INTRODUCTION

OVERVIEW

Occasionally, a patient's treatment protocol may need to be modified from the originally ordered protocol due to an intervention.  For instance, a patient may begin treatment under the Wagner 3 Diabetic Foot Ulcer (DFU) protocol and during the course of therapy, may need to have an amputation and flap procedure. The patient's protocol would then change to compromised flap of the foot.  At this time, the Modification of Treatment Protocol Form (see attachment) would need to be completed explaining the reason for modification, signed by the ordering physician and communicated immediately to the staff. The form may be scanned into the EMR or placed in the paper chart for reference. 

Another situation might be a change in treatment depth due to seizure risk. For example, a patient with Osteoradionecrosis of the mandible starts a treatment course at 2.5 ATA for 30 treatments. Throughout the course of therapy, the patient shows signs of oxygen toxicity and has a seizure on the 21st treatment. The provider may opt to decrease the treatment ATA from 2.5 to 2.0 depending on the risk and additional interventions. The Modification of Treatment Protocol Form would need to be completed and communicated to the staff.