Peripheral ischaemia

‘Ischaemia’ means inadequate supply of oxygenated blood to an organ or part of the body. ‘Peripheral ischaemia’ refers to lack of blood supply to a limb.

Peripheral ischaemia is a serious condition in which blood flow to a limb is restricted by narrowing or blockage of the arteries.

The classic signs of acute limb ischaemia are sometimes known as the six Ps:

  • PAIN

    • This refers to when the limb is at rest. Pain on walking might indicate intermittent claudication which is an early, treatable sign of peripheral arterial disease.
  • PALLOR

    • Pallor means an unhealthy, pale appearance. An acutely ischaemic limb often appears white in comparison to the other limb. Other discolouration of the limb, such as abnormally pink, blue, mottled or black, suggests more chronic or advanced ischaemia.
  • PARAESTHESIA

    • Paraesthesia is an abnormal sensation, such as pins and needles, or numbness.

  • PARALYSIS

    • Paralysis is an advanced sign which suggests an element of irreversible ischaemia.
  • PERISHINGLY COLD

    • The limb feels very cold when compared to the other limb.
  • PULSELESSNESS

    • If there is no pulse and ischaemia is suspected, arterial Doppler signals should be checked.

Who is at risk from peripheral ischaemia?

Individuals with Type 1 or Type 2 diabetes, coronary artery and smokers of any age are at increased risk.

1 in 3 diabetics over the age of 50 are affected by peripheral arterial disease.

1 in 5 (20%) of all adults over the age of 60 are believed to have peripheral arterial disease to some degree.

Peripheral ischaemia is one of the most common types of serious claim against GPs

Peripheral ischaemia is one of the most common types of serious medical negligence claim against general practitioners. This is because delay or failure to diagnose the condition or inadequate or delayed treatment leads to devastating consequences for the sufferer, including ulceration, gangrene and the loss of the limb.

Peripheral ischaemia claims arising from surgery

Limb ischaemia leading to amputation can also be caused by surgical errors or delays, such as:

  • Surgical injury to the popliteal artery.
  • Failure to protect a patient with a known risk of thrombosis by appropriate peri-operative anti-coagulation.  
  • Delay in surgery to treat a popliteal aneurysm, leading to amputation
  • If lower limb revascularisation by angioplasty (a procedure to improve blood flow by widening the artery by inserting a balloon or stent) is negligently delayed, leading to avoidable amputation, this may also result in a claim.

Protecting our clients when negligently caused injuries leave them with a future risk of amputation

Where a negligently caused severe injury leaves the individual at risk of needing an amputation in the future, a claim can be made for provisional damages, in which settlement is secured for the current injury, preserving the claimant’s right to return to court for more compensation in the event that the anticipated future amputation occurs.

 

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