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In addition to a patient¡¯s medical clearance, it is important that the following are in place:

• Patient has the potential to participate in three hours of therapy a day
• Minimal returns for outpatient visits and diagnostic testing during rehabilitation stay
• Appropriate physician follow-up plan is in place for after discharge from acute rehab facility
• Patient must meet preadmission respiratory criteria
• Patient must have two caregivers identified

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Medical work-up to be complete and with treatment plan agreed upon by primary and consulting services.

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• Vent patients are required to be on stable settings for 72 hours prior to transfer
• Must have stable respiratory status to allow for 3 hours of therapy per day
• Suctioning needed at a maximum frequency of every 4 hours
• Trach guidelines:
  • If new, first trach change must occur more than 24 hours prior to arrival
  • Any trach change of size or type should occur at least 24 hours prior to arrival
• Respiratory treatments are a max of every 4 hours
• Peep must be less than 8 cm H20 unless required for leak speech
• FiO2 less than or equal to 40%
• Ventilator Modes used for Rehabilitation: AC/PC; AC/VC; SIMV/VC; SIMV (PC/PS) with a rate

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• PO/enteral/SQ only
• Generally no IV push meds, except IV antibiotics
• DVT Prophylaxis/anticoagulation plan established

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• PO diet or able to tolerate tube feeding to provide caloric and fluid requirements
• PEG tubes are preferred
• TPN patients need to be on a stable solution, cycled at night with a plan for discharge to home on TPN

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These are guidelines. For more information, please speak with your Shirley Ryan ÄÛBÑо¿Ôº liaison or consulting physician.