Management of a patient with an arterial injury
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When an arterial injury is suspected, urgent investigations and treatment should be carried out. With multiple injuries, it is necessary to prioritise the injuries, dealing first with breathing, then with bleeding complications, the brain and, finally, the bones. With an arterial injury, it is necessary to stop the bleeding to determine the extent of the injury and then to affect a repair, with restoration of the circulation. Bleeding can be controlled by pressure, blood loss can be replaced by transfusion and the nature and extent of the damage assessed by duplex ultrasound imaging or arteriography. Sometimes, the extent of the injury is clear and direct surgical repair can be carried out without the need for investigations.