Walk into every consult prepared.

CONSULTATION SCRIPT: "Dr. [Vascular Surgeon], this is Dr. [Name] from the ED. I'm calling about a 70-year-old male with an acute cold, pulseless left lower extremity concerning for acute limb ischemia. His name is [Name] in Room [Room].

Key points:

• Sudden onset left leg pain and numbness, now cold, mottled, and pulseless below the femoral artery
• No palpable or Doppler pulses distal to femoral
• Motor and sensory deficits present
• Vitals stable: BP 138/82, HR 92, afebrile
• Heparin bolus and infusion initiated
• CTA ordered, results pending
• No history of trauma, recent atrial fibrillation diagnosis, not on anticoagulation
• No prior vascular interventions on this limb

Would you like to see the patient now or wait for the CTA results? Is there anything else you need while we await imaging?"

CRITICAL DATA POINTS:

• Limb findings: cold, pulseless, sensory/motor deficit, level of occlusion
• Onset and progression of symptoms
• Heparin initiated
• Vital signs
• Relevant history: atrial fibrillation, no trauma
• Imaging status: CTA pending

IF CHALLENGED:

1. "Why didn't you wait for the CTA before calling?" "Given the classic findings of acute limb ischemia and potential for rapid deterioration, I wanted to involve you early. I'll update you as soon as imaging is available."
2. "Has the patient had vascular surgery before?" "No prior interventions on this limb per available records and patient history."
3. "Can't you just admit to medicine first?" "Given the acute ischemia and risk for limb loss, I believe vascular evaluation is warranted before admission."