Kim Saunders – Hands-On Clinical Lab – AATOAVANU

This clinical lab will outline best practice guidelines for arterial, venous, and neuropathic ulcers. It will also provide hands-on clinical labs to practice leg assessments, wound treatments, ankle-brachial index,

Kim Saunders – Hands-On Clinical Lab – AATOAVANU

Lower extremity wounds are difficult to diagnose and heal if the correct etiology is not diagnosed. Thus the clinician needs bedside non-invasive diagnostic tools that can be used to screen perfusion and determine sensory neuropathy. Also, learn ways to off-load a diabetic neuropathic ulcer, even in rural areas.

This clinical lab will outline best practice guidelines for arterial, venous, and neuropathic ulcers. It will also provide hands-on clinical labs to practice leg assessments, wound treatments, ankle-brachial index, monofilament testing, and off-loading neuropathic ulcer techniques.

OUTLINE

Define Lower Extremity Arterial Disease (LEAD) Guidelines

Pathophysiology of LEAD
Best Practice Guidelines: Assessment
Pathophysiology
Diagnostic Assessment: Invasive & Non-Invasive
Arterial Duplex & Angiogram
TCOM & Bedside ABI
Clinical Exam
Best Practice Guidelines: Treatment
Risk Stratification
Perfusion Strategies
Oxygen Strategies
Maintenance recommendations: Non-reconstructable
HANDS-ON LAB:
Perform Sensory Deficit Testing
HANDS-ON LAB:
Simulate Neuropathic Off-loading techniques

Define Lower Extremity Venous Disease (LEVD) Guidelines

Pathophysiology of LEVD
Best Practice Guidelines: Assessment
Pathophysiology
Lymphedema, Lipedema, Venous Insufficiency Edema
Clinical Exam
Lymphangitis, Stasis Dermatitis, Hemosiderin Staining
Atrophie Blanche, Lipodermatosclerosis, Vasculitis
Best Practice Guidelines: Treatment
Perfusion Determination
Matching Compression to Perfusion
HANDS-ON LAB:
Venous Insufficiency Leg & Ulcer Assessment
Determine Plan of Care

Lower Extremity Neuropathic Disease (LEND) Guidelines

Pathophysiology of LEND
Best Practice Guidelines: Assessment
Labs, Nutrition
Skin, Edema, Malformations, Neurosensory
Tissue Perfusion: Diagnostics & Referrals
Classification Systems
Best Practice Guidelines: Treatment
Off-loading Options: TCC, Half Shoe, Healing Sandals
Diagnosing Infection & Treatment
Wound Care & Adjunctive Therapies
Emerging Technology
Surgery
HANDS-ON LAB:
Perform Ankle-Brachial Index (ABI)
HANDS-ON LAB:
Neuropathic Foot Ulcer Assessment & Plan of Care
HANDS-ON LAB:
Arterial Disease Leg & Ulcer Assessment
Determine Plan of Care

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OBJECTIVES

Analyze treatment goals when vascular ulcers are non-reconstructable
Evaluate the arterial flow in any setting using the bedside ABI
Evaluate the arterial diagnostic work-up for recommended referrals
Analyze treatment goals when vascular ulcers are non-reconstructable
Distinguish between lymphedema, lipedema, and venous insufficiency edema
Differentiate assessment/treatment for stasis dermatitis, atrophie blanche, Lipodermatosclerosis
Match level of compression to ankle-brachial index
Justify wound treatment to perfusion
Contrast diabetic ulcer classification systems to predict time to heal & referrals recommended
Contrast neuropathic foot off-loading options

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