Rachel cared for a patient in the PACU who had a lumbar fusion. The patient had no complaints of pain, however, during assessment, Rachel noticed an absent pedal pulse. At the time there was no significant difference in color or skin temperature on the extremity. Instead of ignoring or assuming this was the patient's baseline, Rachel called the doctor. The neurosurgeon immediately got a vascular consult and a workup. The patient had a devascular limb from a blood clot and was taken back to surgery and is doing well. Had Rachel not been prudent, the patient could have possibly lost a limb. This could have easily been missed under the circumstances.