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Fri Nov 30 06:58:42 GMT 2007

The most important determinants of survival from any blood-letting is the immediate actions of the victim themself, followed by the immediate actions of the first and possibly the second responder; the rest is of secondary importance. The GSW to the groin victim who chooses to lie supine and keep cool rather than run will clearly bleed less. The first responder who puts a strong palm or knee (whatever it takes) on the bleeding site and achieve hemostasis will improve the survival of the patient. Exsanguinated patients have a time limit, and the longer bleeding go unchecked and the patient is hypoperfused, the more likely they are to succumb ("Guyton's Law"). The patient who arrives exsanguinated to the emergency department without vital signs can be resuscitated, but survival depends mostly upon the time it takes in restoring vital signs with volume (crystaloid and blood - including plasma). Withholding volume in this scenario would be insalubrious. Sending the patient to the opera
tion room with hemostasis and decent vital signs will improve survival from a compressable vascular injury.

The football player was unlucky.

DB

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Femoral Artery Injury