Vascular Trauma

Do not leave the tourniquet on for more than 120 minutes - Chris Nickson

Vascular Trauma
Vascular Trauma

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Extremity arterial injury

The ‘nugget method’ described by Shokrollahi et al (2008) is effective...

The occluding finger should be substituted with a dental roll or tightly folded “nugget” of gauze. A tourniquet may be temporarily applied proximally to facilitate this. Once the positioning is correct and no further bleeding is occurring, slightly larger or less folded pieces of gauze can be placed one on top of the other, creating an inverted pyramid of gauze. The layers of gauze are secured with a loose bandage. Only very light pressure need be applied to the top layer of gauze to maintain hemostasis, as the pressure is “focused” onto the bleeding point. This technique is based on the equation: Pressure=Force/Area.

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 Extremity arterial injury

Apply direct pressure and elevation +/- pressure bandaging. Consider applying adrenaline soaked gauze or hemostatic dressings if available. Tourniquets may be life saving.

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