Journal Review in Vascular Surgery: Vascular Extremity Trauma

It’s 2 a.m. and a patient with a GSW to the thigh is rolling into the trauma bay. He’s hypotensive, tachycardic, and has a tourniquet in place. Do you get a CTA or go straight to the OR? What do you do with the tourniquet?

Join us as we work through this and two other cases of extremity vascular trauma and break down the literature to answer these questions and discuss how we should approach these challenging injuries.

Hosts:

·      Christian Hadeed - PGY 5 General Surgery, Brookdale Hospital Medical Center

·      Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center

·      Andrew Harrington – Division Chief, Vascular surgery, Richmond University Medical Center

·      Lucio Flores - Vascular surgery, Brookdale Hospital Medical Center

Learning Objectives:

·      Apply the X-ABCDE approach to patients with extremity vascular trauma, including the role of early hemorrhage control and tourniquets.

·      Recognize the hard and soft signs of extremity arterial injury and determine when additional vascular imaging is indicated.

·      Describe the role of the ankle-brachial index, CT angiography, and conventional angiography in the evaluation of suspected extremity vascular injury.

·      Discuss the principles of operative management of extremity vascular injuries, including temporary shunting, vascular repair, and restoration of limb perfusion.