Vascular occlusion — recognition and first response in US
What's your first-response drill for a suspected vascular occlusion, and the local emergency/reporting details I should have on the wall?
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- Dr Morgan Ellis★ 212
Recognition: disproportionate/increasing pain, blanching, dusky or mottled skin, delayed capillary refill — any visual change is a same-minute emergency (call 911 and arrange urgent ophthalmology). Act on suspicion. Stop, warm compress and massage, then flood the territory with hyaluronidase and reassess every 15–30 minutes, repeating until perfusion returns (follow current ACE/consensus guidance). Hyaluronidase (e.g. Hylenex, Vitrase) — confirm availability and your prescribing/standing-order setup and keep an emergency kit on site. Report serious adverse events to FDA MedWatch / FAERS. Have your kit and a written pathway in the room before you inject filler.
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