9 Day Certified Lymphedema & Wound Therapist (62.5 CE hrs On-line + 9 Days Live Training (8am 8pm *daily times vary; 153 CE hrs Total!

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1 1 9 Day Certified Lymphedema & Wound Therapist (62.5 CE hrs On-line + 9 Days Live Training (8am 8pm *daily times vary; 153 CE hrs Total!) On-Line COURSE OUTLINE/Overview of Topics (62.5hrs): Lymphatics & Lymphedema: 1) General anatomy, physiology & pathophysiology of the arterial & venous systems 2) Lymphatic System Anatomy & Physiology a) Overview b) Embryology c) Lymphangiogenesis d) Initial Lymphatics (Lymph Formation) e) Precollector lymph vessels f) Lymphatic Collectors (Lymph Transport) g) Lymphangions h) Lymph Nodes i) Lymphatic Trunks j) Lymphotomes/Lymphatic Territories k) Normal Lymph Flow l) Anastomoses m) Congestion Zones 3) Lymphatic System Pathophysiology a) Description b) Pathological process c) Safety factors d) Clinical Relevance to Wound Healing e) Clinical Relevance to Edema Management 4) General medical assessment (relevant to lymphedema) a) Medical management, diagnosis b) Date of onset, treatment history c) Cognition & safety, psychological, social d) Co-morbidities relevant to lymphedema e) Medications, allergies f) Vital signs, pain g) Height & weight, nutrition h) Functional mobility, equipment i) ADLs and adaptive equipment 5) Skin assessment & treatment a) Sensation, temperature, moisture b) Vascular skin changes c) Folliculitis, cellulitis (erysipelas), fungal infections d) Intertriginous dermatitis e) Scars f) Radiation therapy

2 2 g) Lymphangiectasias h) Chronic inflammation 6) Vascular assessment a) Pulses, capillary refill b) Buerger s test c) Venous duplex ultrasound d) Ankle brachial index e) Toe brachial index 7) Lymphedema classifications, staging & complications a) Lymphedema definition b) Lymphedema classifications c) Potential complications of lymphedema 8) Lymphedema/edema assessment a) Edema questionnaire b) Stemmer s test c) Circumferential girth measurements d) Calculating volume e) Calculating total circumferences f) Pitting & rebound g) Texture h) Special tests 9) Complex decongestive therapy (CDT) a) Overview b) Components of CDT c) Phases of treatment d) Indications, Contraindications, Precautions e) Skin & nail care f) Manual lymph drainage therapy g) Multi-layered lymphedema (compression) bandaging h) Compression garments i) Home program j) Adjunctive treatments 10) Differential diagnosis & treatment of common lower extremity edemas a) Chronic venous insufficiency b) Deep vein thrombosis c) Lymphedema d) Phlebolymphedema e) Malignant lymphedema f) Lipedema g) Lipolymphedema h) Congestive heart failure i) Renal insufficiency/failure j) Dependent edema k) Other edemas 11) Best practices 12) Compression 13) Advanced cancer and end of life 14) Surgical intervention 15) Care of children with lymphedema Wound Care & Edema: 1) Anatomy, physiology & pathophysiology of the arterial, venous, and lymphatic systems 2) Anatomy & physiology of the integumentary system 3) Integumentary system pathophysiology 4) Principles of wound healing 5) Types of wound closure 6) General medical assessment (relevant to wounds) 7) Nutrition & hydration assessment & treatment 8) Dermatological terminology - primary skin lesions 9) Skin assessment

3 3 10) Edema assessment 11) Wound assessment 12) Differential diagnosis, classification, & treatment of common wound types arterial & venous ulcers 13) Differential diagnosis, classification, & treatment of common wound types neuropathic foot ulcers 14) Classification & treatment of burns 15) Classification & treatment of other wound types 16) Atypical ulcers 17) Wound care basic skills 18) Managing bioburden & infection 19) Wound dressings 20) Topicals 21) Moisture barriers 22) Edema management 23) Identifying & overcoming barriers to wound healing 24) Differential diagnosis & treatment of common lower extremity redness 25) Palliative wound care 26) Adjunctive modalities for wound healing 27) Skin grafts 28) Cellular & tissue based products 29) Growth factors 30) MMPS & TIMPS 31) Photography, legal issues, referrals Wound Debridement: 1) General Medical Assessment (Relevant to Debridement) 2) Wound Debridement Overview a. Why Debride? b. Autolytic Debridement c. Enzymatic Debridement d. Maggot Debridement Therapy (MDT) (Bio-Surgical Debridement) e. Ultrasonic Assisted Debridement f. Mechanical Debridement g. Conservative Sharp Debridement h. Chemical Debridement i. Surgical Debridement 3) Conservative Sharp Debridement 4) Maggot Debridement Therapy 5) Atypical Ulcers & Debridement 6) Debridement Legal Considerations & Referrals Pressure Injury Prevention & Treatment: 1) USA statistics 2) Etiology 3) Staging 4) Deep Tissue Injury 5) Mucosal membrane pressure injury 6) Kennedy terminal ulcer 7) Medical device related pressure injuries 8) Differential diagnosis

4 4 a. Incontinence Associated Dermatitis b. Intertriginous Dermatitis c. Moisture Associated Skin Damage d. Candidiasis/tinea pedis e. Heel ulcers/arterial f. Neuropathic ulcers g. Friction injury 9) Risk assessments 10) Nutrition 11) Technology for early detection 12) Support surfaces 13) Positioning & repositioning 14) Prevention: moisture management 15) Pain assessment & management 16) Surgery 17) Palliative care 18) Adjunctive modalities 19) Teamwork, communication & implementation 9-Day Live Training SCHEDULE: Day 1: Modern MLD Certification (10 CE hrs) 8am 7pm; Lunch Break: 1-2pm 7:30-8:00am Attendee Sign-In 8:00-8:30 Pre-Test 8:30-9:30am Review of Normal Lymph Flow Patterns New Discoveries in Lymph Flow Patterns 9:30-10:30am Utilization of Standard Touch Technology (if available) Lab: Palpation Dermis, Hypodermis, Fascia 10:30am- 1:00pm Lab: ILWTI Maps & Anatomically Targeted MLD Techniques for Terminus, Thoracic Duct, Lymph Nodes, Superficial & Deep Abdominal Lymphatics, Anastomoses Lab: Sequence Maps & Central Decongestion for Upper Extremity Lymphedema 1:00-2:00pm LUNCH BREAK Lab: ILWTI Maps & Anatomically Targeted MLD Techniques for 2:00-5:00pm Congestion Zones, Dermal Lymphatics Lab: Sequence Maps & Peripheral Decongestion for Upper Extremity Lymphedema Lab: Sequence Maps & Central Decongestion for Lower Extremity 5:00-7:00pm Lymphedema Lab: Sequence Maps & Peripheral Decongestion for Lower Extremity Lymphedema 7:00pm Attendee Sign-Out

5 5 Day 2: Modern MLD Certification (10 CE hrs) 8am 7pm; Lunch Break: 1-2pm Lab: Mapping & Central Decongestion for L Lower Extremity 8:00-10:00am Lab: Mapping & Peripheral Decongestion for L Lower Extremity 10:00-Noon Lab: Mapping & Central Decongestion for R Upper Extremity Lab: Mapping & Peripheral Decongestion for R Upper Extremity Noon-1:00pm Lab: MLD Techniques for Fibrotic Tissue 1:00-2:00pm LUNCH BREAK 2:00-3:30pm Lab: MLD for Truncal Lymphedema 3:30-5:30pm 5:30-7:00pm Lab: Mapping & Central Decongestion for R Lower Extremity Lab: Mapping & Peripheral Decongestion for R Lower Extremity Lab: Mapping & Central Decongestion for L Upper Extremity Lab: Mapping & Peripheral Decongestion for L Upper Extremity 7:00pm Attendee Sign-Out Day 3: Modern MLD Certification (10 CE hrs) 8am 7pm; Lunch Break: 1-2pm 8:00-9:00am Lab: MLD for Pelvic & Genital Lymphedema 9:00-10:30am Group Lab: MLD for Head & Neck Lymphedema 10:30- Group Activity: Complex Case Study Development 11:30am 11:30am- Group Activity: Complex Case Study Mapping & POC 12:30pm 12:30-1:00pm Group Presentations: Complex Case Studies 1:00-2:00pm LUNCH BREAK 2:00-3:00pm Group Presentations: Complex Case Studies 3:00-4:30pm Lab: Complex Case Study Treatments

6 6 4:30-5:30pm Individual Activity: Complex Case Study Mapping & POC Individual Activity: Complex Case Study Treatment/ Practicum 5:30-7:00pm Testing/Post-Test 7:00pm Attendee Sign-Out Day 4: Advanced Bandaging & Decongestive Compression (10 CE hrs) 8am 7:30pm; Lunch Break: 12:30-1:30pm, Evening Break: 5:00-5:30pm 8:00-8:30am Principles of Compression Bandaging Bandaging Indications, Precautions & Contraindications 8:30-9:30am Lab: Performing Bedside ABI 9:30-10:30am Lab: Circumferential Measurements & Volume Calculation 10:30am-11:30am Lab: Toe & Finger Bandaging 11:30am-12:30pm Lab: Custom, Lower Leg Bandaging 12:30-1:30pm LUNCH BREAK Lab: Custom, No-Slip, Lower Leg Bandaging with Fibrotic 1:30-3:30pm Tissue Management Lab: Custom, No-Slip, Full Leg Bandaging with Fibrotic Tissue 3:30-5:00pm Management Lab: Custom, No-Slip, Full Arm Bandaging with Fibrotic Tissue Management 5:00-5:30pm EVENING BREAK 5:30-7:30pm Lab: Case Studies 7:30pm Attendee Sign-Out Day 5: Advanced Bandaging & Decongestive Compression (10 CE hrs) 8am 7:30pm; Lunch Break: Noon-1:00pm, Evening Break: 5:00-5:30pm 8:00-11:00am Lab: Custom, No-Slip, Full Arm and/or Leg Bandaging with Fibrotic Tissue Management & Practicum Testing 11:00am-Noon Lab: Genital Bandaging 1:00-3:00pm Principles & Types of Decongestive Garments Lab: Trimming & Fitting Decongestive Garments 3:00-5:00pm Lab: Complex Decongestive Garments for Advanced Lymphedema 5:00-5:30pm EVENING BREAK 5:30-7:30pm Case Study Presentations 7:30pm Attendee Sign-Out

7 7 Day 6: Advanced Compression Garment Selection & Fitting (10 CE hrs) 8am 7:30pm; Lunch Break: Noon-1:00pm, Evening Break: 5:00-5:30pm 8:00-8:30am Pre-Test 8:30-9:00am Compression Engineering & Function and Categories Compression Categories: Circular Knit, Flat Knit, Short Stretch/Inelastic Wraps, Night Garments Compression Indications, Precautions & Contraindications 9:00-10:00am Differential Diagnosis of Edemas and Compression Implications The Compression Selection Guide & How to Use It 10:00-Noon Circular Knit Textiles/Garments for Different Types of Edema Lab: Measuring & Fitting for Upper Extremity Circular Knit Garments Lab: Measuring & Fitting for Lower Extremity Circular Knit Garments 1:00-1:30pm Lab: Donning and Doffing Tips & Techniques for Circular Knit Garments 1:30-2:00pm Flat Knit Textiles/Garments for Different Types of Edema 2:00-3:30pm Lab: Custom Flat Knit Measuring & Fitting for Legs and Feet 3:30-5:00pm Lab: Custom Flat Knit Measuring & Fitting for Arms and Hands 5:00-5:30pm EVENING BREAK 5:30-7:30pm Lab: Case Studies 7:30pm Attendee Sign-Out Day 7: Advanced Compression Garment Selection & Fitting (10 CE hrs) 8am 7:30pm; Lunch Break: Noon-1:00pm, Evening Break: 5:00-5:30pm 8:00-9:00am Short Stretch/Inelastic Wraps for Different Types of Edema ABI Influence on Compression Selection 9:00-10:30am Lab: Measuring & Fitting for Short Stretch/Inelastic Wraps 10:30-Noon Night Garments for Different Types of Edema Lab: Measuring & Fitting for Night Garments 1:00-1:30pm Head/Neck & Trunk Compression Garments 1:30-3:30pm Lab: Measuring & Fitting for Custom Inelastic Garments 3:30-4:30pm Case Studies & Garment Selection 4:30-5:00pm Billing & Reimbursement for Garments 5:00-5:30pm EVENING BREAK 5:30-7:30pm Case Studies 7:30pm Attendee Sign-Out

8 8 Day 8: Practical Wound Care for Lymphedema Management (8 CE hrs) 8am 5pm; Lunch Break: 12:00-1:00pm; Supper Break 5:00-6:00pm Differential Diagnosis of Lower Extremity Wounds & 8:00-9:00am Classifications 9:00-10:00am Dressing Categories & Function 10:00-11:00am How to Manage Intertriginous Dermatitis How to Manage Moisture Associated Skin Damage; Partial/Full Thickness Ulcerations How to Manage Candidiasis & Fungal Infections How to Manage Cellulitis How to Manage Lymphorrhea How to Manage Radiation Burns 11:00am-Noon MLD for Wounds Wound Care Skills Lab: Handwashing, Donning & Doffing PPE, 1:00-3:30pm Setting Up Clean Field, Cleansing & Irrigation, Wound Assessment, Taking a Culture, Dressing Application 3:30-5:00pm Lab: Negative Pressure Wound Therapy 5:00-6:00pm SUPPER BREAK Day 8 Evening: Introduction to Oncology & Lymphedema Management Live Webinar (2 CE hrs) 6:00-8:00pm General Oncology Overview, The Cancer Experience, Role of 6:00-6:45pm Rehab, Cancer Statistics Cancer Pathogenesis, Classifications, Staging, Grading Medical Treatments & Side Effects 6:45-8:00pm Oncology Lymphedema Statistics, Risk Factors, Causes Breast Cancer Statistics, Risks, Staging Breast Cancer Medical Treatment & Side Effects Diagnosis Codes & Billing Exercise Testing & Prescription Breast Cancer Rehabilitation Evaluation & Treatments Axillary Webbing Syndrome Radiation & Chemotherapy Prostate Cancer & Lymphedema, Gynecologic Cancer Lymphoma, Melanoma Oncology Rehabilitation Summary 8:00pm Attendee Sign-Out

9 9 Day 9: Venous Leg Ulcer & Phlebolymphedema Management (8 CE hrs) 8am 5pm; Lunch Break: Noon-1:00pm; Supper Break 5:00-6:00pm 8:00-9:00am Venous Leg Ulcer (VLU) Statistics Gold Standard Treatment for VLUs Characteristics of VLUs Mixed Ulcerations (Arterial-Venous) Atypical Ulcers mimicking VLUs 9:00-10:00am Wound Assessment 10:00-10:30am Lymphatic Assessment of VLUs & Diagnosing Phlebolymphedema Manual Lymphatic Drainage for VLU Healing and Phlebolymphedema 10:30-11:30am Wound Care & Dressings for VLUs 11:30-Noon Types and Importance of Vein Procedures 1:00-2:30pm Lab: Compression Bandaging for VLUs & Edema Reduction; Adapted Compression Bandaging for VLU/Phlebolymphedema 2:30-4:00pm Inelastic Compression Garments for VLUs, Edema Reduction, and Phlebolymphedema 4:00-5:00pm The Compression Selection Guide: Types and Importance of Long-Term Compression Garments 5:00-6:00pm SUPPER BREAK Day 9 Evening: Wound Debridement Certificate (2.5 CE hrs) 6:00-8:30pm 6:00-8:30pm Lab: New Mechanical Debridement Option Lab: Conservative Sharp Debridement, Enzymatic Debridement, Chemical Debridement Lab: Foot Models Practice Lab: Maggot Debridement Therapy* *live maggots application subject to availability 8:30pm Attendee Sign-Out, Course Evaluations, Certificates