by Cat Weber
We're resuming our Physio interview prep series with a Trauma & Orthopaedics question and answer, part of our Trauma & Orthopaedics preparation pack.
NB: Our questions and answers from the Physio interview preparation series are only examples serving as a guide; and depending on the type of job, the place of work, or the interview panel members, you might need to adapt and/or provide other elements in your answers. We hope they help you understand what the interviewers look for, and if you have any questions don't hesitate to leave them in the comment section. You can also grab your own copies of our interview preparation packs for dozens of other questions and answers explained.
You're seeing a 75-year-old lady day 1 post left hemi arthroplasty for a fractured neck of femur.
a) Talk through your initial assessment
You would preferably want your first assessment to be joint with an OT so you can both get a good picture of the patient and start the discharge planning from that session. You may also need the other pair of hands from a manual handling point of view!
Check post-op notes are there any specific instructions you need to adhere to. Check the post-op X-Ray, are the surgeons happy with it?
Observations, how’s their blood pressure, would you want to get them up if the BP is already on the low side.
Check blood results, particularly haemoglobin levels – low Hb can cause people to feel very dizzy and may lead to a vasovagal type event. Ensure the doctors are aware if it is low and the patient is symptomatic as they may want to transfuse them.
What pain relief have they had already? If they are due some then ask the nurse for this to be administered about half an hour prior to your session.
What social history has already been gathered in the clerking? You will need to ask the patient or relative more detail, particularly previous mobility/function and their home setup.
Neuromuscular and range assessment in bed – this will give you a good indication of how much pain they’re in and also how well your functional assessment will go.
If the patient is in agony and is unable to bend their knee or straight leg raise then there is not much point continuing. It may be a good idea to ask for them to have more pain relief.
If they have some good movement, power and pain is managed then progress to functional assessment. Transfer to edge of the bed and gauge ability to stand, transfer or mobilise.
NB: Make sure you include that you have considered hip precautions. Although there have been studies to suggest that complying to hip precautions makes no difference to dislocation rates most surgeons still want them adhered too. Here's a good article for you treating this, and you can also head over to Nikki’s blog article on this topic on our website.
b) You stand her up and she begins to look pale/clammy and reports dizziness what do you do?
To prevent further deterioration sit her down and assist her back to bed, call for help if required to ensure safe manual handling precautions are followed.
Check her observations is there a significant BP drop (>20mmHg systolic)? If so this is likely postural hypotension which could be due to many things such as anti-hypertensives working too well, dehydration, low Hb amongst other causes.
Offer her fluids.
Inform nurse and doctor – maybe medications need altering.
Document events in the patient’s notes, including all observation recordings taken.
In this scenario the interviewers will want to know that you will do all you can to ensure patient safety as well as your own.
Here we go, this should give you a good head start! Of course, you can talk in a bit more details about some parts, but hopefully this has given you some good pointers on what to expect from a typical T&O interview question and how to answer it. For more questions and answers don't forget to get a copy of our Trauma & Orthopaedics preparation pack. And lastly, remember the “SDS” rule:
- Always be Safe and risk assess
- Document everything
- Seek help when you need it.
Our T&O pack designed for newly-graduated physios or physios applying for band 5 / junior positions includes interview questions and answers, key articles and references and top tips for the job, amongst others. This is also useful for Band 6 physios going onto a Trauma & Orthopaedics rotation for the first time or who need a refresher.
6 interview preparation packs, for less.
Related blog post(s)
Qualified & Practising - 3 reasons to abolish hip precautions Nikki explores the evidence behind hip precautions and see by how much they actually do reduce the risk of dislocation.
About the author
Cat is a Senior Physiotherapist rotating within Trauma and Orthopaedics at one of London’s 4 Major Trauma Centres. Rotations include Major Trauma, Amputees, Elective and Trauma Orthopaedic wards. She is a member of the UK-Emergency Medical Team where she will use her acute trauma skills to assist the team should they be deployed to a natural disaster. You can read more about this in the blog featured on the QualifiedPhysio website. Cat has also been a guest speaker at QualifiedPhysio seminars talking about the Physiotherapist’s role in Major Trauma.