Week 4 - Amputations, Burns, aged care, Palliative care Flashcards
2 main reasons for performing amputations?
- patients health
2. patients function
2 factors causing amputation
- PVD (diabetics) - gangrenous toe. 85% diabetes related lower extremity amputations preceded by foot ulcer
- Traumatic (mostly MVA or MBA)
How many K levels are there?
4
List the key features of the differences of K levels
K0 - not eligible for prothesis
k1 - single- axis, constant friction knee (household ambulator)
K2 - Single-axis, constant friction knee (community ambulator)
K3 - Fluid and pneumatic control of knees (community ambulator beyond simple locomotion (exercise, traverse most environmental barriers)
K4 - Any ankle knee system appropriate (exceeds basic ambulation, high impact, stress or energy levels for athletes.
List the physiotherapy aims following LL amputation? (4)
GIMP aims
- Continuous ax of goals, needs and abilities
- set realistic tx plans
- promote independence
- re-educate mov’t patterns, optimize independent fx for ADL including self-care, aids, device use and return to work/leisure
List issues affecting goal achievement (6)
- residual limb condition
- concurrent pathology
- social & env’t
- lack of motivation
- inappropriate equipment
- lack of specialist services
What are the 3 features of pre-operative physiotherapy (3)
PEA
- physical, functional, psychological ax
- educate about rehab including exercise
- Wheelchair & mobility practice
What are the features of post-operative physiotherapy (12)
SPPLDD WATER
- sutures
- Pain
- Physical, fx ax
- Liaise with MDT
- Dressing
- Drain
- Wound healing
- Aids and devices
- Transfers
- Exercise
- Refer for discharge
list 2 main reasons why amputated body part is perceived (Phantom limb pain)
- Nerves severed and nerve injury
2. Brain area dedicated to that part & expects sensory information, processing altered info as pain
Mx for phantom pain (7)
M ARE CCC
- Ax
- reassure
- Electotherapy TENS
- compression
- massage, relaxation
- coordinate with analgesia
- counseling
Physiotherapy Ax and Mx for pre-prosthetics? (5)
CCELR
- Compression, shape
- Cardio fitness
- exercises - strengthen, stretch
- Liaise with MDT
- Refer for discharge
Physiotherapy Ax and Mx prosthetic (7)
PEE GAAP
- Ax (physical, fx, psych)
- Exercise
- gait re-education
- pain control
- Progress with aids
- ADL as part of MDT
- Educate about residual limb care/prosthesis
List life long management of prosthetic (6)
RI Race
- exercise
- interventions (revise)
- Appointments (Review)
- Community agencies (liaise)
- Re-integration (normal living)
- Resource (act)