Vascular Consult 🩸

Guide for vascular surgery consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.

📋 Key Info to Have Ready

Patient identifiers: full name, date of birth, location and MRN
Reason for consult and timeline (e.g. onset of limb pain, wound deterioration)
Past Medical History: vascular history (PVD, diabetes, previous bypass/angioplasty, aneurysms), smoking status
Medications: antiplatelets, anticoagulants, diabetic medications
Observations: vitals, limb perfusion (capillary refill, pulses, colour, temperature, sensation)
Relevant bloods: FBC, U&E, coagulation, HbA1c if diabetic, inflammatory markers if infection suspected
Imaging: duplex/Doppler if done, CTA/MRA if available, plain X-ray for osteomyelitis
ABPI if measured (do not delay urgent referral to get ABPI)
Clinical impression and what you are seeking (e.g. ?acute limb ischaemia, ?infected foot ulcer, ?DVT)

Limb assessment: pulses (femoral, popliteal, DP, PT), capillary refill, colour, sensation, motor function
Duplex ultrasound – for DVT, arterial stenosis, aneurysm screening
ABPI – chronic limb ischaemia; avoid or interpret with caution in diabetics (calcification)
Bloods – FBC, U&E, coag, CRP; consider lactate if ?acute ischaemia
Imaging – CTA/MRA for acute ischaemia or pre-op planning; X-ray if ?osteomyelitis under ulcer

Hi, this is [Your Name], the intern from [Team Name]. I'm requesting a vascular consult for a [Age] year-old [M/F] with [e.g. acute onset leg pain / non-healing foot ulcer / suspected DVT].
They have a background of [PMH – e.g. diabetes, PVD, smoking]. On examination the limb has [e.g. absent DP/PT pulses, cool and pale / ulcer with surrounding cellulitis]. Observations are [stable/unstable].
We've [got duplex pending / sent bloods / started LMWH if DVT]. We're concerned about [e.g. acute limb ischaemia / infected diabetic foot / need for duplex] and would appreciate your review.
Let me know if you need any further information or imaging before you see them.

Acute limb ischaemia (6 Ps: pain, pallor, pulselessness, paraesthesia, perishing cold, paralysis) is an emergency – refer immediately and document time of onset
Do not delay referral for ABPI or duplex if clinical picture suggests acute ischaemia
For diabetic foot ulcers, document wound site, size, depth, surrounding skin, probes-to-bone; offloading and podiatry input help
Clarify whether the consult is urgent (e.g. acute ischaemia, rapidly spreading infection) or routine

Guide for vascular surgery consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.

Patient identifiers: full name, date of birth, location and MRN
Reason for consult and timeline (e.g. onset of limb pain, wound deterioration)
Past Medical History: vascular history (PVD, diabetes, previous bypass/angioplasty, aneurysms), smoking status
Medications: antiplatelets, anticoagulants, diabetic medications
Observations: vitals, limb perfusion (capillary refill, pulses, colour, temperature, sensation)
Relevant bloods: FBC, U&E, coagulation, HbA1c if diabetic, inflammatory markers if infection suspected
Imaging: duplex/Doppler if done, CTA/MRA if available, plain X-ray for osteomyelitis
ABPI if measured (do not delay urgent referral to get ABPI)
Clinical impression and what you are seeking (e.g. ?acute limb ischaemia, ?infected foot ulcer, ?DVT)

Limb assessment: pulses (femoral, popliteal, DP, PT), capillary refill, colour, sensation, motor function
Duplex ultrasound – for DVT, arterial stenosis, aneurysm screening
ABPI – chronic limb ischaemia; avoid or interpret with caution in diabetics (calcification)
Bloods – FBC, U&E, coag, CRP; consider lactate if ?acute ischaemia
Imaging – CTA/MRA for acute ischaemia or pre-op planning; X-ray if ?osteomyelitis under ulcer

Hi, this is [Your Name], the intern from [Team Name]. I'm requesting a vascular consult for a [Age] year-old [M/F] with [e.g. acute onset leg pain / non-healing foot ulcer / suspected DVT].
They have a background of [PMH – e.g. diabetes, PVD, smoking]. On examination the limb has [e.g. absent DP/PT pulses, cool and pale / ulcer with surrounding cellulitis]. Observations are [stable/unstable].
We've [got duplex pending / sent bloods / started LMWH if DVT]. We're concerned about [e.g. acute limb ischaemia / infected diabetic foot / need for duplex] and would appreciate your review.
Let me know if you need any further information or imaging before you see them.

Acute limb ischaemia (6 Ps: pain, pallor, pulselessness, paraesthesia, perishing cold, paralysis) is an emergency – refer immediately and document time of onset
Do not delay referral for ABPI or duplex if clinical picture suggests acute ischaemia
For diabetic foot ulcers, document wound site, size, depth, surrounding skin, probes-to-bone; offloading and podiatry input help
Clarify whether the consult is urgent (e.g. acute ischaemia, rapidly spreading infection) or routine