When should I refer a patient with suspected acute limb ischaemia to secondary care for further management?

Refer a patient with suspected acute limb ischaemia to secondary care immediately for urgent assessment and management. Acute limb ischaemia is a vascular emergency requiring prompt evaluation by a vascular multidisciplinary team to determine the need for revascularisation such as angioplasty or bypass surgery. Early referral is critical to prevent limb loss and other serious complications. Clinical assessment should include examination of pulses, limb viability, and symptoms suggestive of critical limb ischaemia. Immediate referral is indicated if there are signs of critical limb ischaemia such as rest pain, ulceration, or gangrene, or if acute limb ischaemia is suspected based on clinical presentation. Secondary care will perform necessary imaging (e.g., duplex ultrasound, magnetic resonance angiography) and initiate appropriate interventions. Pain management and specialist input may also be required in secondary care settings.

In summary, any suspicion of acute limb ischaemia warrants urgent referral to secondary care for further assessment and management by vascular specialists to optimise outcomes and limb salvage.

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