UMEM Educational Pearls

Category: Airway Management

Title: Peripheral Vascular Trauma

Keywords: Vascular, Trauma (PubMed Search)

Posted: 5/10/2010 by Rob Rogers, MD (Updated: 12/7/2019)
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Some considerations in the patient with a penetrating vascular injury (gunshot, stab):

  • Obtain ankle-brachial index on all patients and document
  • An ABI <0.9 indicates the need to perform an arterial study
  • Traditional approach to penetrating extremity injury has been to perform angiography
  • Recent (good) studies have shown that CTA of the involved extremity is just as good if not better than angiography, and a lot of centers have moved to CTA
  • Obtain vascular surgery consultation if there is any concern for an arterial injury. Never hurts to err on the side of caution. 

References

 

Am Surg. 2008 Feb;74(2):103-7.

CT angiography effectively evaluates extremity vascular trauma.

Peng PDSpain DATataria MHellinger JCRubin GDBrundage SI.