Pre-Op Amputation Management Flashcards
What are 5 common Typical Pre-op Patients?
Diabetic/Vascular patients with non-healing wounds
Post-trauma patients, primarily burns or severe orthopedic injuries with poor healing
Cancer
Arthritis with severe joint deformity and wounds
CP, CRPS(RSP), Congenital deformities, Chronic pain related to past injuries
What are common characteristics of pre-op patients?
Over age 60
Limb loss due to disease
More disabled with more comorbidities
In the US, over half of limb amputations are due to what?
Complications with DM
When does PT involvement start?
Before the decision to amputate
What is the primary focus of pt edu??
Tailored to patient’s needs and situation; visits are limited in this range. PT can facilitate peer visit and/or opportunity to meet with an prosthetist
What are three aspects for pre-op edu Pain Management?
Assess for existing pain prior to surgery and treat aggressively as a team
Educate patient and family/caregivers what to expect post-op
Especially important for individuals with pre-surgical pain issues
What is the most common objective way to measure pain? What are two others?
VAS
SF-MPQ (short form McGill pain questionnaire)
PIS (pain interface scale)
Is pain med addiction common?
No, if taken as directed
When should you intervene w/ pain relief?
As soon as possible. It is easier to relieve minor pain before it becomes major
Should a patient be actively involved with making a choice among prosthetic vendors?
Yes
What are different topics you should educate your patient on pre-op?
ROM
Strength
Exercise (Cardiovascular)
Balance
What are 3 things a HEP should address??
- Current ROM and Strength
- At-risk ROM and Strength
- Encourage cardiopulmonary exercise, if possible.
What are 8 Community Integration aspects for pt edu?
Current level of mobility (how will it be affected, especially bilat) Resources available Prior or expected level of mobility Vocational concerns Recreational concerns (e.g. sports leagues) Home assessment Recommendations Driving
What are 3 methods of home assessment discussed in class?
Physical assessment at home (can use videos)
Paper assessment by patient or family (unlikely)
Verbal assessment (rare)
What are 4 recommendations for com. integration pre-op edu?
Ramp/wheelchair accessibility
Shower adaptations
Lighting
Clutter reduction (Pets are common)
