ORTHO ASSESSMENT
*PERSONAL DATA-
1)NAME:FOR IDENTIFICATION
2)AGE:PREVELANCE FOR CERTAIN DISESASE
3)GENDER:PREVELANCE FOR CERTAIN CONDITION
4)ADDRESS:DISTANCE FROM PATIENT HOUSE TO TREATMENT CENTRE
5)OCCUPATION:CAUSE OF MODIFICATION
6)DOMAIN:RIGHT/LEFT
7)BMI:WEIGHT/HEIGHT2
8)REFFERED BY:
9)PROVISIONAL DIAGNOSIS:
10)DOA:DATE OF ADMIT
11)DOO:DATE OF OPERATION
12)DOD:DATE OF DISCHARGE
13)CHIEF COMPLAIN:IT SHOULD BE IN PATIENT OWN WORD-
i)SYMPTO MS
ii)LOCATION
iii)DURATION
*HISTORY-
1)PRESENT HISTORY:
-ALLOWED TO NARRATE HISTORY
-DATE OF ONSET OF SYMPTOMS
-MECHANISM OF INJURY
-MODE OF ONSET
-CONDITION-IMPROVED,STATIONARY,DETERIORATED
-MUSCALR WEAKNESS
2)PAIN HISTORY-
i)SIDE: ii)SITE:
iii)MODEOFONSET:
, SUDDEN/GRADUAL/PERIODIC/INSIDIOUS
iv)DURATION OF PAIN:
ACUTE=7 TO 10 DAYS
SUB-ACUTE=10 TO 7 WEEKS
CHRONIC=MORE THAN 7 WEEKS
v)TYPE OF PAIN:
CRAMPING,DULL,ACHING MUSCLE
DULL,ACHING LIGAMENT,JOINT
CAPSULE
SHARP,SHOOTING NERVE ROOT
SHARP,BRIGHT,LIGHTNING NERVE
BURNING,PRESSURE,STINGING,ACHING SYMPATHETIC NERVE
DEEP,NAGGING,DULL BONE
SHARP,SEVERE,INTOLERABLE FRACTURE
THROBBING DIFFUSE VASCULATURE
vi)CHARACTER OF PAIN:
CONSTANT
INTERMITTENT
vii)BEHAVIOUR OF PAIN:
DIURINAL VARIATION OF 24 HRS
viii)AGGRRAVATING FACTOR:
ix)RELIEVING FACTOR:
xi)INTENSITY:
BASED ON 2 SCALES:
A)VAS=VISUAL ANALOG SCALE
B)NPRS=NUMERICAL PAIN RATING SCALE
NO PAIN WORST PAIN
|
0 1 2 3 4 5 6 7 8 9 10
NO PAIN MODERATE PAIN WORST PAIN
3)PAST HISTORY:
*PERSONAL DATA-
1)NAME:FOR IDENTIFICATION
2)AGE:PREVELANCE FOR CERTAIN DISESASE
3)GENDER:PREVELANCE FOR CERTAIN CONDITION
4)ADDRESS:DISTANCE FROM PATIENT HOUSE TO TREATMENT CENTRE
5)OCCUPATION:CAUSE OF MODIFICATION
6)DOMAIN:RIGHT/LEFT
7)BMI:WEIGHT/HEIGHT2
8)REFFERED BY:
9)PROVISIONAL DIAGNOSIS:
10)DOA:DATE OF ADMIT
11)DOO:DATE OF OPERATION
12)DOD:DATE OF DISCHARGE
13)CHIEF COMPLAIN:IT SHOULD BE IN PATIENT OWN WORD-
i)SYMPTO MS
ii)LOCATION
iii)DURATION
*HISTORY-
1)PRESENT HISTORY:
-ALLOWED TO NARRATE HISTORY
-DATE OF ONSET OF SYMPTOMS
-MECHANISM OF INJURY
-MODE OF ONSET
-CONDITION-IMPROVED,STATIONARY,DETERIORATED
-MUSCALR WEAKNESS
2)PAIN HISTORY-
i)SIDE: ii)SITE:
iii)MODEOFONSET:
, SUDDEN/GRADUAL/PERIODIC/INSIDIOUS
iv)DURATION OF PAIN:
ACUTE=7 TO 10 DAYS
SUB-ACUTE=10 TO 7 WEEKS
CHRONIC=MORE THAN 7 WEEKS
v)TYPE OF PAIN:
CRAMPING,DULL,ACHING MUSCLE
DULL,ACHING LIGAMENT,JOINT
CAPSULE
SHARP,SHOOTING NERVE ROOT
SHARP,BRIGHT,LIGHTNING NERVE
BURNING,PRESSURE,STINGING,ACHING SYMPATHETIC NERVE
DEEP,NAGGING,DULL BONE
SHARP,SEVERE,INTOLERABLE FRACTURE
THROBBING DIFFUSE VASCULATURE
vi)CHARACTER OF PAIN:
CONSTANT
INTERMITTENT
vii)BEHAVIOUR OF PAIN:
DIURINAL VARIATION OF 24 HRS
viii)AGGRRAVATING FACTOR:
ix)RELIEVING FACTOR:
xi)INTENSITY:
BASED ON 2 SCALES:
A)VAS=VISUAL ANALOG SCALE
B)NPRS=NUMERICAL PAIN RATING SCALE
NO PAIN WORST PAIN
|
0 1 2 3 4 5 6 7 8 9 10
NO PAIN MODERATE PAIN WORST PAIN
3)PAST HISTORY:
