ISBAR

Question 1

Identification

Answer 1

-Full name
- Gender
- Date of birth
- address
Acronym:NGbA

Question 2

Situation

Answer 2

• Presenting complaint or reason for admission
• When did that happen?
• Where is it located?
• previous treatment
  -Footwear
• referral from Gp
• Secondary concern
  Acronym: RWWFRSP
  Also, OLCDARS FROM soap

Question 3

Background

Answer 3

1- Allergy
2-medical condition with dates and past surgery
3- Medication including dosage
4- Diabetes
5- level of Hba1c
6- falmily history
8a-living status
8b-Driving
9- alcoholic drink
10-smoking
11- occupation
12- eyesight
13- difficulty to reach the feet
14- use of mobility aids
15- wearing orthotics
16- seeing another health professional (allied health)
17- Objective findings ( refer to objective findings card
Acronym:
AMMH- FLDAS-OoDEMA

Question 4

Vascular assessment findings

Answer 4

1- Dorsalis pedis and tibialis posterior are (Check on further tests if pulse is not available) either present or absent
2-SVPFT
3-Hair pattern
4-Varicose pain
5-Oedema
6-colour
7-Tempreture
8-Skin
9- claudication and rest pain
Acronym: PSHVCTRCSO

Question 5

Skin condition and morphology

Answer 5

1- skin color
2-skin texture
3- adequate fat padding
4- presence of hypercretotic lesion, verruca and foreign body
5- interdigit maceration
6- venous statis
7- pigmented lesion
8- erythema
9- Oedema
10- Ulcer
11- melanoma check
12- foot deformity
Acronym:TFC-MPE-UMF

Question 6

Neurological assessment

Answer 6

1- Tuning fork
2-reflexes
3-abnormal sensation
4- Monofilament
Acronym: Tram

Question 7

Assessment

Answer 7

1- mentions the paitient name and age,
Upon examination , the patient is found at ———– risk of foot complications category (–) due to the findings in the objective assessment.
2- Th presenting complaint is most likely due to —– on the (location L or R)
3- Differential diagnosis

Question 8

Recommendations

Answer 8

Short term:
- Discuss the origins of the lesion or presenting complaint as well as educate the patient on the footwear ( refer to appropriate footwear card)
Discuss ulceration risk associated with neurovascular issues
- cut the nail and debride the callus
-apply padding if required
- recommend the patient moisturize the skin regularly to prevent hardening of the skin

Question 9

Long term

Answer 9

• Conduct Doppler ultrasound to monitor pulses
• using neurothesiometer to quantify the proprioception integrity or loss
• If padding was successful consider a permanent insole (refer to padding education and instruction card)
• further assessment is required to check on the patient’s gait cycle and referral to biomechanical clinic
• Correspondence to Gp and diabetic educator
• Follow up on HbA1c and footwear
  -review of lesion
  -review of risk (neurovascular assessment)