High separation of the upper limb in the area of the shoulder joint with damage to the axillary artery accompanied by massive arterial bleeding and rapid development of critical blood loss.
- Placing a classic tourniquet over the wound is impossible due to the level of damage and proximity to the body.
In situations of immediate threat, the main method of temporarily stopping bleeding is direct clamping of the imagined bleeding vessel with a surgical clamp.
- In the absence of a clamp or the impossibility of visualizing the vessel, tamponade of the wound channel with hemostatic drugs and a pressure bandage is used, however, rebleeding is possible during transportation.
Additional time is given by intravenous administration of tranexamic acid in the prehospital phase, but definitive bleeding is achieved only in the operating room by ligation or repair of the vessel.
The most effective combined tactics are:
- Stop bleeding at the site, quick evacuation and final surgical treatment;.
- Success is determined by early training of personnel, knowledge of anatomy, control of vascular clamp and regular training.
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