Understanding the Role of Temperature Assessment in Patient Care
Discover how temperature assessment plays a crucial role in informing patient care, particularly in detecting inflammation and potential complications such as diabetic foot issues. Learn about normal foot temperature variations, the importance of thermal symmetry in healthy feet, and the limitations of using temperature as a diagnostic tool. Explore visual examples and research findings in this insightful discussion by Dr. Peter Plassmann.
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Presentation Transcript
How Temperature Assessment can Inform Patient Care Dr Peter Plassmann www. podium. care Version 1 04/09/2019
Why Temperature Assessment? Generally Inflammation 1st response of body to problem Inflammation generates heat Heat can be detected Gradual build-up over time The idea is: Problem Inflammation Detection Action! Examples Van Netten et al.1 : In patients with complications, temperatures at contralateral regions differ by more than 2 C International Diabetes Federation2: Temperature differential of 2 C degrees Celsius [...] can signify either an infection or an already early stage active Charcot foot. 1Infrared Thermal Imaging for Automated Detection of Diabetic Foot Complication, Journal of Diab. Sc. & Tech., Vol 7, Issue 5, September 2013 2Report 2017, ISBN: 978-2-930229-86-7, https://www.idf.org/component/attachments/?task=download&id=1152
What is Normal Foot Temperature? This Artificially created image Made by averaging thermograms from 100 healthy volunteers1 Standardised Conditions: o Imaged 10 minutes after socks-off o 22 C room temperature o No smoking, caffeine, alcohol, ... o ... Average normal foot temperature 1A result of a clinical trial (2015-2016) funded by the National Institute for Health Research (NIHR) under grant II-LA-0813-20007.
What is Normal Foot Temperature? It varies More at toes Less in instep 1 std. Deviation (i.e. 68% of all cases) Average normal foot temperature 1A result of a clinical trial (2015-2016) funded by the National Institute for Health Research (NIHR) under grant II-LA-0813-20007.
What is Normal Foot Temperature? Healthy feet are thermally highly symmetrical1 If not, there may be a problem 1Macdonald, A., Petrova, N., Ainarkar, S., Plassmann P. et al., Thermal symmetry of healthy feet: a precursor to a thermal study of diabetic feet prior to skin breakdown, Physiological Measurement, 38 (2017), 33-44, doi:10.1088/1361-6579/38/1/33
What is Normal Foot Temperature? But be careful Temperature is not specific, just an indication Heat is not a diagnosis ! Some examples of perfectly normal feet: Symmetrical but odd Hot little toe Asymmetric but OK (footballer) Images courtesy of Audrey Macdonald, Freeman Hospital, Newcastle upon Tyne Hospital NHS Foundation Trust
What Could We Detect Early? Some examples - Ingrown toenails - Plantar fasciitis - Arterial occlusion (cold) - Morton neuroma Charcot foot episode Pressure Pre-ulcer Outcome Tissue hypoxia Images courtesy of Nina Petrova & Michael Edmonds, Diabetic Foot Clinic, King s College Hospital NHS Foundation Trust
How? Temperature detectors Cheap, readily available Low resolution (spatial & thermal) Assessments not repeatable, no records Inexpensive (ca. 70) Good accuracy (bias) & precision (repeatability) Designed for fever detection (forehead) large measurement area, misses small features Can be time consuming to use (5 toes, heel, ..., x2 feet) No image, manual recording required www. podium. care
How? Temperature detectors 200 to 900 Not medically certified Usually not radiometric (only > 5k models) ... ... or only 2 C accuracy (or worse) Stable >10 min after switch on Awkward to use in clinical practice (connect to PC, upload, tag & annotate image, save somewhere,...) www. podium. care
How? Thermetrix Podium Simple to use Designed for podiatry Class I medical device (soon Class IIa) Thermal and visual image Accurate & precise A professional tool Partnership programme www. podium. care
The Thermetrix Partnership Reasons to join Full training & technical support CPD & expert lectures Marketing support to grow you and your practice Realise potential without capital outlay Improve your offering and attract more patients Product updates and services (stats, analysis,...) included ..... more at our stand Patient Family & Carers Podiatrist Thermetrix
