift to non-invasive ventilation. He joked that his colleague had described non-invasive ventilation as "ventilator foreplay... preparation for the big event" at a time when using non-invasive ventilation first became available. However, today with modern non-invasive systems we can support patient at an appropriate level without robbing them of the dignity of being able to speak etc when previously patients were given a tracheostomy tube or endotracheal tubes for ventilation straight away.

Some inspirational quotes from this lecturer:

• 'Fall in love with all areas of physiotherapy that you encounter'. 
• 'I see a lot of physiotherapists wearing a stethoscope, but the most important tool you bring into the ICU is your hands... stethoscopes only give you a fraction of the information... physiotherapists feel the physiology happening with their hands'.