A 22-year-old male, aluminum factory worker, was brought by his friend to the ED after he accidentally fell on a sharp glass, 30 minutes ago. The patient presented with moderate bleeding from lacerations in his forearm. He was feeling dizzy and in severe pain.
Co-Morbid Conditions: None
Hand dominance: right-handed
Occupation: Aluminum factory worker
Denies smoking and use of the illicit drug
Last tetanus booster: unknown
Temperature oral: 36.7 C
Peripheral pulse rate: 91 bpm, regular
Respiratory rate: 17 bpm
Blood pressure: 164/75 mmHg
Oxygen saturation, on room air: 100%
GSC: 15/15
This is a deep laceration. Bleeding is one of the critical problems here. Because blood loss is a deadly situation, even with a simple laceration, we should concern about vascular injury. However, in the ED, our role is not the finding the actual problem in the early moments. Our role is to stop the bleeding immediately with some simple maneuvers or applications. Of course, this case should be evaluated for foreign body (direct visualization, x-ray, US may help), tendon and muscle injuries as well as nerve injuries. But, bleeding control is the first priority.
To learn about management, please read the chapter below.
Basics of Bleeding Control by Ana Spehonja and Gregor Prosen
