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Physiotherapy Clinical Placement – Site Specific Information Dandenong Hospital The acute physiotherapy department provides a 7 day per week service to patients in the acute wards and the Emergency Department, and a Monday to Friday service to the sub-acute wards. The physiotherapy service covers acute medical and surgical wards, emergency department, ICU, CCU, children’s ward, orthopaedic inpatients & outpatients, acute rehabilitation, geriatric evaluation and management, women’s health & continence inpatients & outpatients. The department also provides a service to the psychiatric wards as required. Staff members are allocated into streams for patient management, student education and supervision. Regular in-service training, literature reviews & Quality Improvement activities are undertaken. Professional Development & post graduate study is encouraged. Recommended Student Preparation Cardiorespiratory This placement involves the assessment and treatment of common respiratory conditions e.g. COPD, pneumonia, asthma; assessment and treatment of abdominal surgery patients e.g. cholecystectomy, bowel surgery; and potential exposure to ICU. Areas for revision: Cardiovascular and respiratory systems Subjective and objective cardiothoracic assessment Basic treatment techniques e.g. relaxation techniques, airways clearance techniques, positioning Pathology of common respiratory diseases e.g. COPD, asthma, pneumonia Thoracic imaging Auscultation Pharmacology (common medications and pain relief) Musculoskeletal Musculoskeletal placements will take place either on the sub-acute wards or the acute and outpatient services. The acute placement involves the assessment and treatment of orthopaedic inpatients and outpatients, as well as attendance at orthopaedic outpatient clinic and ward rounds. The sub-acute placement will take place on either South West 2, which has a rehabilitation focus for the Under 65 age group, or on West 2, an inpatient aged-care rehabilitation unit. The caseload will primarily be a mixture of fractures of the upper and lower limbs, joint replacement surgery, as well as some general reconditioning following prolonged hospital stay. Areas for revision: Review all theory relating to fractures (in particular, hip fractures, wrist, ankle and proximal humeral fractures), hip and knee joint replacements, ACL reconstructions, and elective shoulder and knee surgery. Ensure you are familiar with contraindications for these conditions. Review and be prepared to teach safe transfers, the use of gait aids, mobility progression, and step / stairs with gait aids in different weight bearing situations. Revise: Pharmacology theory, with particular reference to analgesia Handling and passive mobilisation techniques for all joints / limbs Principles of exercise prescription. Be prepared to justify, prescribe, and progress exercises proactively Electrotherapy theory, contraindications, precautions and applications Hydrotherapy theory, physiological principles, and indications/contra-indications for participation Students attending the Musculoskeletal placement at Dandenong can also expect to see Paediatric. orthopaedic inpatients and outpatients. Students are expected to have a basic understanding of common paediatric orthopaedic conditions. A general understanding of the differences between the management of paediatric conditions and those seen and treated in the adult population is desirable. It is expected that students will develop the ability to proactively treat children of all ages, irrespective of their condition, within a family focus. It is expected that the student will be able to prioritise treatment for inpatients and outpatients All musculoskeletal students in the Monash Clinical-School are expected to revise all musculoskeletal lectures, and have pre-read and have access to Hoppenfield & Murthy, “Treatment and Rehabilitation of Fractures”. Neurology This placement involves assessment and treatment of acute stroke patients, located in the Stroke Intervention Unit on South West 4, and subacute neurological patients located in West 2 and South West 2. Students will be expected to assess and treat a variety of neurological patients, including stroke, MS, GBS, traumatic spinal cord injury, and somatoform disorder. A component of the placement will involve the treatment of acute general medical patients on SW4. Areas for revision: Anatomy and functions of the brain, basic subjective and objective neurology assessment, pathology and prognostic indicators for stroke and other common neurological conditions (e.g. Parkinson’s disease, MS), positioning, basic treatment techniques, balance assessments, and discharge options. Please bring a stethoscope, notebook for supervisor feedback, and a watch. All Monash Clinical-School students on a neurology placement will attend a series of combined tutorials. Therefore, you will be required to pre-read and prepare using your neurology tutorial manual. You are required to have access to your manual on clinic in both 3 rd and 4th year. Electives Emergency Department and Acute Assessment Unit Students can expect to see a variety of patient types in ED including; STI's, acute management of fractures/dislocations, LBP, elderly falls/discharge planning and acute neurological/vestibular assessments. In addition, students will be involved in the assessment and treatment of medical patients admitted to the Acute Assessment Unit located in ED. Students may have the opportunity to follow the care of patients seen initially by allied health in ED and then admitted to AAU. Women’s Health and Continence Students will participate in acute obstetrics including post-natal education classes held in the mornings during placement. Afternoons will involve seeing outpatients with a wide range of women's health complaints, including; ante and post -natal musculoskeletal issues, incontinence and return to exercise issues. The hours and start time required during clinic can vary each day and some out of hours observation of childbirth education classes will be required. Students should revise university lectures and textbooks and have an understanding of the body changes during pregnancy. ICU and HDU Dandenong ICU has 14 beds consisting of both ICU & HDU patients. The caseload consists of post op surgical, plastics & vascular patients, as well as medical patients (COAD, pneumonia, asthma, respiratory failure). Many patients are intubated with ETT and tracheostomies. Students should be familiar with the basics of ventilation, common lines & attachments & assessment / treatment of critical care patients.