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Year 3 - Junior Surgery > Vascular Trauma > Flashcards

Flashcards in Vascular Trauma Deck (19)
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1
Q

What are three main anatmocally distinct categories of vascular trauma?

A
  • Peripheral arterial trauma
  • Chest vessel trauma
  • Retroperitoneal bleeding
2
Q

What are some causes of peripheral vascular trauma?

A
  • Penetrating injuries (e.g. stab wound)
  • Blunt objects (e.g. fractures)
  • Invasive procedures (e.g. arteriography)
3
Q

What are the two types of signs of an arterial bleed?

A
  • Hard signs
  • Soft signs
4
Q

What are some hard signs of an arterial bleed?

A
  • Rapidly expanding haematoma
  • Area with a palpable thrill/audible bruit
  • External arterial bleed
  • Acute limb ischaemia following trauma (not corrected by reduction/relocation of limb)
5
Q

If hard signs are present how should the patient be managed?

A

Urgent surgery

6
Q

What are some soft signs of an arterial bleed?

A
  • Bleeding
  • Wound/trauma near to a major artery
  • Diminshed unilateral pulse
  • Small haematoma
  • Neurogenic defecit
7
Q

If soft signs are present how should the patient be managed?

A
  • Consider duplex USS
  • Consider referral to vascular
8
Q

How are limb vasculature injuries managed?

A
  • Surgery (mostly)
9
Q

What is key to managing limb vasculature injuries?

A

Managing the haemorrhage and preventing ischaemia

10
Q

What are prioritised over limb injuries?

A

Head injuries and trunk blood loss

11
Q

After what period of ischaemia are limbs unlikely to survive?

A

6-8 hours

12
Q

How are chest vascular injuries managed?

A
  • Management of possible pneumothorax/tamponade first
  • If stable sent for CT chest
13
Q

How do most thoracic vessel injuries occur and where?

A

Rapid deceleration in RTA leading to damage at the isthmus of the thoracic aorta

14
Q

What percentage of people die before reaching hospital with an injury to the isthmus of the descending aorta?

A

90%

15
Q

How is a throacic vascular injury managed?

A
  • Fluids
  • Aortic stent/open repair
16
Q

How do patients with a thoracic aorta injury present?

A
  • Chest/mid scapular back pain
  • Haemodynamic instability
  • Trauma to the chest
17
Q

What can cause a retroperitoneal bleed?

A
  • Pelvic fracture
  • Acute pancreatitis
  • Ruptured AAA
  • Spontaneous
  • Arteriogram
18
Q

How should a retroperitoneal bleed be managed?

A
  • Request CT
  • Fluid resuscitate
  • Refer to vascular
19
Q
A