Browse categories and answer follow-up questions to refine your symptom profile.
Time critical priorities
Acute limb ischemia priorities
Limb threat categorization
Viable limb category I
Threatened limb category IIa
Threatened limb category IIb
Irreversible ischemia category III
Time last known normal perfusion
Symptom onset within 14 days
Sudden onset minutes to hours
Progressive onset hours to days
Vascular surgery and interventional activation
Category IIb immediate threatened limb
Category III irreversible limb
Immediate stabilization
Resuscitation basics
Airway and breathing concerns
Aspiration risk with altered mental status
Supplemental oxygen for hypoxemia
Circulation and access
Two large bore IV lines
Cardiac monitor
12 lead ECG for atrial fibrillation or ischemia
Analgesia and limb protection
Opioid analgesia for severe ischemic pain
Limb at rest
Limb in neutral or dependent position
Avoid elevation
Avoid external heat or cold
Immediate medical therapy
Anticoagulation on diagnosis
Unfractionated heparin systemic anticoagulation
Contraindications checklist
Active major bleeding
Recent intracranial hemorrhage
Severe uncontrolled coagulopathy
Dosing strategy
Bolus 80 units per kg IV
Infusion 18 units per kg per hour IV
Alternative no bolus strategy for high bleeding risk
Monitoring targets
aPTT per institutional heparin nomogram
Anti Xa per institutional protocol
Limb viability triggers
Escalation triggers
Threatened limb physiology
Rest pain
Sensory loss
Motor weakness
Absent arterial Doppler signal
Irreversible ischemia physiology
Profound anesthesia
Paralysis
Rigor
Mottling fixed discoloration
Absent arterial and venous Doppler signals
Pitfalls and safety
High risk pitfalls
Normal proximal pulses with distal occlusion
Popliteal or tibial occlusion
Embolus to distal vessels
Neurologic mimic
Acute stroke with limb weakness
Spinal cord compression
Overreliance on pain as ischemia marker
Diabetic neuropathy
Sedation and altered sensorium
Missed compartment syndrome after reperfusion
Increasing pain out of proportion
Pain with passive stretch
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.