UMEM Educational Pearls

Category: Vascular

Title: Acute Limb Ischemia

Keywords: Ischemia (PubMed Search)

Posted: 9/9/2008 by Rob Rogers, MD (Updated: 10/18/2019)
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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