Vascular Surgery
PAD, aneurysms, DVT and the acutely ischaemic limb.
Use as a study guide only. These notes are part of a free open-access medical education (FOAMed) project and may contain errors or outdated information. Always verify against current guidelines (e.g. eTG, RACGP, local health district policies) and reputable sources before applying anything to patient care. See the full disclaimer.
Clinical pearls & learnings
Tips and tricks collected over the years — a living list that grows with every rotation. Use as a study guide only and check current guidelines before acting on anything.
Acute vascular emergencies
Acute limb ischaemia
Recognise it early with the "6 Ps": pain, pallor, pulselessness, paraesthesia, paralysis, and perishingly cold. Paraesthesia and paralysis are late, ominous signs signalling irreversible ischaemia — this is a time-critical surgical emergency needing urgent vascular review, anticoagulation, and imaging (CT angiography) without unnecessary delay.
DOACs and DVT — a caution
Confirm adherence and dosing before attributing a DVT/PE "despite anticoagulation" to true treatment failure — under-dosing, missed doses and drug interactions (particularly with other P-glycoprotein/CYP3A4-active medications) are common and easily overlooked explanations. Also actively screen for an underlying malignancy or other prothrombotic state in unprovoked or recurrent VTE.