Table 1 |
|
|
Clinical signs for prediction of an arterial extremity injury. |
|
| "Hard signs" |
"Soft signs" |
|
|
|
| Active or pulsatile hemorrhage |
Asymmetric extremity blood pressures |
| Pulsatile or expanding hematoma |
Stable and non-pulsatile hematoma |
| Clinical signs of limb ischemia |
Proximity of wound to a major vessel |
| Diminished or absent pulses |
Peripheral neurological deficit |
| Bruit or thrill, suggesting AV-fistula |
Presence of shock/hypotension |
|
The presence of a "hard sign" of an arterial injury warrants an immediate surgical exploration with the option of an on-table angiography. In contrast, the "soft signs" are less specific in predicting a significant arterial extremity injury. In exclusive presence of a "soft sign", such as an asymmetric ankle-brachial-index, the recommended further diagnostic workup includes an angiography or CT-angiography. | |
Bravman et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2008 16:16 doi:10.1186/1757-7241-16-16 |
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