September 11, 2019
- Get definitive airway control when necessary
- Use modality you’re most comfortable with
- Hard signs - pulsatile bleeding, bruit or thrill, expanding hematoma, airway compromise, massive hemoptysis (think airway injury), hematemesis (think esophageal injury), grossly injured trachea, neurologic deficit, subcutaneous emphysema.
- Soft Signs are hypotension that resolves, stable hematoma, wound in proximity to major vascular structure, minor hemoptysis, dyspnea, dysphagia, chest tube air leak, vascular bruit or thrill (depends on surgeon).
- Hard Sign on presentation goes straight to the OR. Soft Sign on presentation gets some imaging done
- Resuscitate with blood products -> Activate massive transfusion protocol
- Most hemorrhage will respond to direct pressure
- Don't miss other injuries!