Acute arterial ischemia: Difference between revisions
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==Management== | ==Management== | ||
* | *[[Unfractionated heparin]] | ||
*[[ | **80 units/kg bolus; then infuse 18units/kg/hr | ||
*[[ASA]] | |||
*Dependent positioning | |||
*Pain control | |||
*Fluid resuscitation and treatment of heart failure as needed to improve limb perfusion | |||
*Vascular surgery consultation (clot retrieval, balloon angioplasty, intraarterial tPA, stenting, bypass) | |||
==Disposition== | ==Disposition== | ||
Revision as of 17:38, 8 June 2015
Background
Clinical Features
6 Ps
- Pain - Claudication or pain with leg elevation; typically earliest sign
- Paraesthesia - May be associated with weakness; preservation of light touch is good guide to viability
- Pallor
- Paralysis
- Pulselessness - May be accompanied by skin changes; late finding
- Poikilothermia - Limb is cool to touch when compared to other side; late finding
Differential Diagnosis
Diagnosis
Management
- Unfractionated heparin
- 80 units/kg bolus; then infuse 18units/kg/hr
- ASA
- Dependent positioning
- Pain control
- Fluid resuscitation and treatment of heart failure as needed to improve limb perfusion
- Vascular surgery consultation (clot retrieval, balloon angioplasty, intraarterial tPA, stenting, bypass)