Another module, another tick in the box for completing, it successfully!
The purpose of the Physical Regional Examination Technique module is to be able to perform a regional examination and identify any abnormalities within the musculoskeletal system and special senses examinations.
The module elements were how to perform an appropriate examination in an overall assessment of the function area; perform appropriate level of cardio-respiratory system to assist in the assessment of the function area; consent; vision testing; conversational voice (CV) testing; and hand and feet examinations.
As they say the first two elements are 'bread and butter' skills for paramedics' and everyone would get a much more in depth assessment than this training module. These elements which paramedics use daily on every patient. This element was more to do with the functionality, range of movement, power, grip and dexterity and the impact it could have on a claimants daily live; for example, if a PIP claimant had a shoulder issue, it is assess the function and impact of the function, ie decreased range of movement may make them be unable to wash their own hair; or decreased power and grip may make it difficult to hold a cup without spilling it.
As for cardio-respiratory assessment, it was not in depth; as Disability Assessors, we were told to listen to the claimant's breathing on exertion, for example walking from the waiting room to the assessment room; and note if they can speak in full sentences in exertion and at rest. We also had to record the best of three peak flow readings, including working out what a normal level would be. All paramedics should be doing this; and lots more on their patients with shortness of breath (SOB). We would do a initial peak flow reading; however if the patient was breathing through their butt, we won't bother as way higher priorities to deal with, but will get a reading if treatment starts to work.
Next element...Consent! Every Healthcare Professional from Healthcare Assistants to Paramedics to Doctors, learn about how to gain informed consent. This is essential and is drummed into you very early on in your training. You have to gain consent for everything, from blood pressure to examination to drug admission. Any invention with a patient (claimant) requires informed consent. There are a few exceptions for not gaining consent, if your patient is in cardiac arrest or unconscious; plus if you have assessed them thoroughly and deemed them not to have mental capacity due to sepsis, in mental health crisis or dementia, etc. This is a basic skill and should come naturally to all Healthcare Professionals.
Then we got into the special senses of this module... vision testing and conversational voice (CV) testing. The vision testing was definitely not rocket science, if the claimant wears glasses they keep them on; perform the distance chart and read a laminated sheet with various font sizes; having gained their consent to perform these examinations.
The CV training was not scientific,started with shouting the claimants name in the waiting room, talking to them at a normal level and tone. Then, getting them to close their eyes and rubbing my fingers either side and asking them to tell me which side. This was done with hearing aids in situ, if they had them but this would also be noted.
The final element of the module was a hand and foot examination... once again paramedics are good at assessing these elements, for example the punches and kicks from assaults, trauma and possible fractures. This was more focused on the range of movement, power, grip and dexterity, which makes up a healthcare professionals examination anyway.
The next Personal Independent Payment Disability training module article will focus on Mental Function Conditions.
