Guest guest Posted December 5, 2008 Report Share Posted December 5, 2008 Ha......good one Fraser,  However;  Rule one only applies if it is written in ink on paper, for as Khyam once wrote;  " The Moving Finger writes; and, having writ, Moves on: nor all your Piety nor Wit Shall lure it back to cancel half a Line, Nor all your Tears wash out a Word of it "  Which cannot be said for anything written onto a web document and transferred to Word...!  Rule two applies to how it is written down, as incorrect punctuation can alter a meaning...!  Rule three will have every HSE specialist on earth agreeing that this one is your fault alone......!  Rule four applies to everyone faced with an HSE investigation....  P r kelly <fraserkelly2001@...> wrote: From: fraser kelly <fraserkelly2001@...> Subject: Re: Treatment Notes Date: Friday, 5 December, 2008, 8:09 PM rule one. if it ain't written down,it didn't happen. rule two. if it happened,its written down. rule three if it can go wrong,it will. rule four people lie(and the producers of house,owe us all royalties for that one). Fraser > Dear , > > Thank you for your reply which is helpful to see what you would want > in treatment continuation notes. > > A/ 'Wound Toilet' is the cleaning of the wound area prior to > applying the dry dressing, main purpose for a Venous Ulcer is to > keep it moist and clean. > > B/ Venous Ulcers are most frequently located on the lateral aspect > of the ankle, as a result of the mechanism causing them. > > C/ The cause is age - venous wear & tear - varicose veins - gravity, > as a gradual process. > > D/ Size of ulcer will take time to change once treatment starts with > healing it generally gets bigger first - in ideal circumstances a > specialised dressing is done once a week - in remote location with > circumstances of work bd is OK - can take a month to change - so > daily there is no need for measurements. > > E/ Venous ulcers would rarely be bilateral - the oedema is venous > fluid under pressure from gravity so stays in lower region of ankle > around the laterall malleous - part of the treatment is periods of > foot elevation during the day and at night - while the principle > healing comes from compression of the venous system - tubi-grip - > reinforcing natural venous return, which will encourage a reduction > in the oedema. > > F/ As this is a long term treatment then bed rest and restricted > duties for a cook are excluded and as this is not a debilitating > problem, when treated, so full duty is OK. > > It is an interesting condition and as mentioned the treatment is > long term and quite specific unless infection gets in then anti- > biotics are included, sometimes NSAIDs for pain from exposed nerve > endings. > > The points you raised are appreciated but being now familar with the > situation would you require that degree of information, twice daily, > to have an appreciation of the progress, or could you be comfortable > with - ' Varicose Ulcer - clean - moist', treatment, 'Wound toilet - > dressing - tubigrip', considering that usually you would have a > verbal hand over to your relief as well. > > There has been a discussion re this and we are interested in other > points of veiw. > > Brgds > > P. Quote Link to comment Share on other sites More sharing options...
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