Diabetic Foot Assessment
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Transcript of Diabetic Foot Assessment
DIABETIC FOOT ASSESSMENT
A brief outline of a simple foot assessment
Cameron Kippen
In the Beginning
The longer we live the more we seem to rely on the services of others to tend to our feet.
The Podiatric Demographic
Seniors, Sight challenged Hypertensive Peripheral vascular
disease Varicosities Water retention Arthritides Diabetes Obesity Other co-moribidity
Complications of the Diabetic Foot
Ischaemia
Deformity
Infection
Ulceration
Charcot’s neuroarthropathy
Assessing Diabetic Peripheral Neuropathy
• Monofilaments 5.07 (10g)
• Neuropathy Disability Score
• Vibration Perception
• Pin Prick Sensation
• Temperature Sensation
• Propriception
• Ankle Reflex
Semes-Weinstein Monofilaments 5.07 (10g)
Modified Disability Score
Vibration Perception Threshold
Pin prick test Proprioception
Achilles Tendon Reflex
Sensorimotor Symptoms
Muscle Wastage Joint Mobility
Vascular Status
Pulses
Diagnostic Ultrasound
Ankle Brachial Pressure Index
Toe Index.
Foot Morphology & Locomotion
Symmetry
Pivot points and Pressure areas
Amputation
Muscle wastage
Abnormal gait patterns
Footwear Assessment
Size (length and breadth)
Volume
Suitability
Wear marks
Category of Risk
Low risk i.e. no risk factors with palpable pulses and normal sensation. Recommend annual foot examination and education.
Intermediate risk i.e. the presence of neuropathy or absent pulses or foot deformity . Recommend review every 3 to 6 months.
High risk i.e. where two or more risk factors are present (neuropathy, peripheral arterial disease or foot deformity or a previous history of foot ulceration . Recommend 3 to 6 months reviews.
Critical risk Referral GP/Hospital within 24 hours
CARE
Control Blood Glucose Levels
Annual Foot Screening Examination
Report change immediately
Engage in simple daily foot care
Collaborative Approach
Team Care Arrangements –item 723
General Management Plan – 721
Enhanced Primary Care Plan
Community Aids and Equipment Program (CAEP)
References
National Evidence-Based Guideline Prevention, Identification and Management of Foot Complications in Diabetes April 2011
http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/diabetes_foot_full_guideline_23062011.pdf Australasian Podiatry Councilhttp://www.apodc.com.au/ Diabetes Australiahttp://www.diabetesaustralia.com.au/
Commonwealth of Australia
WARNINGThis material has been copied and communicated
to you by or on behalf of Cameron Kippen pursuant to Part VB of the Copyright Act 1968
(the Act).
The material in this communication may be subject to copyright under the Act. Any further copying
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