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Palliative Care - PowerPoint PPT Presentation


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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?.

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Presentation Transcript
why do we reduce toenails
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
Reducing a toenail: Step 1—assess the patient
  • PVD?
  • Neuropathy?
  • Other immunocompromise?
reducing a toenail step 2 collect needed materials
Reducing a toenail: Step 2—collect needed materials
  • Gloves
  • Eye Protection
  • Gauze
  • Nail nippers
  • Bandaids
reducing a toenail how far back do you cut
Reducing a toenail: How far back do you cut?
  • Depends on the condition of the toenail
why reduce corns and calluses
Why reduce corns and calluses?
  • Pain
  • Potential ulceration
  • Difficult definitive treatment
  • Not all patients are good candidates for surgical treatment
corn synonyms
Corn Synonyms
  • Heloma durum (HD)
  • Excrescence
  • Hyperkeratosis
  • Hyperkeratotic papule
callus synonyms
Callus Synonyms
  • Tyloma
  • Intractable Plantar Keratosis
  • Hyperkeratotic papule
debriding a callus step 1 assess the patient
Debriding a callus: Step 1—assess the patient
  • PVD?
  • Neuropathy?
  • Other immunocompromise?
debriding a callus step 2 gather appropriate materials
Debriding a callus: Step 2—Gather appropriate materials
  • Gauze
  • Blade handle
  • Blade
  • Kelly Forceps
  • Gloves
palliative foot care what if you see blood
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
palliative foot care billing issues
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