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    3 Minute Exam DFS

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    WeeChuan Ng
    How to do a 3 minute Diabetic Foot Exam

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    Download as PDF, TXT or read online from Scribd

    3 Minute Exam DFS

    Uploaded by

    WeeChuan Ng
    62 views2 pages
    How to do a 3 minute Diabetic Foot Exam

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    How to do a 3 minute Diabetic Foot Exam

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    62 views2 pages

    3 Minute Exam DFS

    Uploaded by

    WeeChuan Ng
    How to do a 3 minute Diabetic Foot Exam

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    HOW TO DO A 3-MINUTE

    DIABETIC FOOT EXAM


    This brief exam will help you to quickly detect major risks and prompt you
    to refer patients to appropriate specialists.

    MINUTE 1 MINUTE 2 MINUTE 3


    Patient History: Vascular Exam: Refer:
    • Diabetes? (If yes, what are the patient’s • Palpate the dorsalis pedis and posterior • See the reverse side for referral and
    current control measures?) tibial pulse. admission guidelines.
    • Previous leg/foot ulcer or lower limb • Look for distal hair growth on feet/toes.
    amputation/surgery? • Check capillary filling time < 3 seconds Educate:
    • Prior angioplasty, stent or leg bypass in the toes. • Inform the patient about the risk of
    surgery? Neurologic Exam: ulceration and amputation with diabetes.
    • Current ulceration of the lower extremity? • Recommend the patient inspect their
    • Test for neuropathy by using either a
    • Smoking or nicotine use? feet daily.
    Semmes-Weinstein monofilament, the
    • Education the patient on the risks of
    Ipswich touch test or an electronic
    Patient Presentation: walking barefoot, even when indoors.
    tuning fork (ETF).
    • Burning or tingling in legs or feet? • Recommend appropriate-fitting shoes.
    • Leg pain or fatigue with activity? • Recommend smoking cessation.
    Musculoskeletal Exam:
    STEP ONE

    • Changes in skin color or skin lesions? • Recommend appropriate glycemic control.


    • Inspect for any deformities.
    • Loss of lower extremity sensation? • Check the range of motion of the ankle
    and 1st metatarsophalangeal joint (MTPJ).
    Has the patient established regular Adapted from: Miller JD, et al.
    • Look for signs of Charcot foot (hot, red, How to do a 3-minute foot exam
    podiatric care? swollen foot or collapsed arch). Journal of Family Practice. 2014
    REFERRAL AND ADMISSION
    STEP TWO

    GUIDELINES
    After completing the 3-minute foot
    exam, use the risk guidelines at the Risk Guidelines
    right to determine referral urgency.
    HOSPITAL ADMIT OR URGENT REFERRAL
    VERY HIGH Signs of an infection (erythema, lymphangitis, odor or purulence)
    RISK Vascular compromise (gangrene, cyanosis, loss of DP/PT pulse)
    “Every 30 seconds, somewhere Open wound or ulcer
    in the world, a limb is lost as a Signs of active Charcot foot (red, hot, swollen midfoot or ankle)
    consequence of diabetes.”
    - The Lancet 2005
    IMMEDIATE OR “NEXT AVAILABLE” OUTPATIENT REFERRAL
    HIGH Presence of diabetes with a previous history of ulcer,
    Charcot foot or lower extremity amputation
    To inquire about becoming
    a member of the Amputation
    REFERRAL WITHIN 1-3 WEEKS (IF NOT ALREADY RECEIVING REGULAR CARE)
    Prevention Centers of America®
    or if you are a patient seeking MODERATE Peripheral artery disease +/- neuropathy
    DP/PT pulses diminished or absent
    treatment, contact us at:
    Presence of swelling or edema
    855.239.4481
    REFERRAL WITHIN 1 MONTH
    LOW Neuropathy +/- longstanding, nonchanging deformity
    Patient requires prescriptive or accommodative footwear

    REFERRAL WITHIN 1-3 MONTHS


    VERY LOW No neuropathy or peripheral artery disease
    Patient seeks education regarding foot care, athletic
    training, appropriate footwear, preventing injury, etc.
    445 Hamilton Avenue, Suite 800 | White Plains, NY 10601

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