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Fri Nov 30 22:40:48 GMT 2007

Mine was one of the emails lost in transit, it seems.

The other case I've seen of a death from isolated femoral penetrating injury was irreversible shock occurring in the context of massive blood product transfusion during prolonged operative attempts at limb salvage. Aside from the expected larger vessel injury, when the profunda branches are destroyed within a muscular thigh bed, it becomes nearly impossible to localize and staunch bleeding. The hemorrhage is moderate, but unyielding, and the losses accumulate faster than clinically apparent. The patient suffered ongoing and recurrent partially corrected episodes of hemorrhagic shock, then went into MOSF and DIC.

----- Original Message ----
From: "KMATTOX at aol.com" <KMATTOX at aol.com>
To: trauma-list at trauma.org
Sent: Friday, November 30, 2007 1:52:33 PM
Subject: Re: Re. Femoral Artery Injury

In a message dated 11/30/2007 11:55:07 A.M. Central Standard Time,  
Medic541 at hotmail.com writes:

Anyone  else have any suggestions as to what might have  happened?

Not in any particular rank order:  

1.    Cytokine storm
2.    Fatal pulmonary embolism,  Hyperacute  from a ligated femoral vein
3.    ARDS, 
    a.    Fluid overload
    b.    Massive transfusion
4.    Medication complication
5.    CNS injury from repeated cardiac arrest (do not  know if that happened)
6.    Hyperkalemia and acidosis

k

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Re. Femoral Artery Injury