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Diabetes Patient's foot/ Legs Examination (Self introduction (Explain…
Diabetes Patient's foot/ Legs Examination
Preparation
Gathering required equipment
Tendon hammer
Tuning fork (128 H")
Monofilament
Inspection
Skin changes
Shiny appearance of the skin
Erythema - may be suggestive of cellulitis
Hair loss
Calluses may suggest abnormal gait or inappropriate foot wear
Pallor
Ulcer inspection
Examine pains in the foot
Deep punched out appearance
Examine changes in skin
Other abnormalities & musculoskeletal inspection
Charcot arthropathy: deformity due to loss of sensation
Joint deformity
Venous guttening to determine very little blood with in them
Smelling
Erythema
Palpation
Vascular assessment
Assess and compare the temperature of lower limbs and feet
High temperature may indicate cellulitis and deep vein thrombosis
Lower temperature indicates poor periferal perfusion
Assess pulse
Absence of periferal pulses indicate periferal vascular disease
Palpate dorsalis pedis artery
Palpate posterior tibia artery
Neurological assessment
Assess sensation using Monofilament
Self introduction
Explain the procedure and gain patient's consent
Confirm the patient's details (name and date of birth)
Gain consent from patient
Position the patient on an elevated couch at 45 degress
Expose thepatients's lower legs and feet
Ensure patient's privacy
Introduce yourself
Wash and desinfect hands
Patient History Taking (Anamneesi)
Medical history
Previous angioplasty, stent or leg bypass surgery
Allergies
Foot wounds requiring more than 3 weeks to heal
Smoking / nicotine use?
Occupation
Family history