Wounds on the High-Risk Foot
Adult

Wound Management

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Useful Management Information

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

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

Resource:

Diabetic foot Australia

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	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 Foot wound with known 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 calendar days)	No category 2 criteria
Category 3 (appointment within 365 calendar days)	No category 3 criteria
If your patient does not meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: 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

Standard Referral Information

Reason for request

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

Relevant clinical information about the condition

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
All conservative options that have been pursued unsuccessfully prior to referral
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
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

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.)

Essential Referral 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

Relevant clinical history / vascular referrals including previous history of 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 –i.e. x-ray, ultrasound
Clinical photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Send Referrals To

Smart Referrals

Not Available
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Health Service District

Internal Referrals

(E-Blueslips)

Fax

(07) 5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Wounds on the High-Risk FootAdult