The presence or absence of a pedal pulse alongside complaints of deficits should raise a high index of suspicion. Once found, the pedal pulse should be marked as a reference point for reassessments and for hospital staff.
Any time a patient remarks that they are experiencing numbness or tingling, it would be wise to check circulation of that limb. Though not common without some type of associated trauma or comorbidity, such as diabetes, the absence of a pedal pulse alongside complaints of pain warrants further investigation. If a patient is unable not unwilling to ambulate and has associated limb complaints, it would be worthwhile to assess circulation.
Any spontaneous cessation of ambulation without trauma should raise a high index of suspicion. Any degree of peripheral edema increases the difficulty of locating a pedal pulse.
As we know in medicine, water is not gravity-friendly and often collects in the limbs, resulting in bilateral edema that can be very painful. As mentioned earlier, any type of trauma to a dependent limb can complicate the assessment of a pedal pulse.
Due diligence should be performed when assessing circulation in the case of a traumatic leg injury. When the body shunts blood to the core, peripheral circulation is affected. Pulses might be faint or absent depending on the length of time and temperature exposure. Any type of shock that affects central circulation brings the potential for weak or absent peripheral pulses. This includes mechanical cardiogenic , hypovolemic, neurogenic spinal , and systemic shocks anaphylactic and septic.
Fortunately, there are other techniques besides pedal pulses to determine peripheral circulation. Sight: How does the limb present? Is it blue, pale, mottled, or normal in color? Is it attached or partially amputated? Is it in normal alignment, or does it look out of alignment? Touch: How does the foot feel? Is it cold or warm? When you press down does the skin blanch cap refill assessment and immediately return to normal?
Or is there a delay to return of normal coloring in the formally blanched area? A delayed cap fill can indicate perfusion concerns and should be used in conjunction with a thorough patient exam and history. When assessing cap refill on a foot, you can use the nail beds or heel. However, a cap refill can be used on all aspects of the foot. Listen: Listen to what your patient is saying about their foot. Is it tingling? Pins and needles? All of these complaints indicate a circulation check yes, that means the sock has to come off.
A thorough patient assessment and gathering of history helps determine a proper treatment plan. This involves any type of medical intervention, immobilization techniques, and method of extrication. When assessments are performed correctly, we learn how to work smarter, not harder.
Stay safe out there! Sign in. EMS World Expo. Current Issue. Try the other leg If you are unable to find the pedal pulse on one leg, switch to the patient's other leg. Mark the location Once you have found a pedal pulse, consider using a ballpoint or felt pen to make a light mark at the pulse location to make reassessment easier.
Foot temperature and color Finally, if the patient's foot is warm with normal color, it is adequately perfused. This article, originally published December 7, , has been updated. Thank You! Join the discussion. Latest Product News 13 air, ground transport service agencies reaccredited; 1 gets initial accreditation. The current challenges of EMS education. Product Originals Testing, recertification and pandemic pivots 1. What do you do after the lift assist?
What does the future hold for EMS education? Testing, recertification and pandemic pivots 1. You've been successfully signed up for the EMS1 Daily. Health Conditions Discover Plan Connect. How to Find Your Popliteal Pulse. Medically reviewed by Deborah Weatherspoon, Ph. Where it is How to find it Pulse rate Why check it?
When to see a doctor Takeaway The popliteal pulse is one of the pulses you can detect in your body, specifically in the portion of your leg behind your knee.
Where is it? How to find it. Share on Pinterest You can take your popliteal pulse by locating the popliteal artery, which you can feel behind your knee within the popliteal fossa. Illustration by Diego Sabogal. Pulse rate. Why would a doctor check your pulse here?
When to see a doctor. The bottom line. Other symptoms of peripheral arterial disease of the legs may include:. If PAD gets worse, you may have other symptoms that are caused by poor blood flow to your legs and feet.
These symptoms are not common. They include:. Many things can increase your risk for atherosclerosis and peripheral arterial disease PAD. These include:. People who have the disease in one part of the body are likely to have it in other places, including the legs. Call your doctor now or seek immediate medical care if:. Your family doctor or general practitioner can diagnose and treat peripheral arterial disease PAD.
You may be referred to a specialist, such as a cardiologist or vascular surgeon. If your doctor thinks that you may have peripheral arterial disease PAD , he or she will examine you for physical signs of the disease and will ask about your personal and family medical history.
This is a good time to talk with your doctor about any symptoms you have noticed. Your doctor may also do other tests to find out if you have health problems that can cause PAD or make it worse. When you have PAD, you are at high risk for coronary artery disease , heart attack, and stroke. You may have tests for:. Your treatment for peripheral arterial disease PAD will focus on healthy lifestyle changes first.
You may need to take medicines to ease leg pain or to help you manage other health problems. Some people have angioplasty or bypass surgery to improve blood flow to their legs.
It's important to do what you can to improve your health and possibly reverse the buildup of plaque in your arteries.
Making healthy changes and following your treatment plan can reduce this risk. A cardiac rehab program can help you make lifestyle changes. In cardiac rehab, a team of health professionals provides education and support to help you make new, healthy habits.
See Living With PAD for more ideas about changes you can make and about support to help you make them. Medicines are used to help manage other health problems that can raise your risk of heart attack and stroke. You may need medicines to help prevent blood clots, improve cholesterol, or lower blood pressure. Sometimes peripheral arterial disease gets worse despite treatment.
People who have severe PAD may have bypass surgery or other procedures such as angioplasty to restore proper blood flow to the legs. You can prevent or delay peripheral arterial disease PAD by taking steps toward a heart-healthy lifestyle. A heart-healthy lifestyle can also help you manage risk factors such as high cholesterol and high blood pressure. There are many things you can do to keep peripheral arterial disease PAD from getting worse.
These steps may also help lower your blood pressure and cholesterol, which can help control PAD. And doing any one of these things can help you reduce your risk of heart attack and stroke, which is important to do when you have PAD. Take good care of your feet and legs. When you have reduced blood flow to your legs, even minor injuries can lead to serious infections.
Medicines that help lower your risk of heart attack and stroke:. Most of the time, surgery is only done in cases of severe peripheral arterial disease PAD , such as disabling intermittent claudication ; open sores ulcers that won't heal ; or serious skin, bone, and tissue problems gangrene. Bypass surgery redirects blood through a grafted blood vessel to bypass the blood vessel that is damaged.
The grafted blood vessel may be a healthy natural vein or artery, or it may be man-made. The methods of bypass surgery vary depending on the size of the affected artery and where it is located. The type of surgery used to treat PAD will depend on the location of the affected leg artery or arteries.
Endarterectomy is a less common surgery. It is typically done on the large femoral artery, which is in your groin and upper thigh area. This surgery is done to remove fatty buildup plaque and to increase blood flow to the leg. This surgery is done by cutting open the femoral artery and removing the plaque. This surgery may be done by itself, or it may be done at the same time as bypass surgery or angioplasty. In rare cases, peripheral arterial disease gets so bad that some people need to have a leg, a foot, or part of the foot amputated.
People with diabetes are at increased risk for amputation. Amputation is used only when the damage is very severe, possibly life-threatening, and after all other treatment options have been tried. Also in rare cases, a blood clot in an artery can suddenly and completely block blood flow to a leg or foot. Often, severe pain, numbness, and coldness develop within 1 hour. This blockage is an emergency. Clot-dissolving medicines, surgical removal of the clot, or bypass surgery is needed to restore blood flow.
Angioplasty is used for severe disease that causes pain and limping during exercise, pain when at rest, or open sores. Angioplasty can increase blood flow in a narrowed artery. During this procedure, a small, thin tube called a catheter is inserted through a blood vessel in the groin and guided to the affected artery.
When the catheter reaches the narrowed part of the artery, the surgeon inflates a balloon. The balloon presses the plaque against the wall of the artery. This improves blood flow.
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