Ejected from Moving Vehicle

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Ejected from Moving Vehicle at High Speed SYB
January 31, 2008 Julianne Lauring
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Our Patients Subclavian Arteriogram
The cine loop shows the blood going no farther
than this still image
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Normal Subclavian Artery Arteriogram
www.medcyclopedia.com
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Extremity Vascular Trauma

• Generally caused by penetrating injury
• Fractures increase the risk in blunt injury
• More common in military in active war zones
• Difficult to assess the incidence in civilians
  because there is a billing/coding overlap with
  non-traumatic vascular injury
• When the arterial vessel is transected, vascular
  spasm coupled with low systemic blood pressure
  appears to promote clotting at the site of injury
  and to preserve vital organ perfusion better than
  that which occurs with ongoing uncontrolled
  hemorrhage

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Signs

• Hard signs of vascular injury include the
  following
• Observed pulsatile bleeding
• Arterial thrill (ie, vibration) by manual
  palpation
• Bruit over or near the artery by auscultation
• Signs of distal ischemia
• Visible expanding hematoma
• Soft signs of vascular injury include the
  following
• Significant hemorrhage found on history
• Decreased pulse compared to the contralateral
  extremity
• Bony injury or proximity penetrating wound
• Neurologic abnormality

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References

• Emedicine
• www.emedicine.com/med/TOPIC2812.HTM
• Extremity Vascular Trauma by H Scott Bjerke,
  MD, FACS