Site Search
Trauma-List Subscription


Would you like to receive list emails batched into one daily digest?
No Yes
Modify Your Subscription


Home > List Archives

penetrating vascular trauma: bleeding subclavian avf

SJASMD at aol.com SJASMD at aol.com
Sun Apr 23 14:47:31 BST 2006

Tried to send this with an image but no one ever commented. I spoke  to ron 
gross who said it never was received by the message board, although i got  it
i was surprised by lack of comments so I will send the post again but  attach 
rather than embed the image.
In a message dated 4/19/2006 11:07:47 A.M. Eastern Standard Time,  
roydanks at hotmail.com writes:

EAST has  published guidelines for these.  I generally follow them, but will  
deviate as needed.

This is how I handle them:

1)  Physical  exam: 
Wound:  Any signs of expanding  hematoma or pulsatile mass?  If so, go to OR

I had a recent interesting "deviation" from that recommendation
28 year old male sustained stab wound of the left shoulder. on admission  
hypotensive but responded with volume with improved pulses but bleeding from the  
wound which was  managed by pressure.
take a deep breath, trauma surgeons.....
patient brought to angio with manual pressure applied. attached angio  showed 
a subclavian arteriovenous fistula. This was treated by stent graft which  
controlled the bleeding and repaired the vessel in about forty  minutes. 
he was discharged on fourth hospital day. Followup angio at five  weeks 
showed good flow and equal upper extremity blood  pressures.
 i see more of this happening in the future
-------------- next part --------------
A non-text attachment was scrubbed...
Name: subclavian-avf-w-stent-graf.jpg
Type: image/jpeg
Size: 11594 bytes
Desc: not available
Url : http://list.mistral.net/pipermail/trauma-list/attachments/20060423/3b6b1b9c/subclavian-avf-w-stent-graf.jpg

More information about the trauma-list mailing list