This text based course is a transcript of the live webinar titled, "The Hand 101", presented by Rebecca von der Heyde, Ph.D., OTR/L, CHT.
Rebecca Von Der Heyde: I really hope to keep you engaged and motivated to listen and participate for the next two hours. We are going to talk about "Hand 101". I thought about trying to create a course that would capture what I think are the most important things to consider as you start treating patients with upper extremity (wrist, elbow, finger, and hand) injuries. Rather than kind of step-by-step you through things, I wanted to go through different aspects of the evaluation and intervention and try to give you a good, well-rounded picture about what questions to ask, what to know, what to do, and most importantly I think always, what not to do. I think it is really important for us to be cognizant of the things that we know and of course the things we do not know. I want to bring some of those things to your attention as well. I would like to get to know the audience a little bit before we get started. How many of you are treating hand patients right now? How many of you treat more than 50% of patients with hand injuries, or more than 50% of your caseload is patients with hand injuries? Does anyone have a CHT already? How many people are planning to sit for the CHT exam anytime soon or in the future?
Outline
Here is outline that I am going to use for the course today. I am going to start by talking about vascular injury and healing. We will then move on to nerves. Then we will move on to bones and fractures. Finally we will finish up with tendons. These are the four basic structural components of our systems.
We are then going to get into some clinical decision-making. I am going to talk a little bit about evaluation, some priorities for intervention, and I am actually going to go through a pretty tricky case with you. I will give you are little bit of a "heads up" right now and say that it is going to have a bad outcome. I am going to give you kind of a yucky case to think about. Try to understand the decisions we have to make in complex cases and how all of these systems work together in creating an outcome for patients.
Then finally I am going to go through a couple studies and look at the evidence that supports early intervention. You will see evidence sprinkled throughout the talk as I certainly try to bring as much research to the table as I can. But I will really touch on those big studies at the end just to give you some evidence for early intervention that is so important to hand therapy.
Objectives
What are the objectives for today? First I want to try to identify common precautions and contraindications for patients with upper extremity injuries. Knowing these precautions and contraindications can make or break you, and actually truly influence outcomes. I want to make sure that by the time you leave this course today, you are thinking about some of those things that are vital in terms of making sure your patient is safe, and doing their interventions and exercises properly.
The second objective is priority. Thinking about evaluation and intervention, what are our priorities? Thinking about multiple systems as I have already stated.
Finally we are going to use that evidence to support early intervention to maximize function. This is probably the most important thing that I think helps us to be really great at what we do. In terms of occupational therapy, we should look at the research and use it as a springboard to help us use our best clinical reasoning and judgement.
