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Diabetic Foot Examination Cheat Sheet (DRAFT) by

alddanslkndlkanslkdnalksndka

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Introd­uction:

W
Wash Hands
I
Introduce Yourself + Patient's Identity
P
Permission
P
Patient Position + Pain
E
Explai­­nation
Patient must be placed at 45° and lower limbs exposed

Equipment:

10g Monofilament
128Hz Tuning Fork

General Inspec­tion:

•Colour
Pallor, Ischaemic Rubor
•Hair Loss
•Atrophic Skin (Shiny)
•Nail Changes
•Missing Digits
•Healed­/Active Ulcers
•Callus Formation
•Infect­ion­/Ul­cer­ation between toes
•Deformities
Claw Toes, Charcot Joint, Bunions, Overlaping Toes
Comment on Footwear
Protects Feet, Accomodates Deformities, Matches Foot Shape
Always inspect the sole, interd­igital clefts, and heel

Compare left and right throughout

Gait Examin­ation:

 

Vascular Examin­ation:

•Check Temperature
From knees to toes
•Examine skin colour
•Check Capillary Refill bilate­rally
•Pulses:
•Dorsalis Pedis Pulse
•Posterior Tibial Pulse
 
•Buerger's Test:
•Lie Patient Flat
•Lift Feet to 45° for 1 min
•Inspect for Pallor
•Allow feet to hang back down
•Inspect for reactive hyperaemia

Neurol­ogical Examin­ation:

10g Monofilamet + 1 other Neurological Assessment should always be performed
•Light Touch:
10g Monofi­lament in at least 6 sites
•Propri­oce­ption
•Vibration Sense:
128Hz, Dorsal Hallux
•Lower Extremity Reflexes:
Achilles Tendon Reflex - S1, S2
•Pin-prick and Temper­ature Sensation
Absent 10g Monofi­lament + 1 other neurol­ogical assessment confirms loss of protective sensation
  

Gait Examin­ation: