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THE 6 P'S

numeric mnemonic

/ðə sɪks piːz/

Vascular Surgery

Definition

1.The features of acute limb ischaemia.

Expansion

  1. PPain sudden and severe
  2. PPallor pale, then mottled limb
  3. PPulselessness absent distal pulses
  4. PParaesthesia an early warning of nerve ischaemia
  5. PParalysis a late, ominous sign
  6. PPerishingly cold poikilothermia

Notes

Acute limb ischaemia is a surgical emergency — viable tissue has roughly 6 hours before irreversible damage. Paraesthesia and paralysis are the worrying pair: they signal that the nerves and muscle are dying and that revascularisation is urgent.

The same six P's describe compartment syndrome, where pain on passive stretch is the standout early feature.

Origin

Six alliterative warnings that a limb is losing its blood supply.