Vascular – Chronic Limb Threatening Ischemia (CLTI)

Remote Monitoring Virtual Ward (RMVW)

What is CLTI

Chronic limb threatening ischemia (CLTI) is a condition where there is not enough blood flow or oxygen to a part of the body, A narrowing or blockage of an artery usually causes this. There will be reduced blood flow to the affected limb which may cause pain, loss of pulses, coldness, paleness, weakness, or loss of sensation.

What treatment will I have?

Investigative scans will be carried out to ensure a diagnosis can be determined. More information about this can be found on the next page.

Once investigations are reviewed a management team will decide on the next course of action needed. You will be asked to attend a clinic to discuss this with your consultant. Throughout this process you will be monitored at home by a team of registered nurses, ensuring that you get the best possible care in the comfort of your own home.

What happens next?

The RMVW hub team will complete general monitoring observations remotely to check for signs of deterioration. They will use medical devices such as a blood pressure monitor, an oximeter to check your heart rate, and a thermometer to check your temperature twice per day. You will also receive a daily phone call to ensure you are feeling ok and haven’t deteriorated since your previous observations were submitted. 

What happens if I begin to feel more breathless?

If the nurses feel you are not getting better, they will arrange for you to be seen the same day by the vascular team.

What to expect on your investigation day 

The aim of this session is to carry out all the investigative scans that are needed, completed in one day (where possible) to save you having to return to hospital several times.

• You will be contacted by the RMVW team to confirm your appointment.
• You will need to be at the Surgical Outpatients Department by 12:00 pm on the designated day. If you have arranged transport, please give this as your appointment time.
• Please bring all medications that you take regularly and as required with you. The department does not stock any medicines. Please bring enough pain killers if you take them.
• You may bring one family member/carer/friend with you.
• Your medicines will be locked away whilst you are in the department, but you will have access to them and you will be responsible for taking them at the times they are due.
• You may need to have a cannula (drip) inserted ready for your scan. 
• You may leave the department from time to time while you are waiting but you must let a member of staff know that you are going. However, we recommend that you do not leave the department as you may miss your slot for a certain scan which would mean you have to wait longer or have to come back another day. If you do leave the department, you do so understanding this risk. You will also be responsible for yourself whilst away from the Surgical Outpatients department.
• You may be in the department for a few hours. You may wish to bring snacks and drinks with you and something to keep you occupied like a book, newspaper, iPad etc. Please be aware that other people will be waiting in the department so we ask that you use earphones where possible if you have electronic devices.
• If you are on hospital transport, we will arrange this when you have had your last assessment, or you may be able to go directly from that department. 
• Please ensure you have had your cannula removed before leaving the department.
• The management team will review and assess the outcome of the scans, you will then be asked to come into clinic to discuss the next stages of your care.