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Pressure Points Technique for Traumatic Proximal Axillary Artery Hemorrhage: A Case Report

Published online by Cambridge University Press:  16 December 2022

Guy Avital Open the ORCID record for Guy Avital [Opens in a new window] ,
Chaim Greenberger ,
Asaf Kedar ,
Regina Pikman-Gavriely ,
Maxim Bez ,
Ofer Almog  and
Avi Benov
Guy Avital*
Affiliation:
Israel Defense Forces Medical Corps, Ramat Gan, Israel Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Chaim Greenberger
Affiliation:
Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Asaf Kedar
Affiliation:
The Faculty of Medicine, Hebrew University of Jerusalem, Division of General Surgery, Hadassah University Medical Center, Jerusalem, Israel
Regina Pikman-Gavriely
Affiliation:
Israel Defense Forces Medical Corps, Ramat Gan, Israel Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Maxim Bez
Affiliation:
Israel Defense Forces Medical Corps, Ramat Gan, Israel
Ofer Almog
Affiliation:
Israel Defense Forces Medical Corps, Ramat Gan, Israel Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel The Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
Avi Benov
Affiliation:
Israel Defense Forces Medical Corps, Ramat Gan, Israel The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
*
Correspondence: Guy Avital, MD Trauma and Combat Medicine Branch Surgeon General’s Headquarters Israel Defense Forces, Ramat Gan, Israel E-mail: guy.avital.md.il@gmail.com
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Abstract

Introduction:

While the pressure points technique for proximal hemorrhage control is long known, it is not recommended in standard prehospital guidelines based on a study showing the inability to maintain occlusion for over two minutes.

Main Symptom:

This report details a gunshot wound to the left axillary area with complete transection of the axillary artery, leading to profuse junctional hemorrhage and profound hemorrhagic shock.

Therapeutic Intervention:

Proximal pressure of the subclavian artery was applied against the first rib (the pressure points technique) and maintained for 28 minutes.

Outcomes:

Cessation of apparent bleeding and excellent, enduring physiologic response to blood transfusion were observed.

Conclusion:

The pressure points technique can be life-saving in junctional arterial hemorrhage and should be reconsidered in prehospital guidelines.

Keywords

Case Reportjunctional hemorrhagepressure point
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 1 , February 2023 , pp. 130 - 133
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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