This website uses cookies to improve the functionality and performance of the website. to better understand how you use AAPA’s website and services. and to provide vou with a customized exverience. By continuing your use of this website, you consent to this use of cookies. See our Privacy Policy for more information. Got it! AAPA A Day in the Life of a PA in Orthopaedics Consider Galaxy Conference to Learn About Orthopaedics April 13,2018 By Travis Randolph, PA-C, ATC git pectic Have you ever injured muscle, bones, ligaments, or joints? Whether itis your own injury or a family member's injury, most people will be exposed to the field of orthopaedies. It may be a supracondylar humerus fracture sustained on the playground as a kid, a torn Anterior Cruciate Ligament (ACL) playing basketball in high school, or osteoarthritis of a joint developed later in life. iC Wit bang ‘These injuries may range from a very minor sprain to a trauma with catastrophic injury. Regardless of the severity, orthopaedic injuries can be debilitating and devastating to patients. As a PA working in orthopaedics, itis very rewarding and fulfilling to play a role in diagnosing and treating injuries that allow for Patients to fully return to their daily activities could be reconstructing an ACL-Tor an athlete to return to'competition, fixing a fracture that allows someone to walk again, or replacing Travis Randolph, PA-C an arthritic hip joint so a patient can continue fishing. I find being qe Hamu int7 a PAin orthopaedics tremendously satistying — I can improve a imy patients’ quality of life. Yom, I began my mernbenaiag but have now been working as a PA in orthopaedics for almost 10 years, | was able to Will several PAs during my time as an athletic trainer, and they were very influential in my decision to attend PA school. | graduated from the University of Florida in 2008 and have been working in the Department of Orthopaedics at West Virginia University (WVU) Medicine since. wit) bola svepitad acnnicar| For the past 10 years, my primary focus has been on sports medicine. I function a8 a surgical assistant in the ‘operating room two or three days a week; | typically scrub in On cases that require ligamentous graft preparation. In addition to my clinigal, work, | am the Clinical Director of Sports Medicine in association with WVU Athletics. This expanded role allows me to combine my skills as aPAand an athletic trainer toimprove acces 10 meatal care for ll ur student acts, When | am not assting with TBE) ox Ss : a thletes in the athletic rooms the lini I visit with teams on campus and evaluate stent al ae ove basi. 1 assist the team physicians in delivering medical care to the WVU athletes for both er ncacdic and general medical conditions and facilitate orders and scheduling for diagnostic imaging special procedures. or tests and specialty referrals. My days are busy but erwin Jay ae rere § an sea of wnat a ¥7 In OrInOpHEAIES EXpen'ences di pee ~ YevER MDOWN 20-minute commute depending on traffic. I never mind an early morning start in the operating cotta towork salt eaie! This moning Vm gassing wh nee srs rary for ACLLLCL ‘reconst -t the patient at 6:30 make sure he is consente a SS aaen as rake rue he's scheduled his physical ther Then. review the X-rays and MRI ‘and discuss the surgical plan with the TUrREOT My primary role during airgery is the graf preparation. fe typically use autograft tisue. ether hamstring or patella tendon, fo ligamentous reconstruction. For this rat tigamentous reconstruction case, we chose 10 use allograft tissue to reconstruct the ligaments and avoi any further injury tothe patient's knee. The allograft tissue has to thaw. and once itis thawed. I surure the tends of each graft and place them under tension until the surgeon is ready for placement. 1 assist with drilling the bone tunnels and placing the grafts. Once the grafts are securely fixed. close all the surgical incisions ‘and apply the post-op dressing and knee brace. After completing the post-op orders and notes, | check my phone for messages. I have received five texts this moming: four requests from athletic trainers to evaluate ‘tudent athletes and a question regarding imaging. This is my only ligamentous reconstruction case today, $0 T start returning messages and scheduling appointments for evaluations. LI (Ae {int} Mp 10:00 am | eave the hospital and stop by the baseball athletic training room to see a student athlete who has been sick for the past couple of days. [examine him, then discuss treatment for his sinusitis. I make sure he has everything he might need prior to leaving for a series of games on the road. After the student athlete leaves, the athletic trainer and I discuss MRI results from another of his players who sustained an elbow injury last week. We aiseuss ie treatment fran ana rena gwaennes—*) Lo) GY age f (avin) “an 10:30 am | head back to my office to check emails and patient messages. I receive several patient messages each day: post-op questions, physical therapy scripts, medication refills, work notes, and new patient referrals. Itis my responsibility to follow up on these requests and return phone calls to patients. I send in a refill for an anti- inflammatory for a patient and make sure they have a follow-up visit scheduled in clinic. I return a phone call to a patient who has questions regarding wound care instructions following his knee surgery. I try to take a {few minutes to check these messages multiple times throughout the day to ensure a timely response for patients. 1 FeMUrn a Tew emails eTOFe IL § Lime 10 leave or anotner evaluation. 11:00 am Letty reel 1 make my way over to an on-campus athletic training room to evaluate two student athletes. ‘The first is a wrestler who underwent shoulder surgery two weeks ago. I check his surgical sites and range of motion. He still wears his shoulder brace but appears to be doing well with the rehab protocol. | remove his sutures and schedule his next follow-up appointment. | then examine a student athlete. rower, who is experiencing lower back pain. She has tight hamstrings from training that appear to be contributing to her condition. 1 discuss modifying her workouts with the athletic trainer as she gets started in rehab. I then meet with the UG yAd © dorm qin mtgwomen’s soccer athletic trainer to schedule a MRI for one of her student athletes who sustained a knee injury yesterday 12:00 pm I's lunch nd today I meet up with of colleagues for a concussion care management conference. Healthcare providers in spor medicine, emergency medicine, neurology, and physical therapy meet once a month to discuss certain concussion cases and protocols as well as review recent literature regarding head injuries. It is very insightful to get different perspectives from each specialty. Just as our meeting is wrapping up, I get a text to evaluate a wrestler for a laceration that may need sutures, Gnd ey Rats ’ g room to 1:15 pm Thead back to the athletic train evaluate the wrestler. He sustained a laceration nt eyebrow during practice just above h today. I discuss options with the athlete, and he washes to have it repaired, | thoroughly cl hetize the area and suture it closed. 1 plan ws S evar ort inet teas Randoiph examines a student athlete dhe players who Is covoveriny front a foul injury and just started practicing with the deany again, | watch practice to see how she performs wiuje running and jumping. | meet with the athletic trainer and coaching apps yisuwa ner weave mM Ww patients T have scheduled this afternoon. F review labs that came in yesterday and notify pattents of the resuits. {return a cail to a patient recent shoulder MRI. His MRI contieans a rotator Pb Nia splvonts, He Hate made any improvement in physical therapy and wishes to proceed with surgery. { will tum in an OR card surgery His line of work wiil allow for modif ions, so i fax him a note to retum to work on light duty, Two one why underwent ACL reconsiquction and one 4 evetved 1talor-cull of tire palienis are two Weeks poste repair Both patients are recovering weil from their operation, Another of my appointmes a Ca ieee nis is a return patient ne fas ostevartiiitis of us Kuee. His Knee pane has slatted 40 fh i chivity He is not interested in proceeding with knee: me, 90 r 2 replacement surgery at this time. sot injec Auce weitt a corucesternd. He 1 { LOmes yt) hm) wnjeri auiie pause widic unidd suit assue wwe for fracture. 20 T ceder her dard provide ince weil a scrip for pirysneal therapy, ote the exam The x-mye are nag: in ai T finish up with patients and complete my charting for She is glad to hear thar it isn't anvthing more serious. mor TL dignend etee) 5:60 pm (APP) to join our is the lead PA for WVU! Medicine We lows APPs to stay informed on the Senior Council in 2013 ruined ea aicivens tive wecsiaagl FAs aun, pital and this structure all Terenas growth im APP positions at our hos interview goes well.and can now qe ‘Sanu i ave: bunds sangre aun Gnu venga assent axistoiniva ve its. ny ra et be the most typical of PAS working in orthopaedics. [ work with several ‘other PAs in Orthopaedics ae aang vai. ycvionvn sania» Ge Lamengeany Gepmainuca sound an auzaria,ivabagoans ne Jperaring ronen-and see patients in an outpatient clinic: Each PA's role varies slightly. and is often determined juve the Giffereni anpeeis oi iw iy Jeon the move. Most of my appointments are scheduled on an as-needed basis in an effort to seninate and treat injuries as efficiently as possible. vera in jf <0 ic interested in doing to — T would moommend attending jus, Eaacin day 0 PA whe practices in cxthonaed For any ‘AAPA and AAOS's Galaxy conference. This vear is the 10° Annual PA'S Fuheny anfercins takin lace hue 27 ~SJuly 1, 2B1B.in New Or co rye_course workshops for casting. splinting, and iniection techniques. There will aeo be a specific 5 canine in Ortinopanaics. ‘The forslay conference Hod fren rgcons and PAs that cover topics inal subspecialties, Other conference highlights include techniques and MRI presentations on reimbursemm canes and an onhonsedic panel discussion focused on case studies, Register today.and I'l see you there!