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RainyDayNinja
01-13-2009, 03:22 AM
If an artery in someone's leg was either severed completely or partially (like from a piece of shrapnel), what would be used to close it up? Would it be stitched, glued, or something else? The doctors in my story are in a poor area and wouldn't have access to fancy equipment. Also, what complications could arise during the procedure (to make it more dramatic)?

Thanks a bunch!

JHillman
01-13-2009, 05:05 AM
The simplest, and most common method, is to stitch it. But work fast. A bleeding artery in your leg can kill you in very little time. If you don't get the stitches right, you get bleeding when you release the tourniquet (the one you have to put on when you're doing the stitching). Think water hose under pressure with a leak. Or watch old episodes of M.A.S.H. If the do the sewing incorrectly, the blood flow doesn't work after the fact and you get gangrene in the limb- very nasty.

BellaRush
01-13-2009, 07:27 PM
I've had this happen to a horse - of course it takes a lot to bleed out a horse so as much as I was a bit freaked out, it wasn't quite as immediately life-threatening as it would be for a human. I had wrapped it immediately, which did stop the bleeding, but as soon as the bandage was removed by the vet it started pumping again. He would have just sutured it, he said, but he had a broken wrist, so we took her to the clinic. They ended up putting her on the table to do it. It was still tricky for them as it took a lot to stop the bleeding enough to suture it....but that's all they did, nothing fancy. And she (the horse) lived to tell. ;) Only complication that comes to mind is afterwards, the potential of infection.

petec
01-13-2009, 07:40 PM
First go for the pressure point in the groin with either manual pressure or tourniquet( you must release after 20 mins max) Then attend to the wound.

Raise the leg.that will reduce the blood flow

http://www.medi-smart.com/fa-pp.htm

Tsu Dho Nimh
01-13-2009, 10:41 PM
If an artery in someone's leg was either severed completely or partially (like from a piece of shrapnel), what would be used to close it up? Would it be stitched, glued, or something else? The doctors in my story are in a poor area and wouldn't have access to fancy equipment. Also, what complications could arise during the procedure (to make it more dramatic)?

Thanks a bunch!

The classic (as in since the 1600s method) You stitch it in layers ... the "lumen", the muscular walll, and then the outer covering. Lots of stitches, close together, with fine needles and material.

Two complications - as seen in various surgeries I've seen

1 - you unclamp it after stitching and it starts to spurt because it's popped a stitch (reclamp and fix that area)

2 - You unclamp it after stitching and nothing happens because it's clotted shut above the stitching. (you cuss a lot, clamp well above the clot, make a longitudinal slit, fish out the clot, stitch the slit)

xhinmorillo
06-19-2009, 06:16 AM
The bleeding artery in your leg can kill you in just a little time so I think it should be stitch for... some kind of fastest way on that..


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James D. Macdonald
06-19-2009, 06:36 AM
What's this with loosening a tourniquet after twenty minutes?

Anyway, the best way (IMHO) to wound your characters (I'm assuming fiction here) is to figure out what limitations you want to put on them, then finding an injury that'll put that limitation on them, rather than coming up with the injury first then trying to make it do what you wanted to the character.

RJK
06-19-2009, 06:12 PM
I must have read about fixing one hundred wounds in these pages. Your suggestion, UJ is the best answer I've heard yet.

dmytryp
06-19-2009, 08:16 PM
First go for the pressure point in the groin with either manual pressure or tourniquet( you must release after 20 mins max) Then attend to the wound.

Raise the leg.that will reduce the blood flow

http://www.medi-smart.com/fa-pp.htm


What's this with loosening a tourniquet after twenty minutes?


A severed artery in the hip will give a fountain of blood about a meter high. It would kill you in about two minutes (at least this is what they tell you in first aid classes in the Israeli army). The only way to stop it immediately is tourniquet. Either a special one or an improvised one. You take a strap of cloth, make a loop and put a branch into the loop on the side of the leg opposite to the knot and twist it till it tightens. Russian sused to torture people this way by eventually crashing your bone, so it is called a Russian tourniquet.
The pressure point might work for a short while.

Actually after a tourniquet is applied, only a doctor is allowed to release it (at least here). You also need to write doen the time when it was applied because after a certain period of time it is too dangerous to release it (I think it is something like an hour, but I don't remember exactly) and might kill the patient. In this case, you lose the leg.

JrFFKacy
06-20-2009, 06:37 AM
For First-Aid, you elevate the limb and put pressure directly on the wound if possible, or if that isn't possible (due to a bone, or some other foreign object sticking through the skin, etc), put pressure on the main artery near the wound.

As has been mentioned, it only takes minutes to bleed out through an artery in your leg. I actually knew a man who died tragically in a farm accident because he severed the main artery in his thigh. Henceforth, time is of the essence.

It doesn't really matter what kind of thing you use to apply pressure, but direct pressure with some kind of absorbent material is best. I know another story of someone else I know, who sliced his wrist in a shop mishap. The nearest absorbent material was a pile of greasy rags. He held those to his arm, while he called 911 (he was home alone). The Dispatcher kept him on the phone and talking until EMS arrived to transport him, so he wouldn't pass out and let go of his arm. If you cut off a finger with a kitchen knife, it's likely you'll have some tea towels nearby to deal with the blood.

Everyone knows that wound cleanliness is important, but if it's an arterial bleed, cleanliness isn't going to matter if you bleed to death. Your main concern is to stop blood flow. R-I-C-E (Rest, Ice, Elevation, Compression) sort of works for this because your first concern is to slow the pumping of the heart by having the person stop moving and trying to stay calm. Get the limb above the heart, and put direct pressure on it.

First-Aiders are going to want to be very careful around major bleeds, due to infection concerns. If you're not dead certain the person does not have HIV, Hepatitis, etc, wear gloves, safety glasses at minimum. I've helped people dehorn dairy calves (under veterinary supervision), and this entails severing very small arteries, then stopping the bleeding. Even those small arteries can spray blood for a couple of feet. A main artery in a human? Well I carry gloves, safety glasses and various other first-aid stuff in my truck at all times! Never know when I'm gonna roll up onto a serious car wreck and have to deal with it on my own until more people arrive.

dmytryp
06-20-2009, 01:01 PM
I disagree. Direct pressure is ok for smaller wounds, not for a nicked artery.

JrFFKacy
06-22-2009, 06:26 AM
I dunno then, we were told to use direct pressure here. Stick a thick absorbant pad of something on top of the wound and just keep stacking them until you get the bleeding stopped. In my first-aid course, we were told tournquets were old news and it was unwise to use them. But that's a Canadian first-aid course...not necessarily what you'd be doing in Israel.