Diabetic Foot Screening

People with diabetes are at a higher risk for foot-related wounds, ulcers and lower limb amputation.  This is because of nerve and circulatory changes (read here) which occur in diabetes.  For this reason, it is important to regularly assess the feet of diabetic clients.

At McDermott Footcare, the tool used for this assessment is Inlow’s 60-Second Diabetic Foot Screen, obtained from the Canadian Association of Wound Care.  The screening tool consists of a mono-filament device and accompanying checklist.  The frequency of assessment is determined by the initial and subsequent assessment scores.  The higher the score, the more frequent the assessment.  The quick but thorough assessment covers all important areas.

Visual:

The first part of the assessment involves looking to see the condition of the skin and nails.  Are the skin and nails fungal?  Are there calluses or open ulcers?  Are the nails thickened?  Is footwear appropriate or causing trauma?  Look for Charcot’s Deformity, bunions and previous amputations.

Touch:

Next, the temperature of the foot is recorded.  By touching the feet, a comparison is made of the temperature of both feet.  Are they equal in temperature or is one foot colder/hotter than the other?  Are they colder/hotter in relation to the environment? 

The range of motion of the great toe is assessed.  Things to look for include how easily the toe can be moved or is it rigid.  What degree is the rigidity?

Sensation And Other Assessment:

Next comes testing with the mono-filament tool.  10 sites on the foot are touched with the mono-filament and the client’s ability to feel the touch is rated.  The client is also asked whether they feel numbness, tingling, or burning in the feet.  The pedal pulses are felt.  The presence of dependent rubor (redness when the feet are down; pallor when they are elevated) and erythema (reddened areas of the skin) complete the assessment.

Clients respond favourably to Diabetic Foot Screening.  They are advised that it is part of the overall nursing plan of care for keeping their feet healthy.  It is also a good springboard for discussion and health teaching about foot health.  As needed, clients have been advised to see their doctor for further treatment based on the findings of the assessment.

The 60-Second Diabetic Foot Screen is very convenient and quick to complete.  Regular screening gives clients peace of mind that their foot health is monitored appropriately.