Physical therapy
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Chest physical therapy is now widely used after open heart surgery to prevent secondary pathology in the lungs and to improve the phhysical condition of the patient. A brief overview of cardiac surgery is presented. Factors occurring before, during, and after surgery that contribute to postoperative respiratory insufficiency are outlined, and a comprehensive three-phase treatment program is described. Also, treatment guidelines, precautions, and contraindications are discussed.
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Medical documentation of patient care by physical therapy has become a requirement for reimbursement of health services paid by federal and state programs or by other third-party payers. The medical record of physical therapy must satisfy several specific requirements of third-party payers before health services can be reimbursed. ⋯ Medical documentation must show evidence of a prescription, medical reason for treatment, a viable discharge plan, outcome of treatment, coordination of medical services, patient instruction, and discontinuance or adaptation of services when necessary. The requirements for third-party payment based on medical documentation are discussed.
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The management of pediatric cardiac surgery patients at the North Carolina Memorial Hospital is described. The physical therapy program includes education and treatment which is intended to 1) reduce surgical risk by decreasing preoperative pulmonary congestion, 2) reduce the incidence of postoperative pulmonary complications and length of hospitalization, and 3) improve patient and family understanding and cooperation. The program includes a self-instructional package presented by a children's puppet. The package prepares the patient for the events ahead, including the physical therapy program and prospectively frightening aspects of intensive care.