UMEM Educational Pearls

Title: Evaluation of the acute ischemic limb

Category: Vascular

Keywords: ischemia (PubMed Search)

Posted: 1/18/2010 by Rob Rogers, MD (Updated: 11/22/2024)
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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