A 19 year old right handed lady is skiing in the back country when she gets lost and is found 12 hours later after being exposed
to subfreezing temperatures the entire time. On initial physical exam, the fingers of her right hand are completely cold and blue. After gentle re-warming, there are still no palpable radial, ulnar, or digital pulses in the right hand. There are no detectable Doppler signals in these vessels either. What would be the best therapy for this patient? a. Antiplatelet therapy
b. Conservative wound care
c. Emergent amputation of the right hand
d. Urgent angiogram and thrombolysis
e. Several week clinical observation to permit demarcation of necrosis
The best therapy for this patient would be an urgent angiogram to check, via X rays, the state of her blood vessels. With this exam, the doctor can determine the blood flow in the injured vessels. The second treatment to do is thrombolysis, which is a process done to breakdown the blood clots that formed in the blood vessels and that are stoping the normal flow of blood.
