vascular surgery unit & trauma and orthopaedics ward

Question 1

what is amputation required for? (6)

Answer 1

• vascular disease
• diabetes
• trauma
• malignancy
• infection
• unbearable pain

Question 2

what are most lower limb amputations due to? (2)

Answer 2

• vascular diseases like diabetes or peripheral activities

Question 3

what are most upper limb amputations due to?

Answer 3

• trauma

Question 4

what does the LLA incidence range from?

Answer 4

• 7.12 to 41.4 per 100,000 for major
• 8.0 to 46.7 per 100,000 for minor

Question 5

what do minor and major ULA represent out of total amputations?

Answer 5

• 2.6% from 31.8% of total amputations

Question 5

what amputation is more common?

Answer 5

• ULA

Question 6

what is the average hospital stay for amputees?

Answer 6

• 22 days

Question 7

what increases the risk of amputation?

Answer 7

• peripheral arterial disease
• smoking
• diabetes
• coronary artery disease

Question 8

how much does diabetes increase the risk for lower limb amputation?

Answer 8

• diabetes increases the risk of lower limb amputation by over 20 times

Question 9

what percentage of over 60s are affected by peripheral arterial disease?

Answer 9

• peripheral arterial disease affects 20% of people over 60

Question 10

what are people with peripheral arterial disease more at risk of? (3)

Answer 10

• comorbidity
• poorer function
• higher mortality rates

Question 11

what is the average age of amputee patients?

Answer 11

• 70 years old

Question 12

what is the new terminology for amputation?

Answer 12

• disarticulation

Question 13

what are below knees and above knees replaced with?

Answer 13

• replaced with transtibial and transfemoral

Question 14

what remains after amputation?

Answer 14

• residual limb

Question 15

what is the contralateral limb called?

Answer 15

• called good or sound limb

Question 16

what are the main examples of disarticulation? (7)

Answer 16

• partial foot
• ankle disarticulation
• transtibial
• knee disarticulation
• transfemoral
• hip disarticulation
• hemipelvectomy

Question 17

what do physiotherapists reinforce pre- operation?

Answer 17

• reinforce general surgical information, provide advice on rehabilitation and commence assessment & rehabilitation planning before surgery where possible

Question 18

what are patients instructed on?

Answer 18

• instructed in wheelchair use, and bed mobility and transfers should be taught when possible (helps the patient to be autonomous)

Question 19

what two factors should be optimised before treatment?

Answer 19

• respiratory care
• pain control

Question 20

when can carers be involved in pre- operative treatment?

Answer 20

• carers can be involved in pre-operative treatment & exercise programs if appropriate and with the patient’s consent

Question 21

what does post- operative management involve?

Answer 21

• environment and equipment
• compression therapy
• mobility
• early walking aids
• falls management
• wheelchairs and seating
• prevention/ reduction of contractures
• exercise programmes

Question 22

what management is essential post- operation?

Answer 22

• management of phantom sensation and pain

Question 23

when should physiotherapy assessment & rehabilitation start?

Answer 23

• should be ideally started on the first day post- operatively

Question 24

what should be considered and controlled before every treatment?

Answer 24

- pain should be considered and adequately controlled before every treatment

Question 25

what should be given if appropriate?

Answer 25

- respiratory care should be given if appropraite

Question 26

what should physiotherapists do post operation?

Answer 26

- physiotherapist should use their assessments to inform the MDT regarding interventions & discharge planning

Question 27

what are the requirements of physiotherapists with the environment and equipment?

Answer 27

- physios should know about equipment that can aid rehab and daily activities - require knowledge of specialist amputee equipment

Question 28

what are three examples of specialist amputee equipment?

Answer 28

- slings - hoists - residual limb boards

Question 29

what should physios be involved with when necessary?

Answer 29

- physios should be involved in home visits when necessary

Question 30

what should environment and equipment be considered about? (4)

Answer 30

- individual - intervention - rehabilitation setting - discharge destination

Question 31

what should be taught on the first day post- operatively relating to mobility?

Answer 31

- bed mobility - sitting balance

Question 32

what should be taught as soon as possible after operation relating to mobility?

Answer 32

- safe training should be taught as early as possible - out of bed to wheelchair transfers

Question 33

what should physiotherapy help with regarding mobility?

Answer 33

- should help the patient gain maximum mobility post- operatively

Question 34

what are the 5 transfers?

Answer 34

- bed to upright- sited position - wheelchair to bed transfer - bed to wheelchair with board - wheelchair to bed with pillow - bed to wheelchair with pillow