Peripheral Vascular Injuries Treatment & Management
- Author: Niels K Rathlev, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH more...
Perform the following for peripheral vascular injuries:
- Stabilize the extremity in the anatomic position.
- Control hemorrhage with direct pressure.
- Apply a tourniquet proximal to the injury if direct pressure is not effective in controlling hemorrhage.
Emergency Department Care
Immediately reduce displaced or angulated fractures if any evidence or suspicion of vascular compromise exists. Promptly reduce dislocations of the elbow and knee to prevent further injury to neurovascular structures.
External hemorrhage usually can be controlled with direct pressure, but a blood pressure cuff or tourniquet should be applied proximally to the injury if compression fails or is not possible.
Once the patient has been stabilized, identify peripheral vascular injuries and restore normal circulation as rapidly as possible.
Do not apply clamps or hemostats to vascular structures, since this may make definitive repair more difficult and damage surrounding tissues.
A vascular surgeon must be consulted whenever a major vascular injury is a concern.
Vascular injury sustained during battlefield combat is often managed via revascularization. Reconstruction methods should be a focus of combat surgery training. Ligation is also an effective intervention.
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