Q:

An 82-year-old man with a long history of coronary and peripheral vascular disease presents with an acutely ischemic right lower extremity. The following is/are true:

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An 82-year-old man with a long history of coronary and peripheral vascular disease presents with an acutely ischemic right lower extremity. The following is/are true: 


  1. The first step in management should be an arteriogram
  2. If intractable congestive heart failure is present, non-operative treatment with heparin would be appropriate
  3. If prolonged ischemia has occurred, reperfusion should be accompanied by sodium bicarbonate
  4. Regardless of the period of ischemia, fasciotomy should be based on the findings postoperative

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b. If intractable congestive heart failure is present, non-operative treatment with heparin would be appropriate

The first step in the management of acute limb ischemia in any patient is heparin anticoagulation. If intractable heart failure is present, heparin treatment would be appropriate without operation. If prolonged ischemia has occurred, the venting of the first 3–500 ml of venous outflow will allow conservation of RBCs and avoidance of the consequences of high levels of potassium. If the duration of ischemic has exceeded 4 hours, a 4 compartment fasciotomy should be performed at the time of restoration of perfusion.

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