Case Study: TBI Name: DS

Case Study: TBI Name: DS

1. Injuries, conditions, and complications from the bicycle accident

   • TBI
   • Severe B pulmonary contusions with B pneumothoraces
   • multiple facial fx
   • orbital blowout fx
   • L femur fx
     • ORIF
   • Right clavicular displaced fx
     • osteotomy
   • Kidney injury from one of the medications
     • Colistin
     • Continuous antibiotic infusions
   • Left Femoral Deep vein Thrombosis
     • Happened when he was an inpatient
     • could be a precaution for exercise
     • DVT could cause a clot
     • IVC filter
   • 30 lb weight loss
     • atrophy and weakness of all 4 extremities
   • Coma
     • Glasgow coma scale less than an 8
     • Ranchos los Amigos scale
       • 2-3 when he was admitted
       • 6-7 when he went to rehab
   • skin tears
     • bed sores
   • Depression
     • learned helplessness
   • Cognitive impairments
     • needed assistance with short term memory
     • flat affect
   • Adult Respiratory Distress Syndrome
     • ventilator for 3 to 4 months
     • Chronic Respiratory failure
   • Tracheostomy
   • ventriculostomy
   • R posterolateral thoractomy
     • puss in lung cavity
   • Thrombocytopenia
     • multiple blood transfusions
     • anemia
   • C-diff
   • sensorimotor axonal polyneuropathy
   • claw hand deformity

2. Occupations

   • Hobbies
     • traveling
     • basketball
     • running
     • surfing
     • bicycling
     • watching sports
       • football
         • Chicago Bears
       • baseball
         • Chicago Cubs
     • outdoor activities
     • going out with friends
   • Attorney
     • writing
       • right handed

3. family support

   • fiance
   • father
     • learned how to clean wound on his side
   • two cats

4. Occupational Therapy

   • Assessments
     • Beck's Inventory
     • FIM
     • berg balance
   • Interventions
     • competitive time trial activities
     • Splinting for hands
       • MP block lumbercal black splint
       • intrinsic plus position
         • intrinsic plus to help claw hand and stretch out hand
     • Activities in sitting and standing
       • Football matchup
       • corn hole
       • reach for bags off the floor
       • rest breaks
     • Active and passive range of motion
     • pulleys
     • dowel and towel exercises
     • Rickshaw
     • ADLs
   • Adaptive Equipment and assistive technology
     • Tub bench
     • Commode
     • wheelchair
     • reacher
     • walker
       • at discharge
     • quad cane
     • sock aid

5. Problems

   • poor functional endurance
   • decreased functional hand use
   • claw hand deformity
   • decreased functional standing and sitting balance
   • decreased B UE ROM & strength
   • decreased ADLs
     • Dependent for bowel and bladder
       • needed changed twice a day
     • Dietary modifications
       • trouble with holding utensils
       • scooping was slow
   • decreased functional transfers
   • decreased IADLS
   • left foot drop
   • Pain
     • monitored stats
   • decreased mobility
     • sitting at the edge of bed was hard at first
   • vision issues
     • sensitivity to light
   • difficulty breathing

6. Prior level of function

   • healthy
   • independent in all self care, ADLS, and IADLS
   • independent in mobility