Zusammenfassung der Ressource
Vascular
- Acute Arterial occlusion
- restoration of blood flow w/i 4-6 hrs
- heparin 80units/kg bolus
- 18u/kg/hr infusion
- ptt 60-80
- embolus/ acute ischemia
- embolectomy
- LA
- GA
- lack of claudication
- presence of contralat pulse
- cardiac
- arrhtymias
- anticoag
- aneuryms
- anticoag
- valves
- bacteria endocarditis
- atrial myxoma
- art-art
- ulcerated atheroma
- disruption by caths
- blue toe syndrome
- pulse + painful lesions in distal extremity
- aneurysms
- venous-art
- intra-cardiac shunts (PFO)
- intra-pulmonary AVMs (osler-weber-rendu)
- fresh thrmbus
- thrombolysis
- f/u angio
- stenosis
- angioplasty
- 2DE
- HD/ICU monitoring
- thrombin time
- fibrinogen lvl, keep >100 mg/dl
- fdp lvl
- ptt, keep <3-5 x normal limit
- fbc
- alteplase
- urokinase
- reteplase
- mechanical thrombectomy
- w or w/o tpa
- 2DE
- ECG,CXR
- cardiac pt
- if unrel to trauma
- reperfusion injury
- rhabdomyolysis
- muscle mass
- duration of ischemia
- aggressive hydration
- diuresis w mannitol 25g IV
- IV infusion of bicarb
- K, lactic acid, CK
- arrthymias
- myoglobin
- pigment nephropathy and ARF
- compartment syndrome
- intracompartment syndrome >30mhg
- fasciotomy
- > 6 hrs ll ischemia
- combined arterial/venous injruy
- level of occlusion
- 6 'p's : pain, pallor, parasthesia, paralysis, pulselessness,
poikilothermia
- trauma
- intimal flap
- arterial wall hematoma
- compartment sydnrome
- #/disloc
- hard signs
- surgical intervention
- operative expxloration
- reduction of disloc
- prox & distal control of injured artery
- end to end anastomosis
- completion angio
- preparation of uninjured leg or potential vein harvest site
- diminished/absent pulses distal to injury
- ischemia distal to injury
- visible arterial bleeding from wound
- bruit at/or distal to site of injury
- large,expanding or pulsatile hematoma
- soft signs
- doppler comparision w contralat limb
- >10-20% difference
- arteriography
- exploration
- others
- arterial thrombosis
- aortic dissection
- venous outflow occlusion
- low-flow state