How to Create a Hot Foot Line to Prevent Diabetes-Related Amputations: Instant Triage for Emergency Department and Inpatient Consultations

John D. Miller, Eric J. Lew, Nicholas A. Giovinco, Christian Ochoa, Vincent L. Rowe, Leonardo C. Clavijo, Fred Weaver, David G. Armstrong

Research output: Contribution to journalArticle

Abstract

Emergency department visits for lower extremity complications of diabetes are extremely common throughout the world. Surprisingly, recent data suggest that such visits generate an 81.2% hospital admission rate with an annual bill of at least $1.2 billion in the United States alone. The likelihood of amputation and other subsequent adverse outcomes is strongly associated with three factors: 1) wound severity (degree of tissue loss), 2) ischemia, and 3) foot infection. Using these factors, this article outlines the basic principles needed to create an evidence-based, rapid foot assessment for diabetic foot ulcers presenting to the emergency department, and suggests the establishment of a "hot foot line" for an organized, expeditious response from limb salvage team members. We present a nearly immediate assessment and referral system for patients with atraumatic tissue loss below the knee that has the potential to vastly expedite lower extremity triage in the emergency room setting through greater collaboration and organization.

Original languageEnglish (US)
Pages (from-to)174-179
Number of pages6
JournalJournal of the American Podiatric Medical Association
Volume109
Issue number2
DOIs
StatePublished - Mar 1 2019

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Triage
Amputation
Hospital Emergency Service
Foot
Inpatients
Referral and Consultation
Lower Extremity
Limb Salvage
Diabetic Foot
Diabetes Complications
Knee
Ischemia
Wounds and Injuries
Infection

ASJC Scopus subject areas

  • Podiatry
  • Orthopedics and Sports Medicine

Cite this

How to Create a Hot Foot Line to Prevent Diabetes-Related Amputations : Instant Triage for Emergency Department and Inpatient Consultations. / Miller, John D.; Lew, Eric J.; Giovinco, Nicholas A.; Ochoa, Christian; Rowe, Vincent L.; Clavijo, Leonardo C.; Weaver, Fred; Armstrong, David G.

In: Journal of the American Podiatric Medical Association, Vol. 109, No. 2, 01.03.2019, p. 174-179.

Research output: Contribution to journalArticle

Miller, John D. ; Lew, Eric J. ; Giovinco, Nicholas A. ; Ochoa, Christian ; Rowe, Vincent L. ; Clavijo, Leonardo C. ; Weaver, Fred ; Armstrong, David G. / How to Create a Hot Foot Line to Prevent Diabetes-Related Amputations : Instant Triage for Emergency Department and Inpatient Consultations. In: Journal of the American Podiatric Medical Association. 2019 ; Vol. 109, No. 2. pp. 174-179.
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