Treatment recommendations based off of case reports and animal models.  No good human clinical studies to guide therapy at this time.
Symptom relief
Evaluate and manage<unk>  spasm
Reestablish distal perfusion
Manage clinical sequelae of tissue injury
Rehabilitation of limb
Start slow infusion of isotonic solution to keep patent
to be used for arteriogram and administration of vasodilators
Some clinicians advocate initiation of coverage for gram positive and anaerobic organisms if patient is IV drug abuser
Troer et al. withheld Antibiotics in this patient population if no sign of<unk>  present.  No cellulitic changes or spreading<unk>  noted in those managed with antibiotic.
Consider initiation of the following:
Unintentional intra-arterial injection
Skin and soft tissue infections
Blunt cardiac injury
DVT
Hemorrhage of AV fistula
CT contrast media extravasation
Missile embolism
Allergic reaction