This BMJ article reminded us of the importance of considering acute ischaemia as a differential diagnosis when a patient presents with acute-onset leg pain plus or minus sensory loss. It’s easy to convince yourself you can feel a weak pulse when you can’t – an excellent tip is to try counting it. If you can’t feel it well enough to do that, you probably aren’t really feeling it.
If acute leg ischaemia is suspected, see whether it’s possible to get an urgent Doppler (as in, same session – time from onset of symptoms to irretrievable damage has been known to be as little as six hours). If this isn’t available or the Doppler doesn’t find a pulse, admit.
(BMJ 2013;346:f2681 doi: 10.1136/bmj.f2681)