Pulses

Published

Diagnose this:

Pt has a Right femur fracture and is pending surgery.

That limb is warm, 2/2 pedal pulses

Unaffected limb is 1/2 pedal pulse.

In a time span of

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Think it's a blood clot that travelled from the affected limb to the unaffected limb?

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Specializes in DOU.

Think it's a blood clot that travelled from the affected limb to the unaffected limb?

Nope, but I might be thinking of compartment syndrome if you mentioned pain. There might be a clot, but it wouldn't have traveled from one leg to the other.

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I suspect compartment syndrome too.

The force required to cause a femur fracture is huge, and the left leg may have sustained an injury too that could lead to compartment syndrome.

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Specializes in Utilization Management.

I'm confused. The fractured limb has good pulses and the left (unaffected one) has no pedal pulse?

If that's correct, I sure hope he went to surgery for the Lt leg clot (which didn't travel from one leg to the other, BTW) and the Rt leg fx stat.

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Angie,

You are correct. The unaffected/no fracture leg had no pulse.

The fractured leg was the warm/2+ pulse.

No surgery yet (was pending clearance) for 2-3 days.

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Specializes in DOU.
I'm confused. The fractured limb has good pulses and the left (unaffected one) has no pedal pulse?

oops - it was unaffected leg that had no pulse?

It's a good thing someone else read more carefully than I did! :D

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I'm confused as to why/how the unaffected limb had compartment syndrome. Unless the unaffected limb had a tibia fracture that went undiagnosed??? Theorizing here.

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Specializes in LTC, Subacute Rehab.

I will go out on a limb and suggest that something (perhaps a very large aneurysm, or a ruptured one) is wrong with the popliteal artery?

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Specializes in Utilization Management.

Hope he had an arterial US and surg consult for that stat!! :uhoh21:

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Specializes in Cardiac Telemetry, ED.

Lack of pulse is a/w impaired arterial blood flow. A clot or fat embolus would not travel from one leg to another. I would suspect injury to the LLE that initially went undiagnosed. How did the R femur get fractured? MVA?

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Specializes in Ortho, Case Management, blabla.

Are you sure you didn't get the extremities mixed up?

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Virgo,

the R femur got fractured from a slip/fall at home, not MVA.

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