Paucis Verbis card: Acute limb ischemia
Acute limb ischemia (ALI) is a true vascular emergency. It doesn’t occur as frequently as the more high-profile conditions as cerebrovascular accidents and acute myocardial infarcts, but it portends similarly high morbidity and mortality risk.
- How do you stage a patient with ALI, based on the Rutherford classification system?
- What is the ED treatment plan?
- Should this patient go to Interventional Radiology or the Operating Room for more definitive management?
PV Card: Acute Limb Ischemia with Rutherford Classification
Go to ALiEM (PV) Cards for more resources.
The treatment of shock should focus on correcting the underlying pathophysiology. With persistent hemodynamic instability, a vasopressor and/or inotrope should be selected. Reviewing receptor physiology can help you select the best-fit agent for the patient’s clinical condition. There is an especially useful table on medication selection in the reviewed 2008 EM Clinics of North America article.
A few days I wrote about my “peripheral brain” note cards that I carry with me on each ED shift. These cards contain brief summaries of updated guidelines, evidence based literature, and clinical pearls. I constantly get requests for a copy of them, but they are fairly outdated now that I’m out of residency.