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Hi to all

I just wanna know if Podiatrist use stethoscopes I know this forum has a lot of many experienced podiatrists who have been in practice for many many years

Thanks

Bong

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How do you do ABI's without one?

We use a doppler for our ABIs, and you need to use the same measuring instrument for ankle and brachial pressures. We have a stethescope in our dept, but it isn't used.

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Stephen Tucker
Calvary Health Care

My location

Hey.
I was just wondering how often podiatrists use stethoscopes and what kind do they use?

:)

a Littman, but only for taking blood pressure. I usually use a doppler for ABIs, like Stephen.
Richard

The problem is with Dopplers that they do not drape so elegantly around the neck to give that brash and urgent look (a la Clooney) that you can get if you position the stethoscope just right. They also slip off, at least mine does, and that darned Nurse from next door keeps treading on it (the Doppler)

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Darn it Jim, I'm just an old country Chiropodist - not a miracle worker

I use mine for taking blood pressure with a sphygmomanometer, but get ripped all the time for "wanting to be a doctor" (i don't), i just like increasing my clinical skills because one day the batteries or doppler will die

I use it to take their blood pressure. I also use it to check their heart for a normal sinus rhythm before a procedure involving a local and make sure I am not hearing a heart murmur. If I am hearing a Grade 3 or above murmer, I want to clearance from the doctor first in case the patient gets overly anxious during the local injection/procedure.

Steven

Steven

With respect, do you have training in listening for a heart murmur? I have never heard of this being in the remit of a podiatrist before.

Cornmerchant

Ive read up in my clinical medicine texts, so know the auscultation techniques, and there are soundbites online to familiarise with but no, i never use it for the heart, more for curiosity, i use it for just blood pressure mainly because alot of our patients only see thier podiatrist on a regular basis, sometimes they dont see thier gp for years and as a primary health care professional its our duty to ensure red flags are picked up, This was made very clear when your an undergraduate, we also had a talk about melanoma' and how even though were not dermatologists if we feel we find something suspect we refer on asap for the same reason (alot of ppl dont see thier gp). I think what stevens doing is great aslong as hes only checking for the wellbeing of the patient. Just my opinion ignore it if you like i wont be offended.

Jon
I dont have any problem with your opinion, I am just curious as to why a pod would listen to the heart before LA administration. Even my dentist has never listened to my heart before a filling!
I feel that this may well be outside our scope of practise and as such we have no training to carry out this test. It could be very dangerous ground.

Cornmerchnat

Yes i completely agree because as you say, legally its quicksand, plus i know the GPs at my clinic get very annoyed from other pods who send letters about meds or worsening conditions, let alone about heart murmurs (even to the extent of derogatory remarks in the staff lounge)- i dont know why though were all a team , its not like theyre telling the GP what to do just that they are worried about a presenting patient. You can DDX an unconcious patient using pulse anyway, so dont need a stethoscope so not sure about before/during LA, maybe i need to research that. Good idea for a paper :-D thanks people

Just quickly , Disturbed speech, confusion, Coma ,Hypotension, Bradycardia and Cardiac arrest are symptoms of relative overdose of LA , so if you fail to aspirate and hit a vein then you could use a stethoscope if these present (not cardiac arrest obviously) DRSABCD asap!!!!

is Lab Guy a DPM, if so i believe they cover such internal medicine techniques during undergrad

I do a heart and lung assessment prior to surgery, otherwise no, I don't use one in the office.
Steve

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DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA

Hello all,

I understand those of us who use local anaesthesia are also aware of emergency procedures which must be adhered to should the cause arise.

I am not a doctor nor do I advise my patients I am.

I have never checked for a heart murmur (although if one was known I would discuss any intervention prior to any l/a procedure).

Why then add another test to a routine procedure?

Carry a stethoscope?

Never.

I am a podiatrist. If I note something out of the ordinary I alert their GP. That is my job.

Am I lacking in my practice?


I hope not.

Kind regards,

Mandy

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:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”

"I am a podiatrist. If I note something out of the ordinary I alert their GP. That is my job."

Here in the USA the trend is for DPMs to perform their own H&Ps on patients undergoing anesthesia that are ASA l or ll. The heart and lung must be documented. Of course the anesthesia dept. does this as well.

Steve

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DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA

Steve

It is recognised that your training in the USA is different from here in the UK. Since the original post was under the UK heading, I am pretty sure that Bong24 was directing his question to UK pods.

Cornmerchant

Cornmerchant

Im pretty sure a DPM (Steve) knows his training is different, hence the "Here in the USA" comment. Nice to hear peoples thoughts though across the pond so thanks steve =D, i was speaking to our GP the other day and he was telling us all about his OB/GYN training and how he delivered 4 babies, it sounded amazing! Did you do this in your rotations?

Thanks

Jon

Thanks for pointing that out.
Perhaps you should look at the training of DPM before you ask questions related to a rotation in OB?Gyn- I think you may be a little confused in thinking that DPM are the same as medical doctors.

Cornmerchant

"The fourth year devotes itself to diagnostic skills through problem solving in clinical settings. Students rotate through hospital-based clerkships in General Surgery, Internal Medicine, Emergency Medicine, Pediatrics and General Radiology, and also spend three months in elective externships at a variety of National and International sites. " Yeah cornmerchant your right no mention of Obstetrics and Gynaecology but just for fun check the homepage banner http://www.nycpm.edu/image_files/frontbanner1.jpg theres a stethoscope =D

I heard through hearsay about the rotations, seems OBGYM is one of the few they dont do!

Cornmerchant:

Maybe there should be little national flags next to our avatar for a quick way of locating the place of practice.

I have to admit, it does get a little confusing at times, especially when I first joined the PodArena. I really was quite ignorant as to the training and practice differences worldwide for "podiatrists"



Steve

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DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA

Hi All,

I once used a stethoscope on one of my patients!
I came to the conclusion he was dead?
Then he coughed!
It was then that I realized I was deaf?
Isn't the NHS. Audiology wonderful!

Regards,

Colin.

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:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”

Hi Mandy,

"Suffering a fondness for odd things."

A Stethoscope is a very odd thing. Could that be why doctors use it?

Regards,

Colin.

Very likely Colin

I am unsure if my 'fondness for odd things' includes dangly items around the neck though.

Regards,

Mandy.

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:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”