1、BRITISH STANDARD BS ISO 8548-4:1998 Prosthetics and orthotics Limb deficiencies Part 4: Description of causal conditions leading to amputation ICS 11.040.40BSISO8548-4:1998 This British Standard, having been prepared under the directionof the Health and Environment Sector Board, waspublished under t
2、he authorityofthe Standards Boardand comesinto effect on 15October1998 BSI 05-1999 ISBN 0 580 30214 8 National foreword This British Standard reproduces verbatim ISO8548-4:1998 and implements it as the UK national standard. The UK participation in its preparation was entrusted to Technical Committee
3、 CH/9, Orthotics and external prosthetics, which has the responsibility to: aid enquirers to understand the text; present to the responsible international/European committee any enquiries on the interpretation, or proposals for change, and keep the UK interests informed; monitor related internationa
4、l and European developments and promulgate them in the UK. A list of organizations represented on this committee can be obtained on request to its secretary. Cross-references The British Standards which implement international or European publications referred to in this document may be found in the
5、 BSI Standards Catalogue under the section entitled “International Standards Correspondence Index”, or by using the “Find” facility of the BSI Standards Electronic Catalogue. A British Standard does not purport to include all the necessary provisions of a contract. Users of British Standards are res
6、ponsible for their correct application. Compliance with a British Standard does not of itself confer immunity from legal obligations. Summary of pages This document comprises a front cover, an inside front cover, pages i and ii, theISO title page, page ii, pages 1 and 2 and a back cover. This standa
7、rd has been updated (see copyright date) and may have had amendments incorporated. This will be indicated in the amendment table on the inside front cover. Amendments issued since publication Amd. No. Date CommentsBSISO8548-4:1998 BSI 05-1999 i Contents Page National foreword Inside front cover Fore
8、word ii Introduction 1 1 Scope 1 2 Normative references 1 3 Definitions 1 4 Cause of amputation 1 4.1 General 1 4.2 Clinical conditions leading to amputation 1 4.3 Pathological conditions leading to amputation 2 4.4 Specific disease 2ii blankBSISO8548-4:1998 ii BSI 05-1999 Foreword ISO (the Internat
9、ional Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standards is normally carried out through ISO technical committees. Each member body interested in a subject for which a technical committee has bee
10、n established has the right to be represented on that committee. International organizations, governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of electrotechnical stand
11、ardization. Draft International Standards adopted by the technical committees are circulated to the member bodies for voting. Publication as an International Standard requires approval by at least75% of the member bodies casting a vote. International Standard ISO8548-4 was prepared by Technical Comm
12、ittee ISO/TC168, Prosthetics and orthotics. ISO8548 consists of the following parts under the general title Prosthetics and orthotics Limb deficiencies: Part 1: Method of describing limb deficiencies present at birth; Part 2: Method of describing lower limb amputation stumps; Part 3: Method of descr
13、ibing upper limb amputation stumps; Part 4: Description of causal conditions leading to amputation; Part 6: Description of condition of patient requiring a prosthesis. Future parts will deal with other descriptions of limb deficiencies. Descriptors: Medicine, orthotics, prosthetic devices, upper lim
14、bs, lower limbs, defects, description.BSISO8548-4:1998 BSI 05-1999 1 Introduction The outcome of the rehabilitation of a patient who has had an amputation depends not only on the surgery performed and the prosthesis which may be fitted, but also on the cause and underlying condition for which the am
15、putation was performed, and on other disabilities and attributes of the patient. Members of clinic teams in different countries develop their own nomenclature to meet their own needs. Hence there is a need for an international system to be developed in order to compare one publication with another a
16、nd one patient with another. The different care groups who would appreciate and use a standardized system of describing the reason for amputation and the general state of the patient include surgeons, other doctors (especially those concerned with rehabilitation), physical and occupational therapist
17、s and prosthetists. Such a system would also be of value to epidemiologists and government health officials. The system proposed has to meet the needs of the different members of the clinic team and to enable the description of the cause of amputation and the underlying condition to be recorded in a
18、 way that can be easily incorporated in reports. This part of ISO8548 deliberately aims at defining the minimum information to be described. It should be feasible for this information to be included in forms designed by the individual institution and be capable of ready adaptation for computer analy
19、sis. 1 Scope This part of ISO8548 establishes a method of describing the causal conditions leading to amputation and the underlying pathology. 2 Normative references The following standards contain provisions which, through reference in this text, constitute provisions of this part of ISO8548. At th
20、e time of publication, the editions indicated were valid. All standards are subject to revision, and parties to agreements based on this part of ISO8548 are encouraged to investigate the possibility of applying the most recent editions of the standards indicated below. Members of IEC and ISO maintai
21、n registers of currently valid International Standards. ISO 8548-1:1989, Prosthetics and orthotics Limb deficiencies Part1:Method of describing limb deficiencies present at birth. ISO 8548-2:1993, Prosthetics and orthotics Limb deficiencies Part2:Method of describing lower limb amputation stumps. IS
22、O 8548-3:1993, Prosthetics and orthotics Limb deficiencies Part3:Method of describing upper limb amputation stumps. ISO 8549-1:1989, Prosthetics and orthotics Vocabulary Part1:General terms for external limb prostheses and external orthoses. ISO 8549-2:1989, Prosthetics and orthotics Vocabulary Part
23、 2: Terms relating to external limb prostheses and wearers of these prostheses. 3 Definitions For the purposes of this part of ISO8548, the definitions given in ISO8548-1, ISO8548-2, ISO8548-3, ISO8549-1 and ISO8549-2 apply. 4 Cause of amputation 4.1 General The object of surgical amputation is to s
24、ave life, relieve pain and improve function or general health. The cause of amputation is described in three ways. Firstly, by the clinical condition or conditions leading to amputation, secondly, by the pathological condition or conditions and thirdly, by the specific disease. NOTEFor example, the
25、actual clinical condition leading to amputation might be pain caused by inadequate vascular perfusion due to atherosclerosis which is the pathological condition. It follows, therefore, that one pathological condition may be associated with more than one clinical condition leading to amputation, e.g.
26、atherosclerosis may lead to amputation for nonviability and for pain. Furthermore, a specific disease may present with more than one pathological condition, e.g.diabetes mellitus presenting with dysvascularity, infection or neurological disorder or a combination of these. The cause of amputation sha
27、ll be described by including the information as shown in 4.2 to 4.4. 4.2 Clinical conditions leading to amputation The clinical conditions leading to amputation are: a) acute life threatening situation; b) nonviability; c) pain; d) severe injury; e) infection; f) ulceration; g) neoplasm; h) neurolog
28、ical disorder or i) deformity. State the clinical conditions leading to amputation.BS ISO 8548-4:1998 2 BSI 05-1999 4.3 Pathological conditions leading to amputation 4.3.1 General The underlying pathological conditions leading to amputation may be: a) trauma; b) dysvascularity; c) infection; d) neur
29、ological disorders; e) neoplasm or f) deformity. State the pathological conditions leading to amputation and the additional information as shown in 4.3.2 to 4.3.7. 4.3.2 Trauma Traumatic agents may be: a) mechanical; b) thermal; c) electrical; d) chemical or e) radioactive. State the agents responsi
30、ble and whether there was a traumatic severance, subsequent amputation for severe damage, or because the predicted functional outcome was poor. 4.3.3 Dysvascularity Dysvascularity may be due to: a) atherosclerosis without diabetes mellitus; b) atherosclerosis with diabetes mellitus; c) acute vascula
31、r incident, or d) other. State the conditions leading to dysvascularity. 4.3.4 Infection Infection may affect: a) soft tissues; b) bone; c) joints. State the tissues affected and if possible whether the infection is acute or chronic in nature. 4.3.5 Neurological disorders Neurological disorders may
32、result from: a) congenital abnormality; b) injury; c) infection; d) systemic disease; or e) other causes. State the cause of the disorder. 4.3.6 Neoplasm Types of neoplasm may include: a) benign tumours; b) malignant primary tumours or c) malignant secondary tumours. State the type of neoplasm. 4.3.
33、7 Deformity State the nature of the deformity and whether it was present at birth or acquired subsequently. 4.4 Specific disease State the specific disease leading to amputation, using International Classification of Diseases (ICD) codes.blankBS ISO 8548-4:1998 BSI 389 Chiswick High Road London W4 4
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