VASCULAR
DEEP VEIN THROMBOSIS - DVT
Prompt
ResponsePhlegmasia cerulea dolens
Large DVT with potential for complete venous occlusion and infarction
Large DVT with potential for complete venous occlusion and infarction
PromptImaging options for DVT
ResponseUS lower limb - non compressivel deep veins, no variance to pulse wave doppler of iliac veins/can also assess arterial flow
CT venogram - assess clot burden/degree of venous occlusion etc. Anatomic mapping pre-intervention
CT venogram - assess clot burden/degree of venous occlusion etc. Anatomic mapping pre-intervention
PromptManagement priorities
ResponseAnaglesia
Anticoagulation - heparin infusion preferred with loading dose - maintenance and target aPTT
Emergency vascular surgery referral for consideration of thrombectomy/catheter directed thrombolysis
Anticoagulation - heparin infusion preferred with loading dose - maintenance and target aPTT
Emergency vascular surgery referral for consideration of thrombectomy/catheter directed thrombolysis
PromptSVC OBSTRUCTION
Response
Prompt
ResponsePembertons sign (Suggestive of SVC obstruction)
Thyroid swelling/Goitre
Thyroid swelling/Goitre
PromptCauses of SVC obstruction
ResponseMediastinal mass
Pericardial constriction
TB
- Tumours (90%) - primary lung, lymphoma, mets, treatodermoid, parathyroid, thymoma
- Aortic aneurysm - Thoracic
- Retrosternal thyroid
- Thrombosis, radiation therapy
Pericardial constriction
TB
PromptInvestigation of choice
ResponseCT chest with contrast
PromptPULMONARY EMBOLUS
ResponseMOVED TO RESP
PromptINFECTION
Response
PromptOrganisms causing vascular prosthetic infection
ResponseS. Aureus
Coagulase negative staphylococci
Enterococcus
E. coli
Salmonella Spp
Coxialla burnettii/Q Fever
Coagulase negative staphylococci
Enterococcus
E. coli
Salmonella Spp
Coxialla burnettii/Q Fever