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Hi Guys,
Im currently in the process of conducting full Annual Assessments for a nursing home and im quite aware of normal visual, clinical assessments including ABI's etc which will give an indication of PAD however being realistic if i contacted every GP in the area with concerns about most clients having signs of PAD, (including monophasic 0.25kHv Doppler results) they will think im nuts not to consider what is appropriate for their (elderly) age considerations. We consistently have resources for what is not appropriate for our bodies foot health wise (what it shouldn't be like) however what would be the norm in this situation?
I can't seem to find any articles relating to normal findings expected for aged people (obviously their will be some vascular changes with time), im not sure if this sounds like a completely dumb questions but would love any thoughts.
Cheers Tash
:bash:

 

Hi Tash,

I think you could speak to your local vascular team to find out what they would like you to look out for, I'm sure they would only be to happy to prevent unnecessary referrals.

Doing ABPI's on all these people would be quite time consuming when you could just listen to they Doppler sounds and take a history.

In view of the risks, no vascular surgeon is going to operate on an elderly person whose ischaemia isn't impacting on their daily life.

When you find ischaemic feet, find out the claudication distance and inquire about rest pain, if there is none (may be because they can only walk 10yds with the aid of a frame) and if the skin is intact, I just record my findings and give appropriate advice.

I can't help with references but I'm sure input from your vascular team is more appropriate.

Nina