Vascular - created from Mind Map

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

Vascular