Trauma transport decisions

[Brandon O]

Please do not go around clamping carotid arteries, friends.

 

[SpecialK]

Please do not go around clamping carotid arteries, friends.

In all seriousness, if direct pressure doesn't work, I can't put a tourniquet on it, don't have haemostatic gauze or vascular surgical facilities close to hand, then how are we supposed to stop the bleeding? You're saying it's better to let the guy continue to bleed?

And as for that whole brain needing oxygenated blood thing (probably important) ... well he's got two of them?

 

[Brandon O]

In all seriousness, if direct pressure doesn't work, I can't put a tourniquet on it, don't have haemostatic gauze or vascular surgical facilities close to hand, then how are we supposed to stop the bleeding? You're saying it's better to let the guy continue to bleed?

And as for that whole brain needing oxygenated blood thing (probably important) ... well he's got two of them?

He has two, but not with reliable collateral circulation.

Look, I realize this is a hypothetical scenario, but this is a "what if I absolutely can't control the abdominal bleeding, should I cut out his spleen?" sort of question. If the bleeding doesn't stop with direct pressure, keep trying or do it better. I highly doubt anybody is going to have any kind of success clamping or ligating a carotid artery in the field (I cannot even imagine how this would go), and if they did I don't think they would like the result. That is not the treatment for this condition.

I mean, I suppose if it was completely transected, and the proximal stump was just flapping there at you, fully exposed and begging to be secured, but at some point this is entering the realm of fantasy.

(I am happy to defer to any vascular or trauma folks here, of course.)

 

[E tank]

In all seriousness, if direct pressure doesn't work, I can't put a tourniquet on it, don't have haemostatic gauze or vascular surgical facilities close to hand, then how are we supposed to stop the bleeding? You're saying it's better to let the guy continue to bleed?

And as for that whole brain needing oxygenated blood thing (probably important) ... well he's got two of them?

You're correct of course...but, VERY hypothetically speaking, if someone were faced with that consideration however unlikely, you might want two clamps, one distal and proximal...circle of willis and all...but direct pressure would probably be all that was needed distally...