9-1 Multitrauma, polytrauma következtében kialakult funkciózavar / fogyatékosság miatt szükséges rehabilitáció ellátási program (REP)

Multitrauma, polytrauma következtében kialakult funkciózavar / fogyatékosság miatt szükséges rehabilitáció ellátási program (REP)

Ez a REP a következő Rehabilitációs Programhoz tartozik: 

Rehabilitációs Program száma: 9,   Alprogram száma: 1

Több régiót érintő, közöttük életet veszélyeztető sérülések utáni állapot; Több régiót érintő, életet nem veszélyeztető sérülések utáni állapot; Egy régiót érintő, de többszörös funkciózavart okozó állapot. Mindhárom esetben a rehabilitációs célok a trauma okozta funkciókiesések ill. fogyatékosság természetéből adódnak.

 

1./ A páciensek állapotának jellemzése

1.1. Baleset és a kialakult károsodás / funkciózavar / fogyatékosság leírása

BNO

FNO “B” (1-5)

FNO “D” (1-5)

BNO 1 T02.1  T02.4-9  Többszörös törések;  T03.0-9 Több testtájra terjedő ficamok, dislocatiok és distorsiok;  T04.0-9 Több testtájra terjedő zúzódások; T062 Több testtájon idegsérülés, T064 izmok,ínak sérülése; T07 Többszörös sérülések; S32.7   S32.8  Az ágyéki csigolyák és a medence többszörös törése

b730 (izomerő) 

b710 (ízületi mozgékonyság)

d230 (önellátás)

d410 (testhelyzet változtatás)

BNO3  R26.0-8 Járás és mobilitás zavarai; R52.0-9 Fájdalom; M24.1  Ízületi instabilitás; M24.4 subluxatio; M24.8  Működési zavarok; M24.5 contractura; M25.2-3 lötyögő ízület; M25.5 ízületi fájdalom; M25.6 ízületi merevség;  M62.4 izomcontractura; M62.5 izomtömeg vesztés, atrophia; M79.6  Végtagfájdalom; M79.1  izomfájdalom     

b760 (akaratlagos mozgásfunkciók)

b770 (járásminta)

 

d465 (helyváltoztatás segédeszközzel)

d450 (gyaloglás)

 d550 (étkezés)

 

1.2. Állapot-súlyosság: A rehabilitációra kerülő személyek állapot-súlyossága a program kezdetén limitek megadásával: extrém súlyos / súlyos

FUNKCIONÁLIS  ÁLLAPOT

SÚLYOS

KÖZEPESEN SÚLYOS

ENYHE

FNO (az 1.1-nél felsoroltak alapján tól-ig értékek megadása)

A megadott FNO-k közül legalább egy 4-es vagy kettő 3-as

A megadott FNO-k közül legalább egy 3-as, két 2-es

A megadott FNO-k közül legalább két 2-es, többi 1-es

FIM /Barthel

<54   /  <=40

54-90 / 45-70

>90 / >=75

EGYÉB TESZT

Izomerő a leginkább érintett izomban) vagy

ROM (a leginkább érintett ízületben) vagy

VAS (fájdalom)

 

0-2

norm.tartomány 50%-a

>7

 

2-3

50-75%

4-7

 

4-5

>75%

4 alatt

Társbetegség / szervi érintettség

életfontos szerv sérülése (nem agysérülés)

nem életfontos belső szerv sérülése

 

Extrém súlyos, ha  a fenti 3 kategória mindegyike súlyos; Súlyos, ha a  fenti három kategóriából kettő súlyos vagy egy súlyos, a többi középsúlyos; enyhe, ha a fenti három kategóriában legfeljebb egy közepes, a többi enyhe; középsúlyos, ha köztes állapot van.

 

1.3. Humán erőforrás

1.3.1. Ápolási szükséglet: nagy

1.3.2. Specifikus szakdolgozói szükséglet  Bővített csomag. gyógytornász, kötözős nővér (antidecub. ellátás és sebkezelés, trachestoma ellátás), szociális munkás, ergoterapeuta, sporttherapeuta és/vagy hydrotherápiás szakember (gyógytestnevelő), neuropszichológus, munkapszichológus, ortopéd műszerész elérhetősége a hét minden napján

 

1.4. Fogyóanyag szükséglet

1.4.1. Napi átlagos gyógyszer szükséglet: nagy

Alapbetegség(ek) miatt szükséges gyógyszerek + pszichiátriai szerek (pszichiatr. bet., suicidium), infúziók, valamint az átvételkor meglevő vagy később jelentkező szövődmények kezeléséhez szükséges gyógyszerek ( vaskészítmény antibiotikumok).

Rehabilitáció alatt szükséges gyógyszerek: LMWH, fájdalomcsillapítók, izomlazítók, antidepresszánsok,

1.4.2. Napi átlagos kötszer- egyéb orvosi és orvostechnikai anyag szükséglet: nagy 

Alapbetegség(ek), a sérülés jellege és a szövődmények miatt gyakran szükséges:  sebkezeléshez szükséges eszközök, kötszerek, fertőtlenítő szerek, trachea kanül, tápszonda, védőruházat, infúziós szerelék, fecskendők, tűk, pelenka, katheter, ergoterápiás eszközök

1.4.3. Napi átlagos diagnosztikai anyag (fogyóeszköz) szükséglet: nagy/közepes

Alapbetegség megítéléséhez: labor: vérc. (ill. tesztcsík) INR, CRP, We.,  Katheter, EKG. bacteriológia (sebváladék, vizelet) Ergometria

Rehabilitációs alatt szükséges:: rtg (natív, sipolytöltés) UH (ízületi, hasi)

 

2./ Betegutak leírása

2.1. Hogyan kerül a páciens rehabilitációra?

Intenzív osztályról és baleseti sebészetről közvetlenül; /ritkán rövid otthoni ápolás után/ közvetetten ismételt felvétel otthonról, ambulanciáról is történhet

2.2. Mi a jellemzője az adott betegcsoportnak a rehabilitációs ellátás időzítésére vonatkozóan?

Jellemzően korai elsőbbségi rehabilitáció, ritkán programozható (az utóbbi általában késői szövődmény vagy tervezett sebészeti beavatkozást követően és ismételt felvétel

 

3. A rehabilitációs ellátó helyre vonatkozó kívánalmak leírása

3.1. Az ellátási csomag: bővített csomag

3.2. Az ellátási szint: III (polytrauma)/ II. (multitrauma és komplikált monotrauma)

3.3. Az ellátás helyszíne: Fekvőbeteg

3.4. A rehabilitáció várható tartama: 30-90 nap

 

1-3. Ismételt felvétel rehabilitációs céllal (elsőbbségi rehabilitáció befejezését követően)    

Ismételt rehabilitáció válhat szükségessé, ha a primer traumatológiai ellátás és elsőbbségi rehabilitáció után  a fentieken kívül

-         konzervatív kezeléssel nem oldható, súlyos kontraktúra miatt műtét, vagy altatásban bemozgatás történt ;

-         a törésgyógyulás elhúzódása vagy elégtelensége (álízület kialakulása) miatt spongiosa plastica vagy reosteosynthesis, válik szükségessé;

-         a törésgyógyulás során jelentős végtagi tengelyeltérés, csont nekrózis vagy ízületi arthrosis alakult ki, és korrekciós osteotomia vagy endoprotézis beültetés válik szükségessé;

-         a polytraumatizáció mellett ellátatlanul maradt illetve konzervatívan sikertelenül kezelt szalagsérülés következtében krónikus instabilitás vagy éppen (különböző okokból) kontraktúra alakult ki, és szalagplasztika vagy arthrolysis válik szükségessé;

-         a perifériás ideg vagy plexus sérülése nem mutat javulást, és idegtranszplantáció vagy funkcionális rekonstrukciós műtét (izom-ín transzfer) válik szükségessé – ez esetben a 3.1-es REP-ben jelenik meg; ha a többi sérüléssel szemben ez uralja a képet

-         olyan csont- és/vagy lágyrész defektus marad vissza, illetve konzervatív módon nem gyógyuló decubitus alakul ki, ami miatt major plasztikai beavatkozás (csont szegment transzport, myocutan vagy kompozit lebeny, esetleg mikrovaszkuláris módszerrel) válik szükségessé. – ez ebben a betegcsoportban igen ritka

( A fentiektől definíciószerűen el kell különíteni azokat az eseteket, amikor csak megszakítódik az elsőbbségi rehabilitáció, mert a beteget korai szövődmény (haematoma, infekció, rediszlokáció,  a fémanyag elmozdulása, miatt, vagy éppen tervezett okból (drót, állítócsavar, reteszcsavar, fixateur eltávolítása) rövid időre vissza kell helyezni a traumatológiai osztályra.)

Jellemző

Minősítő

1.2. állapotsúlyosság(N/Kp/k)

közepes

1.3.1. ápolói szükséglet (N/Kp/k)

közepes

1.4.1. gyógyszer szükséglet (N/Kp/k)

kicsi

1.4.2. kötszer és egyéb orvostechnikai anyag szükséglet (N/Kp/k)

közepes

elsősorban a kültakarón végzett plasztikai műtétek után lehet nagyobb

1.4.3. diagnosztikai anyag szükséglet (N/Kp/k)

kicsi

a műtétek után ismételt rehabilitációs felvétel során rutin labor, röntgen és UH diagnosztika (nekrózis esetén MR követés)

3.1. ellátási csomag (alap/bővített)

(alapcsomag)bővített csomag                                                                               (sportth.-ra mindig, contractura nyújtásra többnyire, ergometriára, egyedi segédeszközellátásra, spec.antidecub. eszközökre esetenként ismételt felvételkor is szükség van)

a polytraumatizáció után jellemző multiplex problémakör jelentős része az elsőbbségi ellátásban megoldódik, így rendszerint egy végtagi vagy ízületi korrekció után, a túlzottan elhúzódó korai ellátás miatt szükséges adaptációs szabadság után, vagy rekondícionálás céljából történik az ismételt rehabilitációs felvétel

3.2. ellátási szint (I/II/III)

I / II / III is lehet

bár a speciális plasztikai beavatkozások utáni rehabilitációt is célszerű III. szinten koncentrálni

3.3. ellátás helyszíne (fekvőbeteg/NK/járóbeteg)

fekvő, nappali kórház, esetleg ambuláns is lehet, ezt jelentős mértékben befolyásolhatja pl., hogy felső vagy alsó végtagi korrekció történt

3.4. ellátás várható tartama (tól – ig)

 

Ismételt rehabilitáció várható tartama az első évben (hét/1. év)

3-6 hét

a fenti esetek többségében (egyszerű szalagplasztika, endoprotézis beültetés) elégséges, plexus vagy komplikált defektus pótlás után, eszközváltások (gipsz, ortézis, korzett elhagyás, eszköz használat betanítása, kialakult kontraktúrák és izomatrófiák kezelése)           3-6 hónap is lehet

Ismételt rehabilitáció várható tartama a második évben (hét/2. év)

3-6 hét

a fenti beavatkozások jelentős része történhet a második vagy további poszttraumás évben (tengelykorrekció, endoprotézis beültetés, rekonstrukciós műtétek )

jellemző betegutak

1. traumatológiai (ortopédiai) osztály®rehabilitációs osztály

 

2. rehabilitációs osztály szakambulanciája®rehabilitációs osztály

Folytatólagos ambuláns ellátásban (kontrollok, döntés a további rehabilitációs szükségletről) milyen programokra lehet szükség a szokványos ellenőrzésen túl?

Program(ok) és protokoll(ok): kéz funkció zavarok ( 3.1, 3.2) / fájdalom (4.3) / amput. (7.1-3 )

Ellátási szint:  a programok szerint

 

12 hónapon belül várható /javasolt /szükségesnek tartott kapcsolódó ellátás: (karbantartás)  rekondícionálás : fájdalom szindróma kialakulása, vagy ízületi kontractura, izomatrófia megelőzés, kondícionálás, pszichoth., esetleges protetizálás folytatása.

 

 

4. A rehabilitációs terápiás program kötelezően elvégzendő és dokumentálandó elemei az adott betegcsoportban

A. kódolható tevékenységek

orvosi tevékenység

gyógytorna-fizioterápia

egyéb terápia

Bővített csomag

Az összes REP-ben kötelező tevékenységeken túl az alábbiak közül a beteg szükségleteinek megfelelően továbbiak: vegetatív idegrendszer vizsgálata (12006), szenzorium vizsgálata (12000), érzőkör vizsgálat (12004), segédeszköz-ellátás elbírálása (95992), segédeszköz rendelés (93490, izomfunkció vizsgálata (13622), mozgásterjedelem vizsgálata végtagon (13623),  mozgásszervek regionális fizikális vizsgálata (13620), Ortézis-kezelés (83295), ,  sebkötözés (steril 81924, szennyezett 81929, párakötés 91010), Gipszkötés átpólyázása (83132), Gipsz hosszsú, rövid, (83250, 83251, 83252, 83253)

 Gipszágy (8324(T)), Rögzítés kötéssel (83000),   háromszög kendővel (83010) ,  vagy felfüggesztéssel (83030) gyógyászati segédeszköz mintavétel (93490)

egyéni torna (94701) vagy testtájankénti egyéni torna (94504) és passzív kimozgatás egy testtájon (94601), vagy passzív kimozgatás több végtagon (94602), és az alábbiak közül a beteg szükségleteinek megfelelően továbbiak: Járásgyakorlat járókerettel (94401),  mankóval (94402), ízületi mobilizálás (94640), kontraktúra nyújtás (82151), ízületi mozgások gyakorlása (94630), járáskészség fejlesztés (94406), járáselőkészítés ( 94405), izomerősítő gyakorlatok (94530), gyak. ellenállással szemben (94610), Izokinetikus gyakorlás készülékkel (94631), izomrehabilitáció tornáztató géppel (95993), rugalmas pólya felhelyezés (95560), Légzőtorna (94720), Testedzés (95490), manipulációs készség fejlesztése (94408), koordinációs gyakorlatok (94409), szertorna (94603), Értorna (88860), Gyógyászati segédeszköz használatának betanítása (93493), Járásgyakorlatok ortézissel (94404), Járásgyakorlat bottal (94403), Víz alatti torna egyéni (85520), Víz alatti torna csop. (85513),  Víz alatti torna medence segítve (85521), Víz alatti torna kádban (85512), Medencefürdő (94880), szelektív ingeráram (86319), Ultrahang (86911), TENS (86634), magnetoterápia (86921), kryotherápia calis (86121), masszázs kézzel (94712)

Betegfelvilágosítás, oktatás (95320) és az alábbiak közül a beteg szükségleteinek megfelelően továbbiak: önellátásra oktatás (95530), ergoterápia önellátó funkciók begyakorlása (95640), segédeszközök adaptációja (95660), foglalkozásterápia csoportos (95290), ergoterápia, írás tanítása (95650), pszichoterápia (96033), foglalkozásterápia egyéni (95291), ergoterápia manuális (95610), Ügyességfejlesztés (94407), Neuropszich. vizsgálatok

időtartam:

Időtartam: 2,5 óra naponta, ennek 75%-a egyéni kezdetben, később 50%-a

időtartam: napi 30-45 perc, hetente legalább 3x

 

5. A rehabilitáció eredményességének értékelése

5.1./ Változást jellemző teszteredmények: FIM, Barthel, ROM, izomerő VAS                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      

5.2. / Kimeneti jellemző

Munkaképes korúak - foglalkozási rehabilitáció megkezdése, ill id. leszázalékolás megindítása. Tanulók esetén munkaképességi vizsgálatok alapján esetleges pályamódosítási javaslat, iskola módosítás.

Nem munkaképes, ill. időskorúak – szociális gondozás, ill. háziápolás megszervezése, vagy elhelyezés kezdeményezése.

ÖNELLÁTÁS:

Mobilitási és önellátást segítő eszközökkel a sérült személyére nézve önellátó.

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