Vascular Nursing 24 Vascular Trauma скачать в хорошем качестве

Vascular Nursing 24 Vascular Trauma

#VascularTrauma #TraumaCare #EmergencyMedicine #VascularSurgery #ArterialInjury #BluntTrauma #PenetratingTrauma #NerveDamage #LimbSalvage #Complications Vascular trauma, a leading cause of death for those under 44, involves critical injuries to blood vessels. Injury patterns are evolving, with more neck/trunk trauma and increases from intravenous drug use and endovascular procedures. Mechanisms include: *Penetrating Trauma:* Object pierces tissue (e.g., gunshots, knife wounds, iatrogenic injuries during medical procedures). High-velocity missiles cause extensive cavitation damage. *Blunt Trauma:* Injury without an open wound (e.g., motor vehicle accidents, falls). Vessels are crushed, stretched, or torn. Often harder to diagnose and can have worse outcomes due to delayed detection. Diagnosis prioritizes ABCs (Airway, Breathing, Circulation). Key indicators are: *Hard Signs:* Pulsatile bleeding, palpable thrill, expanding hematoma, continuous murmur, or the 6 Ps of acute limb ischemia (Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia). Hard signs necessitate immediate surgery. *Soft Signs:* Suggest suspicion, requiring further investigation (e.g., non-expanding hematoma, proximity of wound to major vessels, weak pulse). *Diagnostics:* Blood tests, duplex ultrasound, CT/MR angiography, and conventional angiography. Management for major vascular trauma is predominantly surgical, with urgency being critical (limb ischemia can occur within 6-8 hours). Techniques include direct repair, bypass grafts (often using patient's own vein), or sometimes ligation for smaller vessels. Potential complications include: Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Pseudoaneurysm (contained arterial rupture). Arteriovenous Fistula (abnormal artery-vein connection). Nerve Injury (very common, often dictates long-term limb function). Compartment Syndrome (pressure buildup in muscle compartments, requiring fasciotomy). Secondary Lymphedema. Nurses play a critical role in assessment, monitoring (especially neurovascular status), and rapid preparation for surgery. Patient education, follow-up, and addressing the social context are crucial for long-term recovery.