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Dear all,

Just reviewing some literature concerning blood pressure assessment as part of the pre-op work up prior to nail surgery. Is this viewed as something that is a must prior to nail surgery? The literature I've looked at doesn't really seem to support this as such.

Any guidance or direction to some helpful literature would be most welcome.

Best wishes.

 

When's the last time your dentist took a blood pressure?

 

When I was given the invoice

 

LOL, funny but also likely untrue ...

In my opinion Podiatry can get a little paranoid and overly anxious. I haven't concerned myself with blood pressure for that major procedure of the IGTN for many years. None of those patient have suffered any ill effect. Imagine my surprise ....

 

So why do you think so many NHS podiatry services across the land include this as part of their pre-op assessment? Belt and braces?

 

Paranoid and anxious ... is why.

Where's the evidence that blood pressure assessment can provide a patient with any benefit, conversely if not performed, this may harm the patient in some way? There isn't any. Now, when working in the NHS you may well be required to follow their peculiar modus operandi - or you may possibly risk a disciplinary action, for neglecting this 'vital' step in patient assessment.

If so, well then you had better comply; but at the very least you can chuckle to yourself reflecting on this folly, when doing so.

 

Indeed. Page 23, why don't you ask them (NHS management) why this is required? Presumably your usual history and physical will pick up any matters of concern. Please let us know the answer you receive.

bill Liggins

 

I agree. The overly defensive medicine approach to patient management seems to be at the heart (no pun intended) of this. It does seem odd to me that many NHS podiatry services have blood pressure monitoring as part of their pre-op assessment when the literature really doesn't point to any substantive reason to do so. Furthermore, the routine assessment of BP pre-op poses a risk to the cancellation of scheduled surgery and the need to potentially re-book those patients in the future.

Happy to share any revelation but I'm not sure it'll be as concrete as I'm hoping for.