How to build a “Hot Foot Line” for rapid response to lower extremity complications in #Diabetes #DiabeticFoot #Footattack #ActAgainstAmputation

SALSA’s “Hot Foot Line” foot hotline constitutes a single point of contact rapid response pager to alert the diabetic foot / Toe and Flow service to urgent needs, systemwide.

Dr. Jennifer Pappalardo expertly reveals the “Hot Foot Line” pager.


Here are some more guidelines/pathways to help develop your own “rapid response team”.

  1. Diabetic Foot Rapid Response Acute Foot Team (DRRAFT) –  Seven essential skills
  2. Three  minute foot exam plus referral guidelines
  3. Three second foot exam for the emergency department

The manuscript describing the Hot Foot Line is here.

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

John D. Miller, DPM*Eric J. Lew, DPMNicholas A. Giovinco, DPM*Christian Ochoa, MD*Vincent L. Rowe, MD*Leonardo C. Clavijo, MD, PhD*Fred Weaver, MD*David G. Armstrong, DPM, MD, PhD*

*Southwestern Academic Limb Salvage Alliance (SALSA) Department of Surgery, Section of Vascular Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, CA.

†Center for the High-Risk Lower Extremity, University of New Mexico College of Medicine, Albuquerque, NM.Corresponding author: David G. Armstrong, DPM, MD, PhD, Southwestern Academic Limb Salvage Alliance (SALSA) Department of Surgery Keck Medical Center of USC 1520 San Pablo Street, Suite 4300 Los Angeles, CA 90033. (E-mail:

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.

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