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The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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[Vascular injury-An underestimated entity?]

Thomas Jerkku1,2, Nikolaos Tsilimparis1, Ramin Banafsche1,3

  • 1Abteilung Gefäßchirurgie und Endovaskuläre Chirurgie, Klinikum der Universität München, München, Deutschland.

Gefasschirurgie : Zeitschrift Fur Vaskulare Und Endovaskulare Chirurgie : Organ Der Deutschen Und Der Osterreichischen Gesellschaft Fur Gefasschirurgie Unter Mitarbeit Der Schweizerischen Gesellschaft Fur Gefasschirurgie
|May 2, 2022
PubMed
Summary

Vascular trauma (VT) in severely injured patients is rare but associated with higher mortality. Optimized emergency care, including vigilance, allocation, and transportation, is crucial for improving outcomes in these critical cases.

Keywords:
AllocationMortalityPrognosisSeverely injuredVascular trauma

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Area of Science:

  • Traumatology
  • Vascular Surgery
  • Emergency Medicine

Context:

  • Isolated vascular trauma (VT) is infrequently documented in traumatology, leading to a scarcity of current incidence and mortality data.
  • This study examines the status of VT within the trauma care of severely injured individuals in Germany.

Purpose:

  • To analyze the incidence, mortality, and clinical course of vascular trauma in severely injured patients.
  • To evaluate the impact of trauma center allocation and care level on mortality in VT cases.
  • To identify areas for optimizing emergency care for patients with VT.

Summary:

  • Analysis of the TraumaRegister DGU® (TR-DGU) from 2002-2012 and 2008-2017 revealed that vascular trauma (VT) in severely injured patients (7%) had a higher observed mortality (OM) than expected mortality (EM).
  • A significant difference between OM and EM was noted in VT cases (+3.4% in the first period, up to +29% in high-risk constellations in the second period), indicating a substantial impact of VT on patient outcomes.
  • The study highlights that treatment level, allocation, and transportation significantly influence OM in VT, underscoring the importance of optimized emergency management.

Impact:

  • The findings underscore a critical need for enhancing emergency medical services for severely injured patients with VT.
  • Recommendations include increased vigilance for VT, optimized patient allocation, and timely re-allocation to appropriate care facilities.
  • Improved management strategies for VT can lead to better patient prognoses and reduced mortality rates in trauma care.