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Management of acute limb ischemia
Just a few pearls regarding acute limb ischemia
- Presents with an acutely painful extremity (may be pale and cool as well)
- Common etiologies include atrial fibrillation, embolism from aortic plaques, and thrombosis of extremity vessels
- Most patients need to be anticoagulated (heparin)
- Vascular surgery should be consulted immediately or the patient needs transfer to a facility that can handle acute vascular emergencies
- Use caution when performing the physical examination, because there may be a pulse present
- Perform bedside ABI to the best of your ability and document
- Diabetics with stiff vasculature may have ABIs of 1 or greater so may be less reliable
References
Vasc Surg Reviews 2007