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How To How To Control Massive Bleeding Using Surgical Instruments
Author : Marshall Black
Submitted : 2012-02-21 Word Count : 720 Popularity: Not Rated
Tags: forceps, surgical instruments, pessary
The fact that the aterial system is a low-pressure system is done easily by comparing aortic pressure to that of regular city water supply. PSI (pounds per square inch), you can stop the water flow by simply using your thumb to cover it. When you consider that regular pressure in the arterial system, by comparison, is only 3 pressure per square inch, Its quite possible to control the bleeding in a blood vessel by applying slight pressure. When giving enough pressure to bring a 45 pressure per square inch hose when set on a 1.5 pressure per square inch bleeder can possible make a slice on the vessel and cause more problems instead of solving the problem.
How to handle a large hemorrhage:
1. Put a finger on the bleeding point & exert the minimal pressure required to stop the bleeding. While one finger controls the bleeding, take the time to analyze the situation & make measures for definitive control of the hemorrhage. No need to hurry at this point, as finger pressure control of the bleeding can be maintained for plently hours of necessary.
2. Improve the exposure. Placing vascular or other clamps deep in a hole to control major bleeding could damage surrounding structures, resulting in inaccurate placement of clamps or further laceration of blood vessels. You can get better exposure using a proximal & distal dissection along the bleeding vessel several centimeters away from the bleeding point.
3. Clamp the bleeding vessel on either side of the point thats bleeding & get rid of hemostatic finger.
4. Repair or ligate the involved vessel.
Clamps can grab tissue in a secure prolonged peroid, where static use of tissue forceps would cause fatigue. For example, Kocher clamps placed on the peritoneal edges will help expose underlying surfaces during separation of adhesions. It's crutial to use a clamp to the gallbladder to stabile it as well as modify its position during cutting. The selection of clamps is based on the fragility of tissue and the amount of sliperage needed. Allis clamps and Kocher, that have tiny jaws for a better ability to apply greater pressure in a small area, are applicable for use on fascia but can be traumatic to bowel or lung, where Babcocks or lung clamps can prevent tearing or crushing.
Atraumatic clamps, such as vascular clamps, are built to hold while exerting the least possible crushing force. Many of these types of vascular clamps have fine teeth, they do this so when the jaws give pressure it wont slide off. With the teeth appling pressure it shouldn't slip off. Most of the wall receives very little crushing pressure when the teeth are applied to the surface. Vascular clamps are the best used when the operator has his own familiar surgical instruments. He can use the clamps with minimum pressure and still feel confident, thereby minimizing the crushing or cutting of a vessel wall.
Author's Resource Box
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This editorial by Pat Q.
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