Diabetic foot risk stratification and triage – active foot disease
Presence of active ulceration or unexplained hot red swollen foot with or without the presence of pain.
Tell people they have active foot problem. Provide written and verbal information about the foot problem and emergency contact number. Assess and document size, depth and position of the ulcer if present. According to training and skill, and where appropriate, offer 1 or more of the following: offloading, control of infection, control of ischaemia, wound debridement and wound dressing. Refer to the Multidisciplinary Diabetic Foot Clinic or Foot Protection Service (according to local protocols) within 1 working day for triage within 1 further working day.
Presence of a limb-threatening or life-threatening diabetic foot problem; Ulceration with fever or signs of sepsis or limb ischaemia, clinical concern of a deep-seated soft tissue of bone infection (with/without ulceration), gangrene (with/without ulceration).
Manage as above. Tell people that they have a foot emergency, refer immediately to acute hospital services (e.g Trauma Unit) and inform the Multidisciplinary Diabetic Foot Clinic (according to local protocols).