LE Amputation Etiology Flashcards
(40 cards)
It is estimated that > ________ individuals are living with the loss of 1 or more limbs in the US. Rates increase dramatically with _____.
- 2 million
- age
82% of amputations are due to _________.
-Secondary to complications of _____, _____.
- vascular disease
- diabetes, PAD
What is important in reducing the incidence of amputations?
- Early patient education
- Proper foot care
Majority of LE amputations are due to __________ while a majority of UE amputations are due to _________.
- vascular disease
- trauma
Why are the rates of amputation decreasing among diabetics, trauma patients, and cancer patients, despite an overall increase in these conditions?
We are doing a better job of educating patients and managing diabetes.
Do comorbidities increase the risk of amputations?
Yes
Are males or females more likely to have dysvascular and trauma related amputations?
Males
Is there racial disparity in regards to amputations?
Yes, African Americans, Hispanic American, and Native Americans are more likely.
Trauma and cancer related amputations are on the _______.
decline
What are the top 4 causes of amputation (in order)?
- Diabetes and PAD (Dysvascular Disease)
- Trauma
- Cancer
- Congenital Deficiencies
____________ is the most common risk factor for ulcer development in diabetes.
Peripheral Neuropathy
Describe the cascade of symptoms of peripheral neuropathy in diabetics that leads to amputation.
- Elevated Blood Sugars damages blood vessels and nerves leading to
- Loss of Protective Sensation resulting in blister or minor injury leading to a
- Ulceration that is non-healing causing
- Amputation
What are the 3 clinical signs of peripheral neuropathy?
- Deficits in sensation
- Motor impairments
- Autonomic dysfunction (different color, hair loss)
All these lead to a vulnerability of the foot to high-pressure and repetitive low-pressure traumas.
What are some other diabetic complications that lead to amputation other than peripheral neuropathy?
- ) Severe ischemic pain
- ) Absent pulses
- ) Local necrosis
- ) Osteomyelitis (bone infection)
- ) Systemic toxicity
- ) Acute embolism
- ) DVT
What are the 2 classic symptoms of PAD?
- ) Intermittent claudication (leg pain brought about by activity)
- ) Loss of one or more LE pulses
What are the 3 risk factors of PAD?
- ) Poorly managed HTN
- ) High cholesterol and triglyceride levels
- ) History of tobacco use
The 3 risk factors for PAD are also risk factors for _________ and _________.
- Stroke
- Cardiovascular Disease
How do we prevent limb loss in patients with diabetes?
- Foot screens (protective sensation, skin temp, distal pulses, visual observation)
- Patient recommendations (daily foot checks)
Do all diabetic patients receive foot screens?
ALL patients
What is included in a foot screen?
- Protective sensation with 10g monofilament
- Skin Temp with palpations for distal pulses (looking for elevated)
- Distal Pulses (arteriosclerosis obliterans)
- Visual Observation (nail shape and color, deformities, swelling, callus formation)
Protective sensation portion of the foot screen is done with a __g monofilament.
10g
Why are we looking for elevated temperatures when doing a foot screen?
Elevated temps show signs of inflammatory response.
When educating patient on performing daily foot checks, what do we tell them to look for?
- Increased temp
- Check pulse
- Nail color change
- Open wounds
What do we do if our patients cant see their feet either from obesity or lack of mobility?
- Teach them to use a mirror
- Teach caregiver
