vascular surgery unit & trauma and orthopaedics ward Flashcards
what is amputation required for? (6)
- vascular disease
- diabetes
- trauma
- malignancy
- infection
- unbearable pain
what are most lower limb amputations due to? (2)
- vascular diseases like diabetes or peripheral activities
what are most upper limb amputations due to?
- trauma
what does the LLA incidence range from?
- 7.12 to 41.4 per 100,000 for major
- 8.0 to 46.7 per 100,000 for minor
what do minor and major ULA represent out of total amputations?
- 2.6% from 31.8% of total amputations
what amputation is more common?
- ULA
what is the average hospital stay for amputees?
- 22 days
what increases the risk of amputation?
- peripheral arterial disease
- smoking
- diabetes
- coronary artery disease
how much does diabetes increase the risk for lower limb amputation?
- diabetes increases the risk of lower limb amputation by over 20 times
what percentage of over 60s are affected by peripheral arterial disease?
- peripheral arterial disease affects 20% of people over 60
what are people with peripheral arterial disease more at risk of? (3)
- comorbidity
- poorer function
- higher mortality rates
what is the average age of amputee patients?
- 70 years old
what is the new terminology for amputation?
- disarticulation
what are below knees and above knees replaced with?
- replaced with transtibial and transfemoral
what remains after amputation?
- residual limb
what is the contralateral limb called?
- called good or sound limb
what are the main examples of disarticulation? (7)
- partial foot
- ankle disarticulation
- transtibial
- knee disarticulation
- transfemoral
- hip disarticulation
- hemipelvectomy
what do physiotherapists reinforce pre- operation?
- reinforce general surgical information, provide advice on rehabilitation and commence assessment & rehabilitation planning before surgery where possible
what are patients instructed on?
- instructed in wheelchair use, and bed mobility and transfers should be taught when possible (helps the patient to be autonomous)
what two factors should be optimised before treatment?
- respiratory care
- pain control
when can carers be involved in pre- operative treatment?
- carers can be involved in pre-operative treatment & exercise programs if appropriate and with the patient’s consent
what does post- operative management involve?
- environment and equipment
- compression therapy
- mobility
- early walking aids
- falls management
- wheelchairs and seating
- prevention/ reduction of contractures
- exercise programmes
what management is essential post- operation?
- management of phantom sensation and pain
when should physiotherapy assessment & rehabilitation start?
- should be ideally started on the first day post- operatively
what should be considered and controlled before every treatment?
- pain should be considered and adequately controlled before every treatment
what should be given if appropriate?
- respiratory care should be given if appropraite
what should physiotherapists do post operation?
- physiotherapist should use their assessments to inform the MDT regarding interventions & discharge planning
what are the requirements of physiotherapists with the environment and equipment?
- physios should know about equipment that can aid rehab and daily activities
- require knowledge of specialist amputee equipment
what are three examples of specialist amputee equipment?
- slings
- hoists
- residual limb boards
what should physios be involved with when necessary?
- physios should be involved in home visits when necessary
what should environment and equipment be considered about? (4)
- individual
- intervention
- rehabilitation setting
- discharge destination
what should be taught on the first day post- operatively relating to mobility?
- bed mobility
- sitting balance
what should be taught as soon as possible after operation relating to mobility?
- safe training should be taught as early as possible
- out of bed to wheelchair transfers
what should physiotherapy help with regarding mobility?
- should help the patient gain maximum mobility post- operatively
what are the 5 transfers?
- bed to upright- sited position
- wheelchair to bed transfer
- bed to wheelchair with board
- wheelchair to bed with pillow
- bed to wheelchair with pillow
