Vascular Assessment

 











© Head & Short Podiatrists Ltd. - Registered in England

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All vascular assessment patients are initially seen for a 30 minute assessment appointment.


During the consultation we will take your medical history, in addition to the physical assessment. It helps us greatly if you complete a medical history form and bring it with you, copies can be downloaded here. We record details including your: name, address, telephone number, email address, date of birth, GP name and address, past and current medical history, allergies, medication, and any previous Podiatry treatment.


This is known as your minimum data set and recording it is a legal requirement. If you refuse to give us this information we will not be able to offer you treatment at our practice. We keep all the information you give us confidentially, in accordance with the guidelines laid down by the Society of Chiropodists and Podiatrists, the Health Professions Council, and the Data Protection Act (we are registered data users registered with the Information Commission).
















In most cases treatment will not be provided at your first appointment, and you will be invited back at a later date.


NB we normally write to your GP, after your first appointment, to inform them that you are registered with our practice and give brief details of any treatment plan. Please tell us if you do not wish us to communicate any information to your GP.



Why is vascular assessment important?


Poor circulation in the legs and feet is affecting a greater proportion of the population. 20% of leg ulcers are due to arterial disease. This is due to several factors as diverse as sedentary lifestyle, aging population, an increase in the Diabetic population and smoking.

The feet are furthest away from the heart and thus often suffer the greatest reduction in blood flow. The wall of the blood vessels can be damaged due to plaques of cholesterol and fibrin blocking the artery; or the vessel’s elasticity can lessen and this can affect the pressure in the ‘network of pipes’. Sometimes arteries become injured resulting in scar tissue which will block the blood flow.


Signs of reduced blood flow to the legs and feet can vary depending on your general health, medication and activity levels. Commonly people complain of thinning of the skin, cold feet, cramp in the calfs or thighs whilst walking, wounds or ulcers which  fail to heal, muscle wasting in the forefoot and rest pain. The symptoms may be different in each foot; and may be masked due to medication or a habitual lack of exercise.


 

How do we assess you?

 

Your circulation to the feet and legs can be checked by the Podiatrist using simple clinical techniques. The history and symptoms will be recorded. Your pulses will be palpated in the foot and ankle.


An examination called the Buerger’s test will be used to check the capillary refill time in your toes. This is where we elevate the leg 45 degrees for one minute then measure in seconds how quickly the toes turn red.


In addition an ankle brachial pressure index can be calculated. This is where we compare the systolic blood pressure in the brachial artery of the arm to the posterior tibial or dorsalis pedis artery of the foot. We divide the foot score by the arm score. A good result is one; but if the value is equal or less than 0.8 blood flow is reduced.The technology used to measure blood flow is doppler ultrasound.


 














How long does the assessment last?

 

Usually about half an hour. You are required to lie still whilst we assess you (don’t worry it doesn’t hurt). 



Who should have this assessment?

 

This is easy to answer. Anyone with a circulation problem or with an underlying medical disorder which may put you at risk. Symptoms do not arise because they want to there is always an underlying cause! Find the cause, treat it successfully and the problem should improve (and may even go away).


Patients with poor circulation will usually need to be referred to a vascular consultant for further assessment and treatment (if necessary).



Where is this service available?

 

This service is available at all of our clinics and for all age groups. It is necessary for you to rest in the clinic for 20 minutes prior to evaluation - so please notify the receptionist when booking an appointment.


The results can be sent to your GP and, where appropriate, you can be referred on to a Vascular surgeon.

 

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