This website uses cookies to ensure you get the best experience on our website. Learn more

Medicine Notes General and Vascular Surgery Notes

Vascular Emergencies Notes

Updated Vascular Emergencies Notes

General and Vascular Surgery Notes

General and Vascular Surgery

Approximately 34 pages

Complete set of notes covering the most common general and vascular surgical conditions. Includes pathophysiology, presentation, investigation and management. Clinically orientated with examination tips and colour-coded by topic. A great overview - ideal for written and clinical finals....

The following is a more accessible plain text extract of the PDF sample above, taken from our General and Vascular Surgery Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Vascular Emergencies

Trauma

  • Penetrating wounds

  • Blunt trauma

  • Invasive procedures (iatrogenic)

Hard signs (diagnostic)

  • External pulsatile bleeding

  • Palpable bruit/thrill

  • Expansive haematoma

  • Ischaemic limb

  • Fracture/dislocation

Soft signs (suggestive of vascular injury but not diagnostic)

  • History of blood loss at the scene

  • Proximity of injury to major vessel

    • Supracondylar and tibial fracture, posterior knee dislocation

  • Small non-pulsatile haematoma

  • Neurogenic deficit

Management

  • IV access (two large bore cannulae) (in contralateral limb – preserve cephalic and saphrenous veins)

  • Fluid resuscitation

  • Surgical exploration and repair

    • Prevent further haemorrhage + salvage ischaemic limb

Chest vascular trauma

  • Blunt trauma

  • Pneumothorax/tamponade

  • CT scan to assess

    • Most common injury = rupture of descending aorta

    • Treatment = stent graft

Retroperitoneal bleed

  • Pelvic fracture

  • Surgery in pelvis

  • Spontaneous (warfarin)

  • Following angiography

Acute Limb Ischaemia

Pain

Pallor

Perishing cold

Parasthesia

Paralysis

Pulseless

Acute ischaemia leads to tissue necrosis in 6 hours unless arterial function restored

Requires prompt assessment and management

Clinical features

  • Marble white limb progressing to mottled blue (venous filling)

  • If the mottled limb blanches it is salvageable

Aetiology

  • Embolism (due to AF etc)

    • Sudden onset ‘gun shot’ pain

    • Known embolic condition

    • Normal pulses in other leg

    • No previous claudication

  • Thrombosis

  • Others = trauma, external compression

Investigations

  • Baseline bloods

    • U+E, FBC, group and save

  • ECG

  • Seek senior advice regarding imaging

Management

  • Analgesia

    • IV morphine

  • Oxygen (increase perfusion)

  • IV heparin to prevent clot propagation

  • Correct hypotension (increase perfusion)

  • Medical management if patient shows sigs of improvement – may be treatable with IV heparin in addition to treatment of...

Buy the full version of these notes or essay plans and more in our General and Vascular Surgery Notes.