From the Guidelines
Hemodynamically unstable patients with ruptured blood vessels should undergo operative management (OM) to control the hemorrhage and initiate damage control resuscitation as soon as possible 1. The treatment approach for ruptured blood vessels depends on the patient's hemodynamic status.
- For hemodynamically stable patients, non-operative management (NOM) may be considered, with the goal of controlling the hemorrhage and managing any associated injuries.
- In cases where NOM is not feasible, or the patient's condition deteriorates, operative management (OM) should be employed to control the bleeding and restore hemodynamic stability. Some key considerations in the management of ruptured blood vessels include:
- The use of angiography and angioembolization (AG/AE) as a first-line intervention in hemodynamically stable patients with arterial blush on CT scan 1.
- The importance of early mobilization and enteral feeding in stable patients to promote recovery and prevent complications 1.
- The need for intensive care unit admission in patients with moderate to severe injuries, particularly those with associated head trauma or spinal cord injuries 1.
- The role of damage control surgery in severely injured patients, which involves an abbreviated resuscitative laparotomy, packing to control hemorrhage, and deferred definitive surgical repair until coagulation has been established 1.
From the Research
Treatment for Ruptured Blood Vessels
The treatment for ruptured blood vessels, also known as hemorrhaged vessels, can vary depending on the severity and location of the injury.
- In cases of severe blood vessel injuries, properly done first aid and initial medical care can save the patient's life 2.
- Treatment may include administration of medications such as Adrenalin hydrochloride, Hydrocortisone, and Sol Haemaccel, as well as transfusion of fresh blood 2.
- For less severe cases, such as extravasation, nursing intervention and thermal application may be recommended 3.
- Local thermal treatments, including cooling with ice packs, can aid in vasoconstriction and limit drug dispersion 3.
- In some cases, spontaneous hematoma may occur due to over anticoagulation by vitamin K antagonist therapy, and treatment may involve management of the underlying condition 4.
- The use of ice packs in the management of epistaxis is not universally accepted and may not have a significant effect on the blood vessels of the nasal mucosa 5.
Management of Hemorrhagic Shock
- The management of hemorrhagic shock may involve the use of drag-reducing polymers, such as those derived from Aloe vera, to improve blood rheology and reduce oxygen radical damage 6.
- However, the efficacy of such treatments is still being researched and debated.
Prevention of Extravasation
- Prevention of extravasation is crucial and can be achieved through regular checks of the extravasation kit, assessment of patients' sensory changes, and continuous education of the medical team 3.