ELT · Ethaniel Lymphatic Team
LymphRank™ Clinical Sign-Off
Protocol v1.0 · 60-minute meeting · GO / HOLD before December 2026 build
All ELT sessions are mobile home visits — therapists drive to the client.
Why we're here
Validate that scoring + session checklist match real ELT care — on paper first, code in December. Higher score = more clinical need (0–500). Clients see plain language, not clinical codes.
60-minute agenda
| 0–5 | Opening — purpose, higher score = worse |
| 5–15 | Client tab — Does 248 / Band III feel right? |
| 15–30 | Five domains — Approve or revise each |
| 30–40 | Bands → treatment + session frequency |
| 40–50 | Therapist tab — 7 protocol steps in real order |
| 50–58 | Five rapid-fire decisions (below) |
| 58–60 | GO / HOLD + signatures |
Who attends
- Clinical lead — required
- Lead therapist — required
- Founder / admin — required
- Surgeon advisor — optional
Bring 2–3 anonymized cases: early post-op, fibrosis concern, wellness.
Five domains — approve each
| Domain | Client sees | Approve | Revise notes |
|---|---|---|---|
| Swelling Severity | Swelling level | ☐ | |
| Fibrosis Risk | Tissue health | ☐ | |
| Drainage Deficit | Drainage flow | ☐ | |
| Pain / Discomfort | Comfort level | ☐ | |
| Mobility Impact | Movement ease | ☐ |
Score bands
| Band | Score | Service | Freq. |
|---|---|---|---|
| I | 0–100 | Flow Reset | 1×/mo |
| II | 101–200 | Flow Reset | 1×/wk |
| III | 201–300 | Post-Op | 2×/wk |
| IV | 301–400 | Post-Op / Fibrosis | 2–3×/wk |
| V | 401–500 | Escalation | 3×/wk + MD |
Escalation rules
- Redness + heat → surgeon review
- Fluid leakage → block booking
- Clearance pending → block until cleared
- Band V → admin escalation queue
Mobile session steps
En route · GPS arrival + home setup · Breathing · Proximal nodes · Trunk MLD (bed/couch) · Distal MLD · Cross-fiber · Compression · Photo
Five rapid-fire decisions — write answers
- Intake sliders enough, or add swelling-by-body-area?
- One fibrosis rubric for all surgeries, or BBL / TT / lipo variants?
- Always 60 min, or 90 min for Band IV–V?
- Circumference every session, first only, or never?
- Client discharged at Band II, Band I, or therapist judgment?
- Minimum home setup + standard vehicle kit for every visit?