PM&R News   •   August 14, 2020

Wow what a year it has been for physiatrists. As many were preparing for Part II, COVID-19 threw us all in a different direction than planned. Considering our specialty was developed in a time of war, who is better prepared for a pandemic than physiatrists?

I wrote an article earlier discussing the early steps we took to keep our patients safe at the beginning of the pandemic. At Tulane-Lakeside Inpatient Rehabilitation Unit in New Orleans, we are happy to report that we have successfully avoided coronavirus transmission on the unit. Although the CDC does not have clear guidelines for inpatient rehabilitation units, many recommendations for long-term facilities can be implemented. Here’s what we are doing:

• Check temperatures at hospital entrance (all staff and visitors)
• No visitors to the rehab unit, except for family training
• All patient doors closed at all times
• Face masks for staff at all times
• Face masks for patients when staff in the room
• Socially distanced physical therapy (depends on gym size)
• OT and SLP performed in patient rooms. If needed can perform outside the room if appropriately distanced
• Physicians closely monitor for signs and symptoms of COVID-19 infection. In addition to fever, we pay particular attention to lymphocyte trends, especially when compared to monocytes and neutrophils.
• Only one staff member allowed in the break room for lunch, two to three in larger conference rooms. We encourage outdoor eating and breaks.
• A low threshold to test staff who may be sick.
• Facemasks are used during therapy sessions, particularly if a patient is having trouble keeping a face mask on

Overall, and purely representative of our rehab microcosm, face masking seems to be the most important measure than can be taken in preventing the spread of COVID-19 on the inpatient rehabilitation unit. I’m sure that additional measures are helpful, but as the curve flattens and restrictions are lifted, face masking will be the last restriction to go. We are hopeful that we can get past the worst of this pandemic soon, considering the inpatient rehabilitation environment is generally a more social environment than other units in the hospital. There is a major aspect of teamwork and encouragement that does help patients heal both mentally and physically.

Finally, the PM&R QBank Review Team would like to thank and continue to encourage all of you in these different and challenging times as front-line physicians getting people back to optimal functional levels. As a physiatrist, our value is immensely important at these times as we have a unique ability to develop rehab programs and monitor the medical progress of patients with multiple medical problems as seen in many acutely ill patients with COVID-19.