Fitting, Delivery, and Patient Education
What the exam expects
Fitting is where design meets skin. Know the fit check sequence: inspect the device interior for rough edges and debris, don the device, check alignment and suspension, then perform a skin check after a short wear interval. Understand pressure tolerance concepts: blanching erythema that resolves is expected; non-blanching or persistent erythema, pinching, or numbness is not. Delivery includes verifying the device matches the prescription, documenting the serial/lot, and teaching donning, doffing, wear schedule, skin inspection, cleaning, and when to call.
Traps
- Declaring a fit 'good' without a post-wear skin check.
- Teaching the wear schedule without a break-in plan and without telling the patient what skin changes warrant a call.
- Ignoring the patient's ability to don the device independently - a device the patient cannot manage will not be worn.
- Failing to document education and the patient's demonstrated understanding (teach-back).
- Missing that a patient with sensory loss cannot self-monitor and needs a caregiver plan or scheduled checks.
Rule of thumb
No skin check, no delivery. Use teach-back: the patient demonstrates donning and states the skin warning signs in their own words.
Worked example
After a 20-minute wear trial, a red area over the tibial crest fades within 15 minutes after removal. That is expected load response. A red mark that persists past 20 minutes, or a patient report of numbness, means the fit is not acceptable - adjust before delivery. Documenting the trial duration and the resolution time makes the decision defensible.