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Acute Care Physical Therapy: When to Stop, Start, Do More, or Do Less

presented by Joe Adler

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A major challenge for the acute care PT is feeling confident knowing when to initiate treatment, stop treatment, continue, or modify activity based on vital signs, laboratory data, and patient signs and symptoms. Through lecture, case scenarios, and clinician interviews, this course will provide a clinical decision-making (CDM) framework for therapists to make safe and effective choices.

Meet Your Instructor

  • Joe Adler, PT, DPT, CCS

    Joe Adler graduated in 1993 with an MS PT from Arcadia University (then Beaver College) in Glenside, Pennsylvania, and earned a transitional DPT degree from Arcadia University in 2011. He has been working at the Hospital of the University of Pennsylvania in Philadelphia since graduation. He spent the first three years testing the waters of outpatient and inpatient acute rehab but found his passion in acute care in 1996 and has never looked back. Joe has more than 20 years of acute care experience. He specialized in the areas of trauma and orthopedics until 2006, when he transitioned into the area of cardiovascular and pulmonary physical therapy, including transplant and critical care. In 2006, he received the APTA Board Certified Clinical Specialization in Cardiovascular and Pulmonary Physical Therapy (CCS) and was re-certified in 2016. Since 2009, he has worked in critical care in a cardiovascular and pulmonary surgical ICU. As his career has progressed, he has taken a special interest in student education, taking on the role of center coordinator of clinical education (CCCE) from 2004-2016 and that of coordinator of our health system’s Acute Care Internship since 2007. His commitment to student/new employee education and mentorship has been complemented by his affiliation as an adjunct faculty member at Arcadia University since 1998, teaching in the content areas of cardiovascular and pulmonary physical therapy and acute care. In 2013, he was appointed Program Chair for the Section on Cardiovascular and Pulmonary Physical Therapy of the APTA, responsible for educational programming at their annual Combined Sections Meeting. In 2015, he was honored to receive the Mary Sinnott Clinical Excellence in Acute Care award from the APTA’s Academy of Acute Care. Most recently, Joe was honored to have been awarded Arcadia University's Adjunct Faculty Award for Distinguished Teaching 2018.

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Chapters & Learning Objectives

Download Learning Objectives
  1. Introduction

    1. Introduction

    This chapter reviews how therapists constantly monitor objective data and subjective patient response. It also discusses fundamentals of normal exercise physiology and how exercise physiology applies to hospitalized patients. The viewer will learn to apply and integrate multiple patient factors to clinical decision-making.

  2. Monitoring

    2. Monitoring

    This chapter reviews the multiple ways therapists monitor and assess patients in their care.

  3. Telemetry Monitoring

    3. Telemetry Monitoring

    A basic working knowledge of telemetry (ECG) and the impact of cardiac electrical functioning on activity tolerance is fundamental.

  4. Clinical Decision-Making: Integrating Signs and Symptoms

    4. Clinical Decision-Making: Integrating Signs and Symptoms

    Making safe decisions regarding activity for hospitalized patients is challenging. Optimizing activity and mobility requires integration of multiple factors. Through a review of case studies, a process for appropriate decision-making will be presented.