Sorry I cannot make it for handoff. Here is some of the info that I would’ve offered as advice.

1. For the Mon-Wed ECU clinic you should focus on chart review first. Figure out which services are
following your patient, and see what they are focusing on. The goal with these patients is to get
them back to their baseline; not necessarily going beyond that.
2. PT/OT is only part of the Rehab focus. While Dr. Murtaza will show you how he gets his HPI,
ROS, etc… from the PT/OT notes, you cannot discount the other services. I kinda forgot to pay
attention to other things (Cards, Pulm, etc…) because I mainly focused on PT/OT, but PM&R
needs to touch base (i.e. read notes) with those other services if they are on board.
3. HPI/Exam is pretty easy for these patients. Since it’s mostly progress notes I asked them how
they have been doing overnight/this AM, and how their primary reason for ECU admission is
progressing. Asked how their PT/OT has been (most if not all are on PT/OT regimen). I let their
chief complaint and presentation guide the exam also. If they have Cards/Pulm following do
those exams as best you can. I wouldn’t ask them to struggle with too much of a physical exam if
they cannot; (PT will ambulate them as needed, I didn’t think it’s proper to do that on my own
as it’s a struggle for most of them and they’re all 1000 years old and fall risks). Honestly time in
the room was like 5 minutes for me. Most will benefit from a skin exam for ulcer prophylaxis.
4. Dr. M. will probably show you how he likes his notes and the templates and where he gets his
HPI. Or other students will. It’s pretty casual.

Here are some quick notes about the patients I saw. I’m trying to remember the services on board for
each Pt but there are probably some I’m forgetting. If the initials don’t match then you most likely a new
admit to the ECU:

Room 472: D.R., 80yo F.

Hx of Iliofemoral bypass graft (L) and Fem-Pop Graft (L) on 2/7/23. PMHx of breast CA s/p mastectomy
2/2022, polyarthritis, HTN, HLD, anemia, CAD, TIA, cachexia. WBAT on LLE. BLE strength decreased 2/2
pain.
Podiatry— following for pressure ulcer to left distal heel; they state waiting 2-3 weeks for viable tissue
prior to any intervention. Wouldn’t unwrap without wound care present. CCM
PT/OT—noting progression with therapy with toleration of 4 stair steps most recently.
Pulm— noted possible effusion?, check on exam and review their notes. Review O2 levels.

Room 473: J.C., 74yo F.

Hx of fall to ground on 2/10/2023 which was 2/2 dizziness. Unable to get up after spending night on the
floor. PMHx of DM, HTN, HLD, lung & colon CA, daily BPPV. BLE knee pain and strength deficits. Noted
sacral pressure ulceration.
PT/OT—noted good progress with therapy; initiated stair training. Will continue skilled RN treatment to
increase functional independence and safety.
Wound Care—check notes on how her sacral ulcer is progressing. Chronic diarrhea has been covering
her wound and delaying healing. She is c.diff negative.
IM—follow for notes re: anti-diarrheal and chronic medications also. How to control her BPPV while
living alone at home??

Room 474: M.R., 70yo F. Spanish-speaking.

Hx of admit on 2/2/2023 after visit to cardiology office. Noted BLE edema 2/2 CHF exacerbation. PMHx
of HTN, chronic renal insufficiency, DM. ECU discharge date keeps extending. Prognosis is poor.
Decreased strength/mobility 2/2 BLE swelling, dyspnea, fatigue on exertion.
PT/OT—notes continued fatigue, increasing BLE edema. Patient desats on 5-6L of O2 (88%-92%). On 2.5L
of O2 she is at 84%-85%.
Cards—check their note for CHF medication adjustments. Pt with diffuse BLE Grade II non-pitting edema.
Pulm—follow them as well for noted rales on exam

Room 475: B.G. 78yo F. Mostly non-verbal. Does not move extremities.
Hx of admit from ED on 2/14/2023 which is 2/2 SOB & Sx concerning for urosepsis. PMHx of nonverbal
Parkinson’s, HTN, HLD, recurrent UTI.
Wound Care— following for sacral/buttocks wounds. Pt is bedridden so skin integrity is paramount.
IM—follow for Abx regimen changes
PT/OT—from their standpoint, pt has met their baseline and they recommend to go home w/assist.

Room 476: was discharged last week

Room 478: was taken off Dr. Murtaza’ s list after Wednesday meeting, but I saw him 2x. Have notes
somewhere if you are interested. His only complaint to me is that there was too much meat and
potatoes in his meals. He has a pretty amazing wound s/p AKA of LLE being followed by Wound Care and
others if you’re interested. Aida from Wound Care appreciated help with changing his dressing so if
that’s your jam she’s around and likes the help.

Peace.