Printable Diabetic Foot Exam Form. Management plan check all that apply. Notes 000 left foot vll.
Diabetic Foot Exam Form
Does the patient have obvious deformities? If so, for how long? Web burning or tingling in legs or feet? Risk categorization check appropriate box. Web orthopedic(pqri 127, 163)leftrightdigital deformities (including hallux valgus)equinusplantarflexed metatarsalcharcot deformitiesprevious amputationsother (e.g., hammertoes, hallux valgus) pressurestat® assessment: Problems with the nerves and blood flow. Evaluation of the diabetic foot is provided here. Diabetes type 1 2 current treatment: Loss of lower extremity sensation? Management plan check all that apply.
Quantified areas of excessive pressure in excess of 6 kg/cm2foot type (e.g., pes cavus, pes planus) Problems with the nerves and blood flow. The exam is used to check the feet for: Web burning or tingling in legs or feet? Web comprehensive diabetes foot examination form name: Risk categorization check appropriate box. The abi is a simple and easily reproducible method of diagnosing vascular insufficiency in the lower. Web systematic screening examinations for neuropathic and vascular involvement of the lower extremities and careful inspection of feet may substantially reduce morbidity from foot problems. Diabetes type 1 2 current treatment: Has the patient established regular podiatric care? Web diabetic patients with signs or symptoms of vascular disease or absent pulses on screening foot examination should undergo ankle brachial pressure index (abi) pressure testing and be considered for a possible referral to a vascular specialist.
