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