1 / 30

Palliative Care

Palliative Care. 1. Why Do We Reduce Toenails?. Reduce pain Prevent potential injury Subungual ulceration Subungual hematoma Cosmesis Not everyone is a candidate for definitive treatment. Reducing a toenail: Step 1—assess the patient. PVD? Neuropathy? Other immunocompromise?.

chakra
Download Presentation

Palliative Care

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Palliative Care 1

  2. Why Do We Reduce Toenails? • Reduce pain • Prevent potential injury • Subungual ulceration • Subungual hematoma • Cosmesis • Not everyone is a candidate for definitive treatment

  3. Reducing a toenail: Step 1—assess the patient • PVD? • Neuropathy? • Other immunocompromise?

  4. Reducing a toenail: Step 2—collect needed materials • Gloves • Eye Protection • Gauze • Nail nippers • Bandaids

  5. Reducing a toenail: Step 3—stabilize the toe

  6. Reducing a toenail: Step 4—Reduce the toenail

  7. Reducing a toenail: Watch for flying toenail

  8. Don’t try this technique with thick toenails

  9. Reducing a toenail: How far back do you cut? • Depends on the condition of the toenail

  10. Reducing a toenail: Step 5—Smooth the nail surface

  11. Reducing a toenail: Podospray

  12. Why reduce corns and calluses? • Pain • Potential ulceration • Difficult definitive treatment • Not all patients are good candidates for surgical treatment

  13. Corn Synonyms • Heloma durum (HD) • Excrescence • Hyperkeratosis • Hyperkeratotic papule

  14. Callus Synonyms • Tyloma • Intractable Plantar Keratosis • Hyperkeratotic papule

  15. Debriding a callus: Step 1—assess the patient • PVD? • Neuropathy? • Other immunocompromise?

  16. Debriding a callus: Step 2—Gather appropriate materials • Gauze • Blade handle • Blade • Kelly Forceps • Gloves

  17. Debriding a callus: Step 3—Load the blade

  18. Debriding a callus: Step 4—Hold the Blade

  19. Debriding a callus: Step 4—Hold the Blade

  20. Debriding a callus: Step 4—Hold the Blade

  21. Debriding a callus: Step 5—Don’t forget negative pressure

  22. Debriding a callus: Step 6—When do you stop? • Blood • Color • Texture • Skin Lines

  23. Palliative Foot Care: What if you see blood? • Don’t say “oops” • Inform the patient • Hemostasis • Clean with alcohol • Dress with antibiotic • Cover with a bandaid • Patient instructions • Follow up

  24. Hemostatic solutions

  25. Palliative Foot Care: Billing Issues • C&C is not covered by Medicare, unless… • Normal toenails are not covered by Medi-Cal • Most private insurance co’s do not cover C&C

More Related