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Prehospital External Aortic Compression for Temporizing Exsanguinating Sub-Diaphragmatic Hemorrhage – A Promising Technique, but with Challenges: Four Illustrative Cases, Including Two Survivors

Published online by Cambridge University Press:  13 January 2020

Bruce Richard Paix Open the ORCID record for Bruce Richard Paix [Opens in a new window] ,
David John Tingey ,
Grant Copley ,
Matthew Casson ,
Damien Shoolbread ,
Hari Davuluru ,
James Doube ,
Wade Emmerton  and
Ryan Kennedy
Bruce Richard Paix*
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
David John Tingey
Affiliation:
Rescue, Retrieval, and Aviation Services, South Australian Ambulance Service, Adelaide, South Australia, Australia
Grant Copley
Affiliation:
Rescue, Retrieval, and Aviation Services, South Australian Ambulance Service, Adelaide, South Australia, Australia
Matthew Casson
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Damien Shoolbread
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Hari Davuluru
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
James Doube
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Wade Emmerton
Affiliation:
SAAS MedSTAR, South Australian Ambulance Service Emergency Medical Retrieval Service, Adelaide, South Australia, Australia
Ryan Kennedy
Affiliation:
Rescue, Retrieval, and Aviation Services, South Australian Ambulance Service, Adelaide, South Australia, Australia
*
Correspondence: Bruce Paix, MBBS, FANZCA, 26 Smith Rd, Echunga, 5153Australia, E-mail: flyingdoc@bigpond.com
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Abstract

External aortic compression (EAC) has long been used to control exsanguinating post-partum hemorrhage, but it has only recently been described in the prehospital trauma setting. This paper reports four cases where manual EAC was used during transport to manage life-threatening bleeding, twice from stab wounds, once from ruptured ectopic pregnancy, and once from severe lower-limb trauma. It showed that EAC has life-saving potential in the prehospital setting, but that safety and efficacy during transport requires the use of a hands-free compression device, such as an aortic tourniquet.

Keywords

exsanguinating hemorrhageexternal aortic compressionprehospital care
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 1 , February 2020 , pp. 115 - 118
Copyright
© World Association for Disaster and Emergency Medicine 2020

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