I wanted to take a photo of this man’s legs on his scooter because he’s got profound heart failure and I’m worried about the edema of his thighs. I have been wondering if the way he sits on his scooter contributes to his edema. (It seems like I have an entire clinic full of people in right heart failure with profound edema.) However, he took off in his scooter so fast he was out the door like a rocket. A few days later there was a news story about the increasing incidence of serious injuries sustained by riding the electric scooters that are becoming increasingly popular in urban areas.
I’ve seen a lot of patient injuries from mobility scooters. Above is the photo of a woman who crushed her leg against a concrete step when she accidentally propelled her scooter forward. I have actually lost count of the scooter related foot injuries, which are not trivial in our patients. However, I haven’t actually tried to keep track of them, but based on this article from the UK, I wonder if we should be?
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This brings into focus the issue of how to best describe these injuries in a manner that is both accurate and amenable to prescribing both basic and advanced therapies. In the photo, you can see that the patient has edema, and this is contributing to the lack of progress in healing this wound. But is this a venous ulcer? Do they have venous insufficiency? Does the patient need compression? Probably would benefit. Will it be covered by her insurance carrier? Maybe not. And if they stall in their healing trajectory, what advanced options such as CTP, do we have at our disposal???? None for a traumatic wound of the lower extremity.