Wounds on the High-Risk Foot
Emergency department referrals
All urgent cases must be discussed with the on-call Registrar to obtain appropriate prioritisation and treatment. Contact through
- Caboolture Hospital (07) 5433 8888
- Redcliffe Hospital (07) 3883 7777
- Royal Brisbane and Women’s Hospital (07) 3646 8111
- The Prince Charles Hospital (07) 3139 4000
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- Systemic inflammatory response symptoms (SIRS) or clinically unwell
- Worsening pain and/or pain not in keeping with progression of the wound/ulcer
- Progressive cellulitis despite initial treatment
- Acute or critical limb ischaemia with necrosis
- Acute Charcot arthropathy if access to podiatry is not accessible within 48 hours
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Foot ulcer or pressure injury with mild to moderate infection <2cm around wound*
- Necrosis/dry gangrene (with or without ulceration) *
- Non-infected foot ulcer. For optimal care, a patient with an ulcer will be reviewed within 48 hours by a specialist High Risk Foot Service
- Peripheral arterial disease, peripheral neuropathy or foot deformity in the absence of adequate community resources
*client to present to High Risk Foot Service within 48 hours. If no High-Risk Foot service is available, consult with a specialist service via telehealth, or present to an emergency department.
Category 2
Appointment within 90 days is desirable
- No category 2 criteria
Category 3
Appointment within 365 days is desirable
- No category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
High-risk foot has 2 or more of the following:
- Peripheral neuropathy (PN),
- Peripheral arterial disease (PAD),
- Foot deformity
Or a history of:
- previous amputation or
- previous foot ulceration
Refer to HealthPathways for assessment and management information if available
Examine both feet for evidence of the following risk factors:
- Neuropathy (use a 10g monofilament as part of a foot sensory examination)
- Limb ischaemia (see CPC on peripheral arterial disease)
- Ulceration
- Callus
- Infection and/or inflammation
- Deformity
- Gangrene
- Charcot arthropathy
- Diabetic Foot Australia
Deadly Feet Program
Deadly Feet is a multi-disciplinary service providing early assessment, risk modification, and specialist intervention for Aboriginal and Torres Strait Islander people at risk of lower limb conditions associated with diabetes and/or peripheral vascular disease. Patients are reviewed by a vascular consultant, a specialist vascular sonographer, and a podiatrist within one 90 minute appointment in the Deadly Feet clinic at Redcliffe Hospital, Caboolture MATSICHS or Galangoor Duwalami Primary Healthcare Service, Hervey Bay.
Deadly Feet offers relaxed referral criteria to support equitable access to health care for Aboriginal and Torres Strait Islander people. Referrals can be made through GP Smart Referrals and no prior pathology or medical imaging are required. Alternatively referrals can be made by contacting the Deadly Feet project team by phone on 07 3647 1500 or at MNVOP@health.qld.gov.au.
Referral requirements
A referral may be rejected without the following information.
- Co-morbidities and past medical history
- Details of all treatments offered, and efficacy to date e.g. type of dressings used, date of commencement of any antibiotics with dose prescribed.
Additional Referral Information (Useful for processing the referral)
- Relevant clinical history/Vascular referrals including previous history or Charcot arthropathy
- History of allergies and list of current medications
- Current podiatry treatment/dressing regimen, toe pressures if available
- Relevant pathology (as clinically indicated)
- Recent vascular imaging (duplex studies, ABPI if already completed)
- Relevant medical imaging results if available – e.g. x-ray, ultrasound
- Clinical photograph – with patient’s consent, where secure image transfer, identification and storage is possible
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org