Admission to BMRH from the Acute Care Hospital
Admission to the BMRH Amputee Program can be directly from the acute care hospital after an evaluation by the BMRH clinical liaison and MD review to identify if an acute care stay is appropriate.  The initial inpatient stay status post amputation is generally 7 - 14 days. 

During the initial inpatient stay, we provide a Comprehensive Team Approach with physical and occupational therapy, nursing, physiatry, psychology, case management, recreational therapy (if appropriate).If applicable, diabetic education is provided.

Individuals work on functioning independently with limb loss including walking, stair climbing, transfers, bed mobility, wheelchair use, bathroom/shower use, family training, skin management, and maintaining health of remaining limb.

Goals of treatment: Initial Inpatient Rehab Stay

• Perform basic Activities of Daily Living with supervision/modified independence, including functional transfers, mobility and energy conservation 
• Determine level of mobility at discharge -- wheelchair vs. ambulatory
• Maintain range of motion at hip and /or knee of amputated limb
• Prevent contractures at hip/knee
• Teach proper positioning in wheelchair
• Achieve independence with Home Exercise programAchieve independence with skin management and desensitization techniques
• Train family how best to assist patient to continue therapy at home
• Provide individuals with proper fitting shoe (healing shoe or diabetic shoes) from an orthotist

Individuals are discharged to Home Care or Outpatient Services for a few weeks to several months for wound healing.  During this time, individuals master the skills they learned in the rehab setting, including maintaining safety in their home environment and maximizing level of independence.

Edema control may be initiated with ace wrap vs. shrinker. Some individuals may not need therapy during the healing period, depending on how they progress. 

Admission to BMRH from a Subacute or Skilled Nursing Facility
Some individuals who are admitted to a subacute or nursing home facilities directly from the acute hospital inpatient stay may still be appropriate for the BMRH Amputee Program.  Individuals need to make an appointment to be seen in the BMRH outpatient Amputee Clinic to be considered for inpatient or outpatient services in the BMRH Amputee Program.
To make a referral or an appointment, call 610-251-5566.

Amputee Clinic
The Amputee Clinic is a BMRH outpatient program that has a dedicated team of healthcare professionals that includes a physiatrist, physical therapist, prosthetist, nurse, and case manager.  Individuals may be seen in the Amputee Clinic from initial amputation until they get their permanent prosthesis.  Referrals can come from an acute care hospital, nursing home or from patient or healthcare professional. 

Initial Evaluation
Individuals are evaluated by each member of the team.  The components include the patient's medical history, strength assessment, skin integrity, and gait assessment with or without a  prosthesis. An initial prosthesis is presented. 

Individuals are followed by the team at BMRH and are evaluated for an inpatient stay.  At the initial evaluation the assessment includes:

• Prosthetic fit evaluated by PT, MD and prosthetist to assess readiness for inpatient stay
• Individuals try on the prosthesis and ambulate
• Skin tolerance is monitored before and after ambulation

At Discharge: Home Care or Outpatient Services
Individuals will continue to work toward increased balance, continued monitoring of sock needs, other functional skills not yet mastered (may include advanced ambulation and elevations) and progressing to walking with a one-handed device.  The duration is from several weeks to several months.

Adapted Driving, if needed, is also available at Bryn Mawr Rehab Hospital.

Follow-up Outpatient Amputee Clinic Appointment
Individuals are now seen in clinic to determine what type of permanent prosthesis is recommended.  They may or may not require further prosthetic training to fine-tune gait/function with the  permanent prosthesis.

Final Amputee Clinic: Follow Up
Individuals have a final check-in with the prosthesis team to assure patient satisfaction.  The patient will have a fine-tuned prosthetic alignment, if needed. Individuals may follow up as needed when other issues or questions arise or for a replacement prosthesis.

Amputee Support Group
Bryn Mawr Rehab Hospital provides an outpatient Amputee Support Group.  The purpose of the group is to discuss social and emotional issues after undergoing an amputation.  BMRH in many instances will incorporate the inpatient population to expose them to future outcomes that are possible with the use of a prosthetic.

To make a referral or an appointment, call 610-251-5566.  Referrals can come from an acute care hospital, nursing home or from patient or healthcare professional. 

The Referral Process
A referral to Bryn Mawr Rehab Hospital can be made by a physician, an insurance case manager, a social worker from an acute-care hospital, or a family member. Our clinical liaisons are available on-site at many acute-care hospitals in the Delaware Valley to review and evaluate medical records and to speak to families whose loved ones could benefit from our specialized services. Family members are strongly encouraged to visit our campus and to tour our Spinal Cord Disorders Unit and therapy facilities when making a decision about rehabilitation care.