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