'Best Feet Forward'.


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Distinguishing proof of dynamic foot issues that require further evaluation and/or treatment ... Diabetes confusions. Confirmation rates in the Central West Gippsland ...
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Module 4.1.1 \'Best Feet Forward\' Workshop material created by The Alfred DPMI Workforce Development Team for the Central West Gippsland PCP Diabetes Prevention & Management Initiative Produced by The Alfred Workforce Development Team in the interest of DHS Public Health - Diabetes Prevention and Management Initiative June 2005

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Acknowledgments This asset was produced in conference with the Central West Gippsland PCP: DPMI Technical Working Group. The presentation has been adjusted from the: Footcare in Diabetes Workbook for Health Professionals . Australian Diabetes Educators Association DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Workshop reason – Level 2 Target Registered medical attendants required in tending to individuals with diabetes i.e. those included in group, home or intense nursing, general expert practice medical caretakers. Target To give preparing to build aptitudes in: Appropriate foot appraisal and documentation of evaluation Identification of foot at high danger of ulceration or removal Identification of dynamic foot issues that require further evaluation and/or treatment Development of foot consideration activity/care arranges predictable with evaluation discoveries. DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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" Best Feet Forward " Project Aim To lessening foot issues in individuals with diabetes Objectives Train social insurance suppliers in the appraisal, characterization and consideration of the diabetic foot To bolster fitting activity arranging and multidisciplinary consideration of diabetic foot issues DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Diabetes intricacies Admission rates in the Central West Gippsland catchment are 2.5 times higher than the state An extensive rate of those conceded with entanglements happen underneath the knee Reference: Public Health Division, Department of Human Services, The Victorian Ambulatory Care Sensitive Conditions Study: Opportunities for Targeted Interventions, June 2002 DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Why play out a foot evaluation? Counteractive action of: foot ulceration gangrene removal Assist in the upkeep of: Mobility Independence Healthy dynamic way of life DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Function of the feet To go about as a steady base of backing To furnish stun assimilation with every progression To adjust to surface inconsistencies To give tangible criticism DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Peripheral vascular ailment Degenerative vascular ailment Most usually it is seen as different impediments of the popliteal supply route and its branches Risk components Hyperglycemia Smoking Hypertension Hyperlipidemia Normal Artery Stenosed Artery Fibrous and/or greasy plaques DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Peripheral neuropathy Impairment of nerve capacity segmental demyelination All nerve filaments can be influenced Sensory Autonomic Motor Ne r V e Axon Ne r V e Axon Myelin Sheath vital for typical motivation conduction Demyelination of axon i.e. no motivation conduction DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Foot ulceration Predisposing variables Vascular Disease Peripheral Neuropathy Infection Physical damage Precipitating elements Physical harm Mechanical (weight ) DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Foot ulceration Extrinsic Pressure Tissue Hypoxia Repetitive rubbing Footwear Intrinsic Pressure Limited joint versatility Callus Formation Altered tissue quality Foot deformation Irregular foot structure DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Foot ulceration-system DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Diabetic Osteopathy (Charcot\'s sickness) Presents as a warm swollen foot or lower leg Often misdiagnosed as cellulites Affects lower leg, subtalar and mid-tarsal joints Severe fringe neuropathy is almost constantly show Urgent orthopedic referral is required Foot must be immobilized while aggravation present DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Diabetic Osteopathy (Charcot\'s illness) DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Foot evaluation WHY? Most foot issues are preventable when recognized early, treated suitably and when individuals are taught to maintain a strategic distance from issues GOAL Prevent removals DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Foot evaluation Aim to distinguish the high hazard foot utilizing as markers History of past ulcer Peripheral neuropathy Peripheral vascular illness Foot distortion DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Foot appraisal Aim to recognize dynamic foot issues check for: Infection Ulceration Calluses or corns Any skin breaks Nail issue DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Assessment device

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Assessment device - last page

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General footcare Feet clean State of Skin – damp/dry/gleaming/smooth/slim Interdigitial territories – macerated/dry Callus Must be viewed as pre-ulcerative, esp in neuropathic foot. Shows up as yellow thickened skin Occurs at weight focuses Early treatment and weight help forestalls ulceration Socks, pantyhose, shoes – suitable, well fitting, give sufficient bolster Orthotics/prosthesis DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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General footcare Shoes Appropriate, give satisfactory bolster general guideline calfskin and trim are best Good condition Well fitting – shoes ought to fit three ways length/width/profundity Poorly fitting shoes can bring about rankles and corns that may ulcerate DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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General footcare Nails Thickened Fungal contamination Ingrown DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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General footcare Note and draw on feet on evaluation structure Ulceration-Non-recuperating wounds may happen anyplace on the feet, take a gander at weight regions e.g. tops/tips of toes, bundle of foot,heel, under callus. May be easy Infection-search for redness, warmth, release, swelling Signs and manifestations might be covered by ischemia or neuropathy Deformities, for example, corns, callus, bunions, hook/hammer toes, heel splits These zones are more helpless to weight and require exceptional regard for shoe fit DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Neurological status Symptoms of neuropathy Pain Burning, deadness, pins & needles Symptoms normally two-sided Often more awful around evening time May be easily affected to touch May be available when initially determined to have diabetes May compound with precarious blood glucose levels DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Vascular evaluation Symptoms of discontinuous claudication Pain in calf muscle when strolling, leg issues Pulses Dorsalis Pedis Posterior tibial Ulcer Gangrene Amputation DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Assess self consideration ability Does/can the customer: Understand impacts of diabetes on the feet Identify fitting foot care hones Smoke Able to enough look after their feet Have debilitated vision/portability DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Flow diagram for diabetes foot exams Start Type 1 and Type 2 Diabetes: when analyzed Annual Comprehensive Foot Exam and Risk Categorization By diabetes instructor/podiatrist/general expert Include training for self consideration of the feet and reassess metabolic control Visually examine feet 6 month to month Visually review feet at each visit Low Risk Feet High Risk Feet Action plan to bolster self consideration and recognizable proof of foot issues Action plan to reestablish and/or keep up uprightness of the feet DPMI Workforce Development – The Alfred Workforce Development Team June 2005 Adapted from Feet can last an existence time. A wellbeing experts manual for avoiding diabetes foot issues. National Diabetes Education Program http://www.ndep.nih.gov/assets/health.htm

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Risk classes DPMI Workforce Development – The Alfred Workforce Development Team June 2005 Adapted from Feet can last an existence time. A wellbeing experts manual for forestalling diabetes foot issues. National Diabetes Education Program http://www.ndep.nih.gov/assets/health.htm

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Action Plan DPMI Workforce Development – The Alfred Workforce Development Team June 2005 Adapted from Feet can last an existence time. A wellbeing experts manual for forestalling diabetes foot issues. National Diabetes Education Program http://www.ndep.nih.gov/assets/health.htm

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Case study one DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Case study two DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Case study three DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Case study four DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Case study five DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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Diabetic Osteopathy (Charcot\'s sickness) D

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