Peripheral Arterial Disease (PAD): EMT Scope of Practice & Interventions

EMTs do not diagnose or treat PAD definitively, but provide critical prehospital support:

EMT Interventions for Suspected PAD

• Assessment: Pain (claudication/rest), pulses, skin changes, capillary refill, ABI if equipped.
• Oxygen: Titrate to SpO₂ ≥94% if dyspneic/hypoxic.
• Positioning: Dependent position (legs down) may improve arterial flow; avoid elevation unless heart failure.
• Pain management: Per protocol (nitroglycerin if cardiac concern, opioids if authorized).
• Wound care: Sterile dressings for ulcers/gangrene; no debridement.
• Transport: Rapid to ED with vascular capability; notify receiving facility.

What EMTs Cannot Do

• Diagnose PAD (requires ABI, imaging, vascular surgery eval).
• Administer vasodilators (cilostazol, pentoxifylline) or thrombolytics.
• Perform revascularization.
• Manage chronic anticoagulation/antiplatelet adjustments.

Critical Differentiation

Acute limb ischemia (ALI) = emergency (6 P's: Pain, Pallor, Pulseless, Paresthesia, Paralysis, Poikilothermia). Requires immediate vascular surgery—EMT role is rapid recognition + transport.

EMTs bridge the gap: stabilize, protect tissue, expedite definitive care.