Re: Gangrene

[nursejane]

Might also want to care plan monitoring for systemic effects as well as, and one of the most important, preparing the resident and staff for the fact that the toes may well fall off. I will never forget about 13 years ago we had a resident with gangrenous toes. They were dry, black, crusty and two did fall off in the bed when the CENA pulled off the covers, even though she was careful. Resident refused a foot board. She almost passed out. Cried for an hour. She thought it was her fault. Took a lot of explaining for that one. Good luck.   ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Saturday, December 13, 2003 9:27 AM Subject: RE: Gangrene Well , his toes are black, crusted, look like a few are ready to fall off, hard to determine just how many areas are open. Pressure or Stasis�I don�t know�can see wound bed on both big toes, but there may be something between the toes that are not able to be seen.  Maybe pressure since it is on the end of toes that rubbed on shoes, but circulation was also an issue.  Charcoal sounds like a good idea, neutralizing odors always seems like a better idea than masking them.            -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of dawn Sent: Friday, December 12, 2003 6:37 PM To: [EMAIL PROTECTED] Subject: Re: Gangrene   Based on your assessment...can you see the wound bed....are the areas caused from pressure? I have put 10-12 charcoal briquettes in a nylon bag and hung it under the resident's bed, which is very effective in controlling odor.   ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, December 12, 2003 8:47 AM Subject: Gangrene   I just admitted an uncontrolled diabetic with gangrene of both feet.  How do I code this? A stage 4 and if so how many?  Wound infection? Will Medicare A pay for a room deodorizer? Any other areas that I might need to address on the MDS?  Any suggestions for careplanning appreciated�this is obviously a first for me.  Thanks.