Do you know when to do CPR?

This is mostly for the PT’s and PT students.  It has been a while since I posted anything, and for that I apologize.  Not an excuse, but our daughter is sick and I don’t have the time to walk away from family for even 20 minutes to read.  This is an old paper that I wrote years ago, while still in the DPT program.  Enjoy and if there are any questions, don’t hesitate to ask.

 

Beattie P, Nelson R. Clinical prediction rules: What are they and what do they tell us? Aus J Physio.2006.52:157-163.

 

1.”Historically clinicians have relied on expert opinion, experience, and intuition to determine which evaluative procedures and what interventions to choose.”

  1. “Clinical prediction rules may be thought of as the combining of relevant clnical findings to calcularte a numberic probability of the presence of a specific disorder or likelihood of an outcome, ie, they act as adjuncts to the evaluative process”

 

PURPOSE:

  1. To describe the potential role of CPR’s in PT practice and to suggest strategies for us to dtermine the appropriateness of using the CPR in daily practice.

 

When are CPR’s needed:

See the other citations as this article would only provide a secondary source for the information. More to come later on the works of McGinn et al and Dellito et al.

 

Proposed use Type of validity Method of testing
Screening: prediction the likelihood of the presence of a specific medical or psychobehavioural condition Criterion-referenced Prospective, cross-sectional comparison of findings from clinical prediction rule to a “gold standard” that indicates the presence or absence of the condition
Prognosis: predicting the likelihood of a specific outcome Predictive Prospective, longitudinal comparison findings from clinical prediction rule to measures of change in patient status over time
Classification into treatment-based groups: predicting the likelihood of outcome when a specific intervention is administered Prescriptive Prospective, longitudinal, randomized, controlled design that compares outcomes following different interventions on subjects with the same score on the clinical prediction rule

 

Before using a CPR, the clinician should be aware of the derivation method, the means for internal validity, the statistics (Sn, Sp, +LR) and the population for whom it is expected (external validity)

 

 

Author: Dr. Vince Gutierrez, PT, cert. MDT

After having dedicated 8 years to growing my knowledge regarding the profession of physical therapy, it seems only fitting that I join the social media world in order to spread a little of the knowledge that I have gained over the years. This by no means is meant to act in place of a one-one medical consultation, but only to supplement your baseline knowledge in which to choose a practitioner for your problem. Having completed a Master of Physical Therapy degree, the MDT (Mechanical Diagnosis and Therapy) certification and currently finishing a post-graduate doctorate degree, I have spent the previous 12 years in some sort of post-baccalalaureate study. Hopefully the reader finds the information insightful and uses the information in order to make more informed healthcare decisions. MISSION STATEMENT: My personal mission statement is as follows: As a professional, I will provide a thorough assessment of your clinical presentation and symptoms in order to determine both the provocative and relieving positions and movements. The assessment process and ensuing treatment will be based on current and relevant evidence. Furthermore, I will educate the patients regarding their symptoms and their likelihood of improving with either skilled therapy, an independent exercise program, spontaneous recovery or if the patient should be referred to a separate specialist to possibly provide a more rapid resolution of symptoms. Respecting the patient’s limited resources is important and I will provide an accurate overview of the prognosis within 7 visits, again based on current research. My goal is to empower the patient in order to take charge of both the symptomatic resolution and return to full function with as little dependence on the therapist as possible. Personally, I strive to be an example for family and friends. My goal is to demonstrate that success is not a byproduct of situations, but a series of choices and actions. I will mentor those, in any way possible, that are having difficulty with the choices and actions for success. I will continue to honor my family’s “blue-collar” roots by working to excel at my chosen career and life situations. I choose to be a leader of example, and not words, all the while reducing negativity in my life. I began working towards the professional aspect of the mission statement while still in physical therapy school. By choosing an internship that emphasized patient care and empowering the patient, instead of the internship that was either closest to home or where I knew that I would have the easiest road to graduation, I took the first step towards learning how to utilize the evidence to teach patients how to reduce their symptoms. I continued this process by completing Mechanical Diagnosis and Therapy courses A-D and passing the credentialing exam. I will continue to pursue my clinical education through CEU’s on MDT and my goal is to obtain the status of Diplomat of MDT. Returning back to school for the t-DPT was a major decision for me, as resources (i.e. time and money) are limited. My choice was between saving money for the Dip MDT course (about 15,000 dollars) and continuing on with the Fellowship of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT) (about 5,000 dollars), as these courses are paired through the MDT curriculum or returning to school to work towards a Doctorate of Physical Therapy degree. I initially planned on saving for the Dip MDT and FAAOMPT, but life changes forced me to re-evaluate my situation. The decision then changed to return for the tDPT, as my employer paid for a portion of the DPT program. My goal for applying to and finishing the Dip MDT and FAAOMPT is 10 years. This is how long I anticipate that it will take to finish paying student loans and save for both programs, based on the current rate of payment. I don’t know if I will ever accomplish what I set forth in the mission statement, but I do know that it will be a forever struggle to maintain this standard that I set for myself.

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