Red flags
- Sensory + motor loss (Rutherford III → irreversible)
- Rigid muscle compartments
- Anaesthetic cool limb
First steps
- ABCDE + analgesia
- Anticoagulate heparin 5000 U IV bolus then infusion aPTT 1.5-2×
- Immediate vascular surgery referral
Key investigations
- CT angio or duplex USS
- Rutherford classification
- CK, K+, myoglobin
Differentials
- Chronic critical limb ischaemia acute-on-chronic
- Compartment syndrome
- Necrotising fasciitis
Initial management
- Embolectomy / bypass / catheter-directed thrombolysis
- Fasciotomy for reperfusion
- Amputation if Rutherford III
Referral
- Vascular surgery immediately
AI clinical assessment
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