![]() Extremity vascular injuries on the battlefield: tips for surgeons deploying to war. Starnes BW, Beekley AC, Sebesta JA, Andersen CA, Rush RM Jr. 2010 16(6):602–8.Īmerican College of Surgeons COT: ASSET-advanced surgical skills for exposure in trauma. Management of peripheral arterial injury. Use of substitute conduits in traumatic vascular injury. Lau JM, Mattox KL, Beall AC Jr, DeBakey ME. Management of lower extremity arterial trauma. Martin LC, McKenney MG, Sosa JL, Ginzburg E, Puente I, Sleeman D, et al. Five-year experience with PTFE grafts in vascular wounds. Western Trauma Association critical decisions in trauma: evaluation and management of peripheral vascular injury, part II. 2009 46(10):779–839.įeliciano DV, Moore EE, West MA, Moore FA, Davis JW, Cocanour CS, et al. discussion 519–22ĭente CJ, Wyrzykowski AD, Feliciano DV. Non-invasive vascular tests reliably exclude occult arterial trauma in injured extremities. Evaluation and management of penetrating lower extremity arterial trauma: an Eastern Association for the Surgery of Trauma practice management guideline. 2011 70:1551–6.įox N, Rajani RR, Bokhari F, Chiu WC, Kerwin A, Eastern Association for the Surgery of Trauma, et al. Western Trauma Association/critical decisions in trauma. Evaluation and management of peripheral vascular injury: part 1. ![]() Keywordsįeliciano DV, Moore FA, Moore EE, West MA, Davis JW, Cocanour CS, et al. A number of damage control options exist in the setting of complex injury or physiologically compromised patients, which include temporary shunting or ligation. Patient with these signs and suspected injury needs to be moved to the operating room ASAP. In regions of difficult anatomy, endovascular and open techniques can be combined in a hybrid approach to minimize morbidity. Nicholas Hatch Educational Pearls: Hard signs of vascular injury include: loss of pulses, severe arterial bleeding, active uncontrolled hemorrhaging, rapidly expanding pulsatile hematoma, and palpable thrill or bruit. Recently, endovascular options for vascular control and definitive management of vascular injuries have emerged. The operative principle of proximal and distal control is critical and has traditionally been achieved via classical open operative exposures. Hard signs in general mandate exploration, whereas soft signs permit more further workup. Life-threatening bleeding may come from a vascular injury or from elsewhere. Patient assessment begins with identification of all life-threatening injuries followed by the identification of hard and soft signs of vascular injury. When a parent or caregiver has shaken a baby, the doctor will examine a baby for signs of shaking or abuse if the parent has not reported the cause of the infant’s apparent injury.Vascular injury management is a fundamental skill for trauma surgeons. Diagnostic SignsĪn infant brought in for assessment of both mild and severe head trauma symptoms will be examined for a number of other signs. A head injury to a child under 6 months of age or loss of consciousness episode for any period of time and/or following a forceful injury like a car accident, require a doctor's visit. The child may have neck pain, seizures, skull indentation, large bump and/or any changes in behavior. Green explains that these are mild to moderate forms of head trauma that do require medical attention if the following symptoms occur: crying longer than 10 minutes, vomiting repeatedly, bleeding from the ears or nose, dripping of clear liquid from the ears or nose, inability to walk or talk normally, rapid swelling just above the ear, severe or worsening headache (or irritability in babies who can't speak yet). If a baby appears confused or off-balance she may have a concussion. Signs that a head injury may require medical attention include a brief, temporary loss of consciousness or a change in conscious state. Although these bumps may be painful or result in bruising, they are often harmless. Green explains that babies and toddlers will “bonk” their head many times during their development.
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