Sunday, 19 November 2017

Foot Screening

This page is intended for use by members of the public, HCP's should use the shared clinical guidelines on the intranet.

People with diabetes may be at risk of developing foot problems. Therefore it is beneficial to be screened, at least annually, to detect the presence of neuropathy, ischaemia and/or foot deformity.  Annual review allows for the identification and monitoring of any changes in an individual's foot risk-status.
See also:

Diabetic Foot Risk Stratification and Triage

Screening

Foot screening is important to enable appropriate management of foot care and/or foot problems for all people with diabetes.

When

  • At diagnosis and
  • Annually thereafter
  • If the individual reports any significant change

How

  • Through use of a validated diabetes foot screening tool
  • Inspection
  • Sensory testing
  • Palpation of foot pulses
  • Foot deformity and callus
  • History of foot ulceration

Who

  • A suitably-trained individual e.g. GP/Hospital doctor/Practice nurse (Low Risk)
  • Podiatrist. (Moderate/High Risk)
  • At Risk Feet

Risk-Categories

The Low Risk Foot 
  Appropriate action:
  • Normal sensation
  • AND good pulses
  • AND no previous ulcer
  • AND no foot deformity
  • AND normal vision

 

Annual screening by a suitably trained Health Care Professional. Agreed self management plan.

Provide written and verbal education with emergency contact numbers. Appropriate access to podiatrist if/when required. Provide Patient information leaflet for

Low Risk Foot

Patient Information is also available on the internet on the mydiabetesmyway website.

The Moderate Risk Foot
  Appropriate action:
  • Loss of sensation (Link to PN)
  • OR absent pulses/previous vascular surgery (link to PAD)
  • OR significant visual impairment
  • OR foot deformity and callus
 

Annual assessment by a podiatrist.  Agreed and tailored management/treatment plan by podiatrist according to patient needs. Provide written and verbal education with emergency contact numbers

Provide Patient information leaflet for

Moderate Risk Foot  

 Patient information is also available on the internet on the mydiabetesmyway website.

The High Risk Foot   Appropriate action:
  • Previous ulcer
  • OR previous amputation
  • OR absent pulses and neuropathy
  • OR callus with risk factor (neuropathy, absent pulse, foot deformity)

 

Annual assessment by podiatrist.  Agreed and tailored management/treatment plan by podiatrist according to patient needs. Provide written and verbal education with emergency contact numbers. Referral for specialist intervention if/when required.

Provide Patient information leaflet for

High Risk Foot

Patient information is also available on the internet on the mydiabetesmyway website.

Active Foot Disease   Appropriate action:

 

Rapid referral to and management by a member of the Podiatry Team/Virtual Multidisciplinary Team. Agreed and tailored management/treatment plan according to patient needs. Provide written and verbal education with emergency contact numbers.  Referral for specialist intervention when required. Provide Patient Information Leaflet for

looking after your foot ulcer

Patient information is also available on the internet on the mydiabetesmyway website.