Amputees Flashcards
Peripheral Neuropathy:
What is it?
Peripheral neuropathy is a condition that occurs when the peripheral nerves (nerves outside the brain and spinal cord) are damaged.
This damage can impair the function of these nerves, affecting sensation, movement, and organ function.
Peripheral Neuropathy:
How does it occur?
It occurs when the nerves are damaged due to various factors, such as high blood sugar (in diabetes), infections, autoimmune diseases, injuries, toxins, or inherited conditions. The damage can affect sensory, motor, and autonomic nerves.
Peripheral Neuropathy:
When can it occur?
It can develop over time, especially in conditions like diabetes, where nerve damage is chronic. It can also occur suddenly, such as after an injury or infection.
Peripheral Neuropathy:
Who does it affect?
It affects people with diabetes, autoimmune diseases (e.g., lupus, rheumatoid arthritis), infections (e.g., shingles, HIV), or those who have had injuries, surgery, or excessive alcohol consumption. It can also be inherited or caused by chemotherapy.
Peripheral Neuropathy:
How does it present?
Symptoms may include:
Numbness, tingling, or a “pins and needles” sensation in the hands or feet.
Pain, burning, or sharp shooting sensations.
Weakness or loss of coordination.
Difficulty walking or performing fine motor tasks.
Loss of reflexes or balance problems.
Peripheral Neuropathy:
How is it treated?
Managing the underlying cause (e.g., controlling blood sugar in diabetes, stopping alcohol consumption).
Medications: Pain relievers (e.g., gabapentin, pregabalin, or tricyclic antidepressants) for nerve pain.
Physical therapy: To improve strength, coordination, and mobility.
Lifestyle changes: Proper nutrition, regular exercise, and managing health conditions.
Causes and Risk Factors for Amputation
What is amputation?
Amputation refers to the surgical removal of a part of the body, typically a limb, due to injury, disease, or other medical reasons.
Amputation
How does it occur?
It occurs due to severe injury, infection, or damage to blood vessels and nerves that makes it impossible to save the affected part of the body.
Amputation
When can it occur?
Amputation can occur in cases of:
Severe trauma (e.g., accidents, crush injuries).
Poor circulation (e.g., in peripheral artery disease or diabetes).
Infections that do not respond to antibiotics.
Cancer or tumors affecting the limbs.
Severe frostbite or burn injuries.
Congenital defects that affect limb formation.
Amputation
Who does it affect?
Amputations affect people with severe trauma, diabetes, peripheral vascular disease, or infections that can’t be controlled. It can also occur in those with cancer or who have congenital limb deficiencies.
Amputation
How does it present?
It presents as a loss of limb or part of a limb, often accompanied by significant pain, swelling, and changes in appearance or function.
Amputation
How is it treated?
Pre-operative care: Stabilizing the patient, controlling infection, managing pain, and preparing for surgery.
Surgical amputation: The limb or part of the limb is removed in a manner that preserves as much function as possible.
Post-operative care: Involves wound care, pain management, physical therapy, and preparation for prosthetic fitting.
Pre-Operative Amputee Assessment
Explanation to the Patient:
“Before your amputation, we will conduct a thorough assessment to prepare you for surgery and ensure the best possible outcome. This assessment involves several important steps:
Medical History Review: We will ask about your current medical conditions, previous surgeries, medications, and any conditions like diabetes or vascular diseases that may affect healing.
Physical Examination: We will assess the area that needs amputation, evaluating the extent of the injury or disease and ensuring there are no other areas that require intervention.
Assessment of Circulation: We will evaluate your blood flow to ensure the remaining limb will have good circulation after surgery, and we may conduct tests like an ankle-brachial index (ABI) or Doppler studies.
Psychosocial Support: We’ll discuss the emotional and psychological impacts of amputation and offer counseling or support services. It’s important that you understand the process and what to expect post-surgery.
Prosthetics Consultation: If applicable, we’ll discuss the potential for prosthetic use, taking measurements for a prosthesis if appropriate, and explaining the process for fitting and rehabilitation.
Pain Management Plan: We will discuss pain control options during and after surgery, including medications and other strategies to help with recovery.
Infection Prevention: We will talk about preventing infection, ensuring proper hygiene, and addressing any concerns you may have about the surgical site.
This pre-operative assessment helps ensure you’re physically and mentally prepared for surgery and recovery.”
Post-Operative Amputee Assessment
Explanation to the Patient:
“After your amputation, we will conduct a post-operative assessment to monitor your recovery and ensure proper healing. This involves:
Wound Healing: We will closely monitor the surgical site for any signs of infection, such as redness, swelling, or drainage. If any complications arise, we will address them immediately.
Pain Management: We’ll assess your pain levels regularly to ensure you are comfortable. Medications, nerve blocks, or other pain management techniques may be used to control post-surgical pain.
Circulation and Skin Care: We will check blood circulation to the remaining limb to ensure there are no complications, and we’ll guide you on caring for your skin to prevent sores or ulcers.
Mobility and Rehabilitation: Our physical therapists will work with you on mobility exercises, helping you to adjust to changes in your balance and posture.
Prosthetic Fitting: If you’re a candidate for a prosthesis, we will begin the fitting process, ensuring the prosthetic device is well-suited to your needs. This will involve multiple fittings and adjustments.
Psychosocial Support: We’ll provide emotional support and counseling as you adjust to life after the amputation. It’s normal to experience a range of emotions, and we are here to support you through the process.
This post-operative assessment is essential in ensuring your recovery is smooth and that you regain as much function and independence as possible.”
Explaining Phantom Limb Pain to a Patient
Explanation to the Patient:
“Phantom limb pain is a sensation that can occur after an amputation, where you may feel pain or discomfort in the limb that is no longer there. This happens because the nerves that once carried sensations from your limb to the brain are still active, even though the limb has been removed.
Why does it happen? When the brain loses input from the limb, it can cause confusion, leading to the sensation of pain or itching where the limb used to be.
What does it feel like? It can feel like cramping, burning, or tingling sensations in the area where your limb used to be, and it can vary from mild to severe.
What can be done? Treatment may include medications (like pain relievers or anticonvulsants), physical therapy, and sometimes mirror therapy or nerve stimulation to help reduce the sensation. It’s important to discuss this with your doctor so we can manage it effectively.
Phantom limb pain is relatively common, and while it can be distressing, there are ways to help manage it as you adjust to life after your amputation.”
