Acute limb ischaemia

Question 1

What is it

Answer 1

-blockage in blood vessels in limb
-can lead to infarction of cells causing loss of limb

Question 2

3 causes ALI

Answer 2

-emboli from heart eg atrial fibrillation
-proximal arterial disease (narrowing of vessels)
Virchow’s triad thrombosis
-hypercoagulability, vascular damage, circulatory stasis

Question 3

Signs and symptoms ALI
6Ps

Answer 3

-pain- constant, persistent
-pallor- cyanosis/ mottling
-pulselessness- ankle pulses absent
-perishing cold
-paraesthesia- reduced sensation/ numbness
-paralysis or power loss

Question 4

ALI risk factors

Answer 4

-older age
-peripheral artery disease
-atherosclerosis
-cardiac arrythmias
-recent MI
-hypertension, cholesterol
-cancer
-smoking
-diabetes

Question 5

ALI differentials

Answer 5

-DVT- similar but without pallor and pulselessness, confirmed by ultrasound
-Stroke/ transient ischemic attack- cause weakness/ numb limb, lack of vascular features
-Raynaud’s- pallor and pain triggered by cold/ stress

Question 6

ALI treatment and management

Answer 6

-correct CABCDE problems first
-pain relief morphine, entonox, paracetamol
-transfer to nearest arterial centre