UMEM Educational Pearls

Category: Vascular

Title: Evaluation of the acute ischemic limb

Keywords: ischemia (PubMed Search)

Posted: 1/18/2010 by Rob Rogers, MD (Updated: 12/7/2019)
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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