Acutely painful limb Flashcards
If an acutely painful limb is cold and pale what should it be treated as until proven otherwise?
Acute limb ischaemia
What are the 6Ps of acute limb ischaemia?
Pale, Pallor, pulselessness, parethesia, perishingly cold and paralysis (Pale, pallor and pulselessness first)
What would the pulses be like in a person with acute limb ischaemia?
No pulses in the side of the leg with the acute limb ischaemia, full pulses in the opposite leg
What are some risk factor for acute limb ischaemia?
Atrial fibrillation, hypertension, smoking, diabetes mellitus, recent MI
What test should be arranged if acute limb ischaemia is suspected?
CT angiogram for confirmation and anatomical delineation and an urgent vascular review
Why is acute limb ischaemia a surgical emergency?
irreversible tissue damage occurs within 6 hours
What should a patient with acute limb ischaemia be given before surgery?
fluids for resuscitation and IV heparin
If an acutely painful limb is hot and swollen what is the first thing that is suspected?
Deep vein thrombosis
Where is the pain localised in DVT?
Calf- tenderness and firmness
What is likely in the medical history for someone with a DVT?
History of pro-thombotic diseases in the family history, immobility, surgery
What score needs to be calculated for DVT, what score needs a doppler scan?
Wells score of greater than or equal to 1
What test can a DVT be excluded with?
D dimer test
How is DVT treated initially?
therapeutic doses of LMWH and then long term anti-coagulation
Other than DVT what can cause an acutely painful hot and swollen limb?
cellulitis or other infections which will require antibiotics
What else other than Acute limb ischaemia, DVT, and cellulitis could cause an acutely painful limb?
Trauma e.g. fracture, neurological e.g. radiculopathies
