Question

If you have difficulty finding a dorsalis pedis pulse in the leg where the catheter was inserted what so you do?

Answer 1

Answer is the dussalis pedis aretery pulse can be pulpated leteras to the extensor hallucis longers tendon on the dorsal surface of the foot, distal to the dossal most prominence of the navicular bone which serves as a reliable and mark for pulpation. Mangement of purse cathetrization difficulty it Step 1: Anticoagulent : - The initial treatment consist of heparin 100 ulicy as a single state dose followed by an infusion of 20 ulkg/hr If there is clinical Improvement in perfusion but the pulse remain absent after u hos cof infusion. Check the activated partial thromboplastin time and adjust the heparin dose appropriatly to cheive a level of covound d's times the control value continue with heparien if. Improvement continous. etherwise go to the next step. step-2 Thrombolysis - thrombolysis should be considered If there is no clinical Improvement with heparin or in the pulse fail to retorn despite improvement in limb perfusion after y ms of infusion and so long as there is no contraindication. Take baseline clotting profile haemoglobin, fibrinogen lenes I and cross match one unit of blood Ensure that patient has adequate venery access. - Toro commenest agent used are streptokinase & recombinient tissue plasminogen activater step-3 Invasive measures: - of the pulse or limb perfusion fail to return despite adequate thrombolysis as assessed by thrombin time and fibrinogen level of or if the viablity of the Thumb is in 2020 03 10 11.2-

Bitteti considered surgery in infant as children adult may benefit from an intervention eg. Angioplasty as stent. surgery often consist of Thrombectomy, repair of intimal flap or repair of aruised vessel. - Heparin alone is expected to be sufficient in woround 75-87. the rest will recieve a lytic agent with complete restoration of the puise in 65t portion restoration in anothes 207. and the remaining 1st will require surgery. Overall, surgery will be requireel in less than St. and very rarely, will the lumb requaire amputation. .... .. please read it I give me thumb up.