Amputation Care Flashcards
How often should soft dressing and elastic wraps changed?
every day
How often should rigid dressing be changed?
every 3 days
Wound drainage
Sanguineous -> Serosanguineous -> Serous
Indication for a bright red blood stain on the dressing
Hemorrhage
Indication for a dark venous blood stain on the dressing
Draining hematoma
Indication for a thickened discolored exudate stain on the dressing
Infection
How long does a traumatic amputation usually heal?
2 weeks
How long does a vascular amputation usually heal?
4-8 weeks
How long do sutures or staples heal?
10-14 days post-op
How long do steri strips heal?
2 wks p sutures/staples are removed
A baseline for pre-prosthetic balance and walking abilities, and outcome measure for pre-prosthetic rehabilitation
Amputee Mobility Predictor Assessment Tool
What type of assessment is the AMPPRO?
performance measure
AMPPRO is used for pts who have…
Limb loss and impairment
Subcategories of AMPPRO
AMPPRO
AMPnoPRO
no. of items for AMPPRO
21
no. of items for AMPnoPRO
20
Indicates how much assistance is required
for the individual to carry out ADLs
Functional Independence Measure (FIM)
FIM is used for pts who have…
CVA
SCI
Brain injury
Geriatric care
Mixed population
no. of items for FIM
18 (13 motor & 5 cog)
Highest score for FIM
126
Lowest score for FIM
18
Factors influencing prognosis include
Ambulation status (pre-op)
Overall physical fitness
Age
Ability to maintain single limb stance s assist
Wound healing
Contracture
Contributing factors to poor prognosis include
Mod-severe Dementia
End-stage renal disease
Coronary Artery Disease
Decreased body mass
How frequently are uncomplicated amputation treated?
4-7 days
What is the duration for treatment of uncomplicated amputation?
30-45 mins; 1x/2x daily
How frequently are frail and old pts c amputation treated?
21 or more days
What is the duration for treatment of frail and old pts c amputation?
30-45 mins; 1x/2x daily
Rehab aims to prevent
Post-op complications
Deformities
Stump edema
Rehab aims to maintain
Strength and general mobility
Other rehab goals
improve balance and transfer
Re-educate ambulation and restore indep.
Treat phantom pain
Therapeutic modalities used for post-op
TENS
Massage
Superficial heat
Cryo
Mirror therapy
Exercise to prevent post-op complications
Ankle pumps
What is used to control stump edema?
Compression socks/bandaging specifically Juzo Socks
How should the pressure be in bandaging a stump?
Moderately firm
Evenly distributed
Decreased proximally
Extra pressure over the corners
Pattern of bandaging
Diagonal, spiral, or oblique
Non-circular
How should the pt position in AKA bandaging?
Hip extension and adduction
How should the pt position in BKA bandaging?
Slight knee flexion
What are the things to do when walking s prosthesis?
Using firm compression socks or bandage during gait training
Use crutch
Normal alignment of the pelvis should be maintained
How to prevent deformities?
Bed positioning and exercises
Dos for BKA positioning in supine
Keep RL flat
Keep legs close together
Lie on a firm bed or couch
Contraindicated position for BKA in supine
Pillow under RL or bet thighs (flexion and abduction)
Cross legs (excessive add)
Letting the RL dangle on the edge
Dos in BKA standing
Standing up or walking every waking hour
Hold RL pointing to the floor
Donts in BKA standing
Hold RL in front our out when walking
Resting RL on walker or cruches
Exercises for High AKA
Hip extensor and adductor isoms
Exercises for Low AKA
Hip extensor and abductor isoms
