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Evaluation of the acutely ischemic limb
Some considerations when evaluating/treating patients with acute limb ischemia:
- Strongly consider anticoagulation (usually with Heparin) early
- Consider the source of the ischemia (LV/LA thrombus, AAA mural thrombus, in situ limb thrombosis)
- Always consider aortic dissection as an etiology of acute limb ischemia (chest pain and leg ischemia)
- Early vascular consult and/or transfer
- Obtain bedside ABIs on suspected cases and remember that diabetics may have normal to falsely elevated ABIs secondary to calcified vessels.
- Common theme in laws suits for missed or delayed cases of limb ischemia: failure to perform and document ABIs