Members do not see these Ads. Sign Up.

Hi

i have a general scenerio question here, working in the nhs on a home visit you discover a necrotic toe. what would be the short term and long term management?

look at medical history the underlying cause diabetes r/ha poor tissue perfusion i.e arterial bypass

scoial history look at mobility

physcal examination does the pt know it was present how long for
has she felt any pain? signs for ischameic pain - cramp

tests vascular with doppler dorsal pedis and posterior tibal
sensation testing with monofilament to determine the cause

dressing choice if its dry and firm to use iodoflex to minimise bacteria load

hospital admittance? for IV antibitoics?
referral to high risk foot ulcer clinic .. complications in terms of waiting to be seen and at times pt may have problem with mobility and transport to go at a regular basis to a high risk clinic?

thanks

 

Hi Nicola,

In my clinical opinion, any sign of critical limb ischaemia, then I would send the patient to hospital A&E ASAP.

Tish

 

Hi Nicola, I would agree with Tish -

short term - immediate referral

long term - depends on the underlying problem and treatment applied.