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Venous Insufficiency, Emergency Medicine

Cameron R. Wangsgard and Bo E. Madsen Reviewed 06/2017
 


Basics

Description

  • Inadequacy of the venous valves that causes impaired venous drainage leading to edema of the lower extremities.

  • A chronic condition of lower extremity vascular incompetence.

  • Normal blo...

Diagnosis

Signs and Symptoms

History

  • Asymptomatic phase:

    • Venous dilation ranging from venous flares to small varicosities

  • Symptomatic phase:

    • Ankle and calf swelling

    • Varicose veins

    • Skin discoloration/hyperpig...

Treatment

Initial Stabilization/Therapy

  • Leg elevation to above the level of the heart

  • Control bleeding with direct pressure.

Ed Treatment/Procedures

  • Leg elevation above the level of the heart

  • Compression s...

Follow-Up

Disposition

Admission Criteria

  • Arterial insufficiency

  • Evidence of cellulitis, lymphangitis, or osteomyelitis may require admission, specifically in a patient that is immunocompromised (on stero...

Pearls and Pitfalls

  • In patients with no palpable pulses, extremity pain, ulcerations, or risk factors for peripheral artery disease, ensure that arterial insufficiency is not the underlying cause befo...

Additional Reading

  • Gloviczki  PA, Comerota  AJ, Dalsing  MC, et al. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vas...

Codes

ICD9

  • 453.40 Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity

  • 454.9 Asymptomatic varicose veins

  • 459.81 Venous (peripheral) insufficiency, unspecified

ICD10

  • I82.409 A...

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