COVID-19: Vascular service guide

April 2020

Scope

This information provides guidance on the management of vascular patients across Devon during the Covid-19 pandemic. The information is based on the Vascular Society recommendations

National guidance

The Vascular Soceity: COVID-19 virus and vascular surgery

Urgent advice

If a referring clinician feels an urgent admission is required or needs advice to determine the urgency of a referral then please contact the appropriate locality; contact details are below.

Urgent vascular referrals include;

  • acute limb ischaemia
  • suspected ruptured AAA
  • diabetic foot sepsis requiring admission

Please call the on-call vascular consultant (available 24 hours) via NDDH switchboard Tel No: 01271 322577

OR

Via email Monday to Friday 8am - 6pm vascularreferrals@tst.nhs.uk


This service is particularly useful for wounds as photos can be attached

​Urgent referrals

Critical limb ischaemia (rest pain and tissue loss)
  • will be considered for revascularisation
Symptomatic carotid stenosis (e.g. amaurosis fugax, transient ischemic attack (TIA), cardiovascular event (CVE))
  • will be considered for endarterectomy
  • many will be managed with best medical therapy only
Abdominal Aortic Aneurysm (AAA)
  • will be considered for treatment on a case by case basis (as is currently the case, e.g. if meet size criteria or symptomatic)
  • current guidance for urgent referral is greater than 4.4cm. However, the size threshold for surgery may be significantly higher than this and needs to weigh up risk of rupture in the next few months with risk of intervention and resource limitation. Those less than 5.5cm are likely to receive A&G regarding non-surgical management and monitoring.
  • Useful patient information can be found at;
  • Abdominal Aortic Aneurysm (AAA) Clinical Referral Guideline:
Varicose Veins with significant bleeding
Diabetic Foot "Hot Feet"

Risk factors for face-to-face review will be decided on case by case basis.

​Routine referrals

  • Asymptomatic carotid stenosis
  • Intermittent Claudication
  • Varicose vein surgery without significant bleeding

Patients can be signposted to the below site for information and advice on these and other common vascular conditions:

Circulation Foundation - Patient Information

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Varicose Veins Clinical Referral Guideline:

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

COVID-19 High risk patient advice

Vascular emergencies in the presence of symptoms of COVID 19 will be assessed and tested along hospital guidelines in A&E at North Devon District Hospital.

North Devon contact information

Contact the Vascular Surgeon on-call through North Devon District Hospital switchboard Tel No: 01271 322577

Supporting information

Patient information

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Publication Date: April 2020

Date updated: May 2020

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Publication Date: April 2020

Date updated: May 2020

Last updated: 04-05-2020

 

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