Must be classed urgent and by phonenot IUR/email

Spreading infection emergency admission to Medicine
01463 704000 and page 4000 (medical on call)
Or
Critical ischaemia contact on call Vascular Consultant 01463 704000

On Admission
Contact Diabetes team (ext 5322/5444)

• Aim for transfer to Ward 6C or 4B depending on nature of foot problem (Medical or Surgical)
• Consider a variable rate intravenous insulin infusion if patient systemically unwell
• Initial assessment should include removal of dressings, examination of feet to assess for indications of peripheral neuropathy (Touch-the-toes test recommended) AND
• Palpation of dorsalis pedis and posterior tibial pulses in both feet
• Refer to Highland Formulary Guidelines for inpatient Antibiotic Management
• X-ray recommended
• For appropriate wound dressings refer to NHSH Wound Management Guideline
• Refer to podiatry Abban St 723250 to alert diabetes Specialist podiatrist for advice on wound management and local debridement (if appropriate)
• Optimal foot protection – Check Protect Refer principles
• Refer to orthotics for advice on pressure relief ext 4178
• Consider referral to diabetes inpatient specialist nurse if appropriate ext 7934

1. Please Refer to Raigmore Hospital via SCI Gateway referral or letter. The patient can be expected to be seen in clinic soon.
2. If there is any doubt concerning appropriate footwear or pressure refer to Orthotics Department, Raigmore Hospital (01463 704178).

This referral pathway will be different for patients in Argyll & Bute

SCI Gateway Referral to Abban Street Podiatry
Tel No 01463 723250
Any concerns about diabetes foot ulceration pre- or post -clinic day should be fielded through the Locality based Specialist Podiatrists.