OMM: Considerations in the Hospitalized Patient

00:01 osteopathic considerations in the hospitalized patient So OMM is the application of osteopathic philosophy, structural diagnosis and the use of hands on manipulation in the diagnosis and management of the patient.

00:17 We follow the tenets of osteopathic medicine which include that the body is a unit of body, mind and spirit.

00:24 The body is capable of self-regulation, self-healing and health maintenance.

00:28 Structure and function are reciprocally interrelated and we base our treatment realizing those concepts.

00:36 So in acute care setting, hospitalized patients usually have an acute illness that requires additional care and attention.

00:43 osteopathic principles and treatment can be integrated into their care.

00:47 But there are certain considerations we do have to take into account.

00:51 So it's important to consider the patient's presentation, that there's no contraindications that may exist to performing osteopathic technique Following osteopathic's model of care, one can develop a plan to integrate OMT to address musculoskeletal somatic dysfunction that may contribute to a patient's recovery.

01:11 So, first and foremost, it's always important to receive informed consent for osteopathic treatment because it's a procedure.

01:19 Patients may not understand or have ever heard of OMM.

01:23 So it's important to take the time to explain in lay person's terms what OMM is and how it could potentially treat their anatomy, their musculoskeletal system and improve their structure and function and to help them heal and recover.

01:38 It might be helpful to explain osteopathic medicine through it's tenets or through models of treatment.

01:44 Patients usually want to hear that what you're doing for them is gonna help them and how it could potentially help them.

01:50 And so, using and following back on the osteopathic tenets or explaining that you're treating their nerves to help balance their autonomic system or they're treating musculoskeletal system to help with reducing pain or restrictions or you're helping to improve their circulatory and lymphatics to help boost their immune system and to help with clearance of lymphatics.

02:12 Sometimes patients, when they hear those things, could better understand what you're trying to do.

02:17 It's important to cite journal articles that demonstrate efficacy of OMM in hospitalized patients, for the patients and for your medical colleagues.

02:26 So, there's been many different studies looking at OMM in treating hospitalized patients with pneumonia and also post-operatively.

02:36 OMM has been shown to help patients recover quicker.

02:39 There's a lot of different applications at OMT potentially could be utilized for.

02:45 Even in the hospitalized patient, and so there's been safety and efficacy that's been demonstrated with utilizing these techniques in this patient population.

02:55 So some of the things that you potentially need to do differently in an acute care or hospitalized setting is to try to integrate how you perform your osteopathic structural exam with your routine physical examination.

03:08 So learn to screen and palpate for key areas of somatic dysfunction and integrate that into your routine physical exam.

03:15 And so when you screen for acute viscerosomatic reflexes and restrictions in the lungs and ribs, you could do that immediately after listening to the lungs.

03:26 You want to learn to assess your patients when they're lying supine in the hospital bed.

03:31 You could utilize translation of the rib cage and assessing the diaphragms and assessing the spinal junctions by sliding your hand underneath their back to try to see if there is restrictions.

03:43 Not everybody could stand up and do a standing flexion test so, you have to learn to adapt and utilize ASIS compression test.

03:50 So there's key areas to check and there's ways to do it while adapting to the patient position.

03:58 You can also incorporate palpation of key drainage areas to assess lymphatic and circulatory congestion.= so looking for leg edema, abdominal congestion.

04:08 look at the upper rib cage to see if there is any sort of swelling or congestion which may be a sign of lymphatic and circulatory congestion.

04:18 So the basic 5 models of osteopathic treatment could be helpful for you when you're thinking about, How should I approach my patient? What techniques I should use? How can I treat them? So the 5 models include the psychobehavioral, bioenergenic, biomechanical, neurologic and respiratory.

04:37 So, when you're faced with a patient that has a specific presentation or complaint, what you could do is to take a look at, thinking about what can I do utilizing the 5 models, to treat their somatic dysfunctions to help them improve in their health.