Figure Legend: The drama of hemorrhage
may lead to unwise maneuvers in the emergency room. Blind clamping
of bleeding structures without proximal tourniquet control is risky and
may compound injury. (1,2) This patient had inadequate control of
bleeding despite multiple clamps placed by an inexperienced physician,
who was successful in clamping the ulnar nerve and flexor carpi ulnaris
tendon, but failed to control the large subcutaneous vein which was actually
responsible for the bleeding. Continued hemorrhage is often due to
partial vessel lacerations, as in this partial laceration of the cephalic
vein (3) and this partial laceration of the radial artery (4). Ligation
of structures without adequate visualization in the emergency room is also
problematic as in this patient who had inadvertent ligation of the ulnar
nerve within Guyon's canal.
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