peripheral arterial disease: acute limb threatening ishcaemia

Question 1

types of pad?

Answer 1

intermittent claudication
critical limb ischaemia
acute limb-threatening ischaemia

Question 2

features of acute limb threatening ischaemia

Answer 2

6 Ps

pale
pulseless
painful
paralysed
paraesthetic
‘perishing with cold’

Question 3

Ix

Answer 3

a handheld arterial Doppler examination.

If Doppler signals are present, an ankle-brachial pressure index (ABI) should also be obtained.

Question 4

Initial Mx

Answer 4

ABC approach

analgesia: IV opioids are often used
intravenous unfractionated heparin is usually given to prevent thrombus propagation, particularly if the patient is not suitable for immediate surgery

vascular review

Question 5

definitive mx

Answer 5

intra-arterial thrombolysis

surgical embolectomy

angioplasty

bypass surgery

amputation: for patients with irreversible ischaemia

Question 6

cause

Answer 6

thrombus

Question 7

related co-mordities

Answer 7

smoking!! - stop

hypertension

diabetes mellitus

obesity

Question 8

medicinal mx

Answer 8

statin

exercise training