- WIPE, blah blah 🙂
- “Take vital signs”
- Position: laying down 45°
- Proper exposure: both legs
- General inspection of the patient + surroundings (walking aids)
- Inspection:
- Color: pallor\erythema
- Swelling
- Joint deformities (Charcot’s joints)
- PVD: hair loss, shiny skin
- Infections (between the toes)
- Pulses
- Ulcers (between the toes)
- Callus (bottom of the feet and heel)
- Palpation:
- Temperature
- Pitting edema
- Pedal pulses: dorsalis pedis + post tibial
- Capillary refill (< 2 secs)
- Sensation: Mono-filament
- First show the pt how it feels (on back of hands)
- Ask pt to close their eyes and tell you if they feel on left\right side
- Vibration: 128 Hz tuning fork
- First show the pt how it feels (on sternum)
- Ask pt to close their eye and tell when they feel the vibration + when it stops
- Place on distal bony prominence
- Proprioception
- W\ pt eyes open, show the pt which is up\down
- Ask pt to close eyes and tell if toe is up\down (hold distal phalanx of great toe by sides)
Mono-filament
- Reflexes:
- Ankle jerk
- Gait:
- Smooth
- Symmetrical
- Antalgic gait
- To complete:
- Full neurological exam
- Educate pt on foot care