vascular

Abdominal Vascular Graft Complications

As trainees I think it is beaten into our heads that all males over the age of 50 with new onset hematuria and flank pain should also be screened for AAA. One thing that is not so much beaten into our heads is how we still have to take hematuria and or hematochezia seriously in these same patients even after they receive endovascular repair. There are many complications that can occur from having an aortic graft placed, but for the purpose of this article let’s focus on Aortoenteric fistula and Endoleaks.

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Updates on TIA

The transient ischemic attack (TIA) places patients at high risk for future stroke. This article reviews the current literature on the diagnosis, management and disposition of patients with TIA. The use of observation and TIA clinics is also discussed.

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Bleeding Hand Wounds

Hand and digital wound bleeding should be managed with hemorrhage control, an adequate exam and proper treatment. There are many tools to help manage bleeding and allow for an adequate exam. Using a topical analgesic such as lidocaine, can be helpful with pain control. The addition of epinephrine to a topical analgesic in hand and digital wounds may not be as scary as once thought and may be considered to help with hemorrhage control in certain wounds.

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Peripheral Vascular Injury Management

Introduction

  • Peripheral vascular injury can be life-threatening or limb-threatening.  Proper understanding of pathology and management is important in the ER.
  • Vascular injuries can be internal and may not be obvious on presentation. Patients with blunt or penetrating trauma who remain hypotensive after a fluid bolus challenge may have internal hemorrhage.
  • Incidence of penetrating and blunt trauma in the US has been rising.
  • Blunt and penetrating causes of peripheral vascular injuries are about equal in the US.
  • Low velocity gunshot wounds are the second leading cause of death in the 15- to 34-year-old age group in the US.  Peripheral vascular injury has been reported to be present in up to 50% of these cases.

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