12-02-20 Vascular Ward

Question 1

What are the different types of pain in vascular?

Answer 1

Ischeamic leg- sharp, acute onset
Claudication- angina but for the leg,
Neuropathic pain- shooting, pins and needles
DVT pain- burning due to a DVT

Question 2

What drugs can you use to treat neuropathic pain?

Answer 2

Amitriptyline (tricyclics)
Duloxetine
Gabapentin

Question 3

What are the various vascular interventions?

Answer 3

Angiography
Stent/balloon 
Surgical thrombolysis
Bypass graft 
Amputation

Question 4

When do the 6 P’s apply?

Answer 4

They only apply for an acute limb

Question 5

What are the indications for amputation?

Answer 5

Life threatening sepsis
Dead limb
Damn nuisance of a limb

Question 6

What screening should should you do of a vascular wound

Answer 6

Colour, movement, sensation

Question 7

What are some extra investigations to carry out surrounding vascular?

Answer 7

Doppler
ABPI (ankle brachial plexus index)- shows blood pressure difference between ankle and brachial artery
Indications of arterial disease

Question 8

What are the presenting symptoms for a triple A?

Answer 8

Severe chest/back pain
Male over 65
Sweating nausea and vomiting
Increased respiration rate

Question 9

What are you initial investigations for an AAA

Answer 9

A- airways
B- breathing 
C- circulation (BP)
D- confusion and pupils
(Don’t Ever Forget Glucose)

Cap refill
Expansible pulses- (pulse goes outwards when fingers are on it, goes out)

Question 10

How do you manage a suspected AAA?

Answer 10

2 wide bore cannulas
Permissive hypotension (stops bleeding, stops clot being thrown off)
Slightly hypotensive (systolic <80)
Cross match, call for blood. Replace like with like
Raise legs to increase BP
Blood lactate
Renal functions