Transcript of What is a prosthetist?
Helen Hill, Senior Prosthetist - Hunter Prosthetics and Orthotics Service: A prosthetist fits artificial limbs to amputees. We quite often do the casting, manufacture, fitting, delivery of lower limbs and upper limbs, so legs and arms, to any amputees that come our way.
Daiko Mizio, Prosthetist - Hunter Prosthetics and Orthotics Service: So normally we cast residual limb with plaster bandages, to make a mold out of that and then fill it with a plaster of paris to produce a cast like this, and modify the shape so that it fits comfortable and nice. And we have a fitting of the device to the clients and make sure it's all comfortable and good to walk on.
Helen: So our day is quite varied, we will often be doing paperwork or manufacture. When our patients come in, most of them are outpatients, we will either be casting them or fitting the legs to them. Quite often we're just doing adjustments or repairs to their limbs. For any of our inpatients, we often work with the physios in gait training and we work with a multidisciplinary team doing case conference and ward rounds to make sure that our patients receive the best possible care.
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Daiko: The amputee normally go through lengths of time being immobilised in hospital, which deteriorates their physical fitness. Being able to walk again or able to use arm for daily tasks help them rehabilitate their body and recover quicker.
Helen: So I'm really excited about the Austral integration that's been developed. So that involves having a titanium rod inserted into the bone of an amputee so whether it's a lower limb or an upper limb, and it negates the need for having a socket and the patient just clicks a leg on and off they go. So that's yeah, quite exciting for us.
Daiko: It's an exciting time for the prosthetic industry because of advancement in technology, there are 3D printing technology coming out that help to provide a service be faster by speeding up the manufacturing process so the patient doesn't have to wait long, and new materials that produce lighter and stronger prosthetic device and also components incorporating microprocessors that would provide the patients more control of their prosthesis.
Transcript of What is an orthotist?
Madeleine Cosgroff, Orthotist - Sydney Children's Hospitals Network - Westmead: An orthotist is an allied health professional that makes assistive braces for all over the body. For example, this could include for the legs, for the feet, for the back, and also for the neck. There's just a large variety of devices that we can make to assist patients in everyday life.
Brett Nicholas, Technical Officer - Sydney Children's and Prince of Wales Hospitals Shared Orthotics Service: An orthotic technician is a person that takes a prescription from an orthotist based on a clinical assessment and then manufactures that device to meet the prescription and healthcare requirements of the patient.
Elaina Vatcky, Graduate Orthotist - Sydney Children's and Prince of Wales Hospitals Shared Orthotics Service: Day-to-day as an orthotist I tend to see patients that might need custom devices or prefabricated devices to be fit to them, to achieve their goals. I'll attend multidisciplinary meetings and I'll also... what's involved in custom workers doing a lot of tech work, like working on the plaster to be able to actually make the devices for people.
Brett: On a day to day basis and orthotic technician manufactures the devices. These devices can be anything from a helmet to a scoliosis brace to an ankle foot orthoses on the lower limb. We manufacture these devices from thermoplastics which we vacuum form. We use a lot of other materials such as metal and leather. More and more we're manufacturing our devices from high-performance materials such as carbon fibre. Carbon fibre is very strong but extremely light, which is a great benefit to our patients.
Daniel Balassone, Orthotist - Sydney Children's Hospitals Network - Westmead: So as an orthotist we work in this department, but not solely in this department, we work in the emergency departments as well, in theatres, in different clinics and on the wards. And our job is to assess patients for orthotic needs, make a clinical judgment and a prescription and actually carry out the fabrication process of the device that's ultimately going to help them.
Madeleine: On a day-to-day basis we'll be seeing a range of patients. For example in our department we would be seeing a paediatric population, so whether that would be assessing your patient, assessing how they walk and why they walk the way they do, we could be casting them with plaster to take a mold of a certain part of their body, we could also be making the braces for the certain part of their body, so this includes plaster work like the leg in front of me. From there we would mold plastic onto this leg, cut it off for the finished product which is the brace for the leg.
Elaina: This helps patients predominantly to be able to achieve their goals in everyday life. So for example, if there's a child that's not functioning well at school and not keeping up with their peers due to their disability, then we might be able to make something or provide them something that will assist them in achieving this goal and feeling more with part of their community.
Thomas Paine, Senior Orthotist - North Shore Ryde Health Service: I like to think that we can add value to the health system by preventing further hospital stay, especially if someone who might be amputee risk, so if we were able to do feel a device, a preventative device, a long-term effect might prevent another hospital admission. And also in general we can facilitate quicker discharge and yeah keep them away from the hospital which is always a good thing.
Thomas Short, Orthotist - North Shore Ryde Health Service: So I think our role as orthotist adds value because we work with a part of a larger team. For example a patient might not be out to be seen by somebody else until we have sorted out any problems with stability of bones, so for example a physio won't be able to get a patient and walk them until they've been seen by us, and so the sooner I see somebody, then the sooner they can see other members of the team and that can help get them out of hospital early and improve their quality of life and save the system money as well.
Madeleine: Some exciting things on the horizon for our profession includes 3D scanning, 3D printing and carving. Basically, 3D scanning is an electronic device that will scan a certain part of the patient's body, then transfer to a computer where you can 3D print from that or also carve from that. From those images we can then make the brace or orthotic device. This is a really quick great solution for our profession.
Casting a child can be very traumatic or even just an adult, it can be quite stressful on the clinicians as well, so this saves a lot of time and a lot of tears for the patients. And it's also a really cool interactive thing for a child to be looking at, is a 3D scan going onto the computer.
