Quote from nunursetoo
Does anyone have any info on why the non operative leg would have absent dp and pt pulses when the operative leg has great pulses?
First, your assessment documents your
findings. If anyone is culpable for not noting a pulseless extremity or a change in doppler/palpable findings, it would be the oncoming nurse who did not assess her patient.
As far as what could cause the other extremity to lose pulse? I wonder if the femoral artery was first opened via PTA (percutaneous transluminal angioplasty)? This is sometimes the case with the many vascular patients we receive in the ICU following vascular bypasses. Since they enter through the oppsite side for the PTA, there is a risk of occlusion of the opposite artery. Both limbs have to be watched carefully.
Also, did the patient at any time have a line in the right groin? Frequently PVD patients have such terrible access, lines (cvc's or art lines) have to be placed in the giant vessels. Of course there's always the complication of occlusion, spasm, or stenosis in this case.
Those are just a couple of ideas. So many things can happen to folks with PVD when they're lying in a hospital bed. Infection, clots, stenosis, vascular or arterial spasm, etc, being a big problem with these patients. I'll bet if you asked the docs, they would not be surprised that the "good" leg is now compromised.
Here's a really good description of fem-pop bypass and PTA:
I will add that usually after a bypass like this the "bad" leg becomes the "good" leg as the problem has been taken care of and bloodflow restored. It's not unusual for the pulses of the unaffected leg to seem highly diminished in comparison to the surgically repaired leg.
As long as you do your assessments, have confindence!