# What if an artery or vein is severed?



## Eyeball (Nov 8, 2020)

Do we have to tie off the two open ends of the tube?
I mean, the two ends are never going to fuse together again are they?


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## paraquack (Mar 1, 2013)

Arteries carry blood away from the heart. Small ones could be tied off. Large one, probably not, 
without starving the extremity of blood and oxygen. The problem is most MDs won't tackle a 
severed artery. They'd pass it off to a vascular surgeon. So it all depends on your training, your 
equipment available and how big your cojones are. As a paramedic, if it was life and death, I'd
try. If it meant loosing a limb, I'd have to think long and hard, becuase I could cause loss of life.
But that's if I had the equipment, and I don't. So, I'd opt to tie off and hope for the best.


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## stevekozak (Oct 4, 2015)

This thread makes my cardiovascular system hurt!


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## ActionJackson (Sep 4, 2020)

stevekozak said:


> This thread makes my cardiovascular system hurt!


Or, as an old Aussie friend used to say: "bloody hell."


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## keith9365 (Apr 23, 2014)

Soldiers from the Viet Nam war to date have a higher probability of surviving severe combat injuries than previous wars due to rapid medevac to trauma centers with trauma surgeons and associated infrastructure there waiting on them. If you take a round to a major artery in a WROL scenario you are going to die plain and simple. Best advice, don't get shot.


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## Kauboy (May 12, 2014)

In SHTF, apply a tourniquet and accept that you're going to lose that limb.
We're talking medieval medicine here...
Cut if off and cauterize. Far better than gangrene, infection, and death.

Without the proper tools, skill, and setting, there's no saving a severed main artery or the limb it's feeding.


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## SOCOM42 (Nov 9, 2012)

Hemostat, then tie it off.

Tie off the flowing end.

Sometimes it is impossible because the vein or artery has retracted it self unless you can recover it..

At least use a tourniquet to stop the flow. 

I had an artery cut in my lower leg, they applied a tourniquet, went up in the leg with a hemostat and pulled the artery down and tied it off.

I had a shot of morphine but it did not do much for the probing, somewhere along the line I passed out, it was not a major artery.

Today, 5 plus decades later the leg is sensitive to the cold, use an electric blanket to keep it warm.


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## SOCOM42 (Nov 9, 2012)

Eyeball said:


> Do we have to tie off the two open ends of the tube?
> I mean, the two ends are never going to fuse together again are they?


They can do them with what they call microsurgery today.

U Mass med center has done and can do that type of surgery.

They did it with my daughter when she had a abdominal artery rupture from Crones disease

Doctors did a resection with her intestines removing three feet, was in surgical intensive care for two weeks.

She was in the OR for 11 hours.


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## MisterMills357 (Apr 15, 2015)

I have read that Quik Clot can stop arterial bleeding, the granuals or the gauze can both do that. The gauze is good for filling holes, it can be stuffed into them.


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## paraquack (Mar 1, 2013)

Putting in time an emergency room for continuing Ed for my certification, I've seen MDs curse the stuff, QuikClot 
is very difficult to remove from the wound. It definitely prevent you from bleeding to death. Learn some first aid, 
PLEASE. Heavy, direct ressure on the wound, plus raising the extrmity above the heart can do a lot. If not, it's 
time to use a tourniquet.


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## NewRiverGeorge (Jan 2, 2018)

SOCOM42 said:


> Hemostat, then tie it off.
> 
> Tie off the flowing end.
> 
> ...


The movie Blackhawk Down has a scene similar where the artery retracts.


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## Piratesailor (Nov 9, 2012)

Hate to say it but in SHTF, you die. 

Unless you have a nurse or doctor right there that has some experience with this type of injury. 

At best you’d lose the limb. At worse, you’re dead.


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## MisterMills357 (Apr 15, 2015)

paraquack said:


> Putting in time an emergency room for continuing Ed for my certification, I've seen MDs curse the stuff, QuikClot
> is very difficult to remove from the wound. It definitely prevent you from bleeding to death. Learn some first aid,
> PLEASE. Heavy, direct ressure on the wound, plus raising the extrmity above the heart can do a lot. If not, it's
> time to use a tourniquet.


The gauze is difficult to remove? I could see that if it were the granuals.

I know first aid, and all I said was Quick Clot worked.
Their website says that the 3rd generation does not cause burns or exothermic injuries.

This is from an abstract at NIH.
https://pubmed.ncbi.nlm.nih.gov/18404080/

Results: There were 103 documented cases of QuikClot use: 69 by the US military in Iraq, 20 by civilian trauma surgeons and 14 by civilian first responders.

There were 83 cases involving application to external wounds and 20 cases of intracorporeal use by military and civilian surgeons. All field applications by first responders were successful in controlling hemorrhage.

The overall efficacy rate was 92% with eight cases of ineffectiveness noted by physicians in morbid patients with massive injuries when the QuikClot was used as a last resort.

These reported failures were thought to be a result of the coagulopathic state of the patient from massive resuscitation or the inability to get the product directly to the source of hemorrhage.

When the QuikClot was applied on responsive patients, the heat generated by the exothermic reaction caused mild to severe pain and discomfort.

There were three cases of burns caused by the heat generated by the QuikClot application with one case requiring skin grafting. There was one major complication from intracorporeal use caused by scar formation from a foreign body reaction.

Conclusions: QuikClot has been effectively used by a wide range of providers in the field and hospital to control hemorrhage.

https://pubmed.ncbi.nlm.nih.gov/18404080/


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## Old SF Guy (Dec 15, 2013)

I cut my femoral artery once.... I started bleeding out and all I could do was take my belt off and tie a tourniquet. Then I started crawling back to the medics.
It was pretty messy and I was fighting to stay lucid.
after about a 200 yards into my journey, I felt myself slipping into cardiac arrest.
I was pretty sure it ws the end.
But then I remembered my old combat lifesaver training and started doing chest compressions on myself.

after about 10 minutes I stabilized myself and continued on until I got to the medics. They rushed me into surgery and saved my leg.
all I can say is that it was a good thing I was there or I surely would have died...


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## SAR-1L (Mar 13, 2013)

Piratesailor said:


> Hate to say it but in SHTF, you die.


 My first thought, for 95% of people.



MisterMills357 said:


> When the QuikClot was applied to responsive patients, the heat generated by the exothermic reaction caused mild to severe pain and discomfort.


I will take quite a bit of pain over death, though in SHTF, shoot me if I get a tooth infection that abscesses and no anti-biotics.



Old SF Guy said:


> But then I remembered my old combat lifesaver training and started doing chest compressions on myself.


 Tougher than I am.


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## Eyeball (Nov 8, 2020)

In 'The Vikings', Tony Curtis had his hand chopped off, so somebody grabbed a flaming torch off the castle wall to cauterise the stump by presumably making the open ends of the veins shrivel up, is that a good way to stop the bleeding of a severed limb or was it just hollywood hokum?


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## Old SF Guy (Dec 15, 2013)

Eyeball said:


> In 'The Vikings', Tony Curtis had his hand chopped off, so somebody grabbed a flaming torch off the castle wall to cauterise the stump by presumably making the open ends of the veins shrivel up, is that a good way to stop the bleeding of a severed limb or was it just hollywood hokum?


In the movie 007 there was a moon base......in the words of Biden... C'mon man....

you can be a tard or choose to repeat it....don't make me poke you in the ....


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## Eyeball (Nov 8, 2020)

Speaking of Biden and the moon, is he supporting Trump's Space Force, or will he let the Romulans and Borg walk all over him?


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## MisterMills357 (Apr 15, 2015)

Eyeball said:


> Speaking of Biden and the moon, is he supporting Trump's Space Force, or will he let the Romulans and Borg walk all over him?


That is funny. You should post a poll.


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## E-Cric (Dec 2, 2020)

Eyeball, 

You will do no good in any trauma scenario trying to tie off the open ends. As many on here have said, the most important thing to do is apply Direct pressure, assess if a TQ is needed ( Venous or Arterial), and apply the TQ, ETB or pressure dressing. You are correct, the blood vessels will not repair themselves and do require cold steel and bright lights. Unfortunately for us the bleed out time of an untreated Artery is very quick, and there are only a handful of them that we have any hope of mitigating (limbs). 

Hemostats are great and BHD did a great job romanticizing how clamping an artery in a combat scenario can be done, while possible it is extremely difficult. When in doubt remember the basics.


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## paulag1955 (Dec 15, 2019)

Piratesailor said:


> Hate to say it but in SHTF, you die.


Possibly (probably?) the best option.


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## MountainGirl (Oct 29, 2017)

SAR-1L said:


> ...
> I will take quite a bit of pain over death, though in SHTF, shoot me if I get a tooth infection that abscesses and no anti-biotics.
> ...


You can add passing kidney stones to that list.


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## Eyeball (Nov 8, 2020)

E-Cric said:


> Eyeball,
> 
> You will do no good in any trauma scenario trying to tie off the open ends. As many on here have said, the most important thing to do is apply Direct pressure, assess if a TQ is needed ( Venous or Arterial), and apply the TQ, ETB or pressure dressing. You are correct, the blood vessels will not repair themselves and do require cold steel and bright lights. Unfortunately for us the bleed out time of an untreated Artery is very quick, and there are only a handful of them that we have any hope of mitigating (limbs).
> 
> Hemostats are great and BHD did a great job romanticizing how clamping an artery in a combat scenario can be done, while possible it is extremely difficult. When in doubt remember the basics.


Thanks, medics will be worth their weight in gold in a post-apoc world..
In the fictional TV show 'Survivors 1975' (episode 'A Beginning') Greg is sawing a log (below) and somehow manages to slice into his arm but luckily for him the group has a woman doctor who fixes him up good, I don't know the exact details but a needle and thread were mentioned


__
Sensitive content, not recommended for those under 18
Show Content










The full episode is still on youtube,
33:00- the accident
34:10- the non-doctors try to fix it
43:02- new arrival Dr.Ruth gives advice
45:33- seems to have done the trick


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## Eyeball (Nov 8, 2020)

SAR-1L said:


> I will take quite a bit of pain over death, though in SHTF, shoot me if I get a tooth infection that abscesses and no anti-biotics..





MountainGirl said:


> You can add passing kidney stones to that list.


And even migraines can be hell without something like dear old aspirin.
When I first began getting attacks 40 years ago I tried to brave them out without popping aspirins but soon changed my mind because it felt like my head was about to explode and I could only crawl into bed feeling half dead for about 8 hours.
So after that I popped two aspirins the instant I felt an attack coming on and they killed 90% of the headache and I was able to function normally.
Whoever invented aspirins deserves a medal..


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## SAR-1L (Mar 13, 2013)

Eyeball said:


> In 'The Vikings', Tony Curtis had his hand chopped off, so somebody grabbed a flaming torch off the castle wall to cauterise the stump by presumably making the open ends of the veins shrivel up, is that a good way to stop the bleeding of a severed limb or was it just hollywood hokum?


I always defer to experts, and their tools for what you are referring to are much more advanced, like soddering.
https://study.com/academy/lesson/cauterization-in-medicine-definition-uses.html

Your version of a torch would no doubt cause more tissue damage, not to mention expose more damaged tissue to infection if you did succeed, and there is also the risk of death from shock due to trauma to the body. If you didn't know how to sterilize your own equipment and improvised gauze, supplies would likely be hard to find/expensive to trade for within about 3-6 months.


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## bigwheel (Sep 22, 2014)

Eyeball said:


> Do we have to tie off the two open ends of the tube?
> I mean, the two ends are never going to fuse together again are they?


As we learned in Boy Scouts..back before the **** pedophile scout masters showed up you got to shut off the artery which is pumping it out. It seems elementary dear Watson. Where are you from?


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## bigwheel (Sep 22, 2014)

E-Cric said:


> Eyeball,
> 
> You will do no good in any trauma scenario trying to tie off the open ends. As many on here have said, the most important thing to do is apply Direct pressure, assess if a TQ is needed ( Venous or Arterial), and apply the TQ, ETB or pressure dressing. You are correct, the blood vessels will not repair themselves and do require cold steel and bright lights. Unfortunately for us the bleed out time of an untreated Artery is very quick, and there are only a handful of them that we have any hope of mitigating (limbs).
> 
> Hemostats are great and BHD did a great job romanticizing how clamping an artery in a combat scenario can be done, while possible it is extremely difficult. When in doubt remember the basics.


I smell a slab saving fireman around here.


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## Prepared One (Nov 5, 2014)




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## Eyeball (Nov 8, 2020)

Incidentally we can be grateful to hollywood for giving us useful medical tips..
For example in 'The Revenant' (below), a bear gashed di Caprio's throat, so he deals with the injury by-
1- emptying some cartridge powder
2- packing it into the wound
3- taking a brand from the fire
4- and detonating the powder with it to cauterise the wound, a nice clean job..


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## hawgrider (Oct 24, 2014)

I just got a whiff of something from across the field.


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## SAR-1L (Mar 13, 2013)

Eyeball said:


> Incidentally we can be grateful to hollywood for giving us useful medical tips..


Well, the first problem here is this is Leonardo Decaprio, and you are more likely to set your beard and clothing on fire and self immolate. Another thought that crosses my mind is I don't see much blood, so in the words of Montey Python "It is merely a flesh wound", the irony of that scene is that guy was missing full-on limbs from bladed combat.


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## Eyeball (Nov 8, 2020)

Okay muchachos let's have a sitrep-
My thread starter question was- *What if an artery or vein is severed?*

And here's a condensed summary of replies so far (in appropriate blood-red ink haha)-

_Paraquack- "tie off and hope for the best"

Keith9365- "If you take a round to a major artery in a WROL scenario you are going to die plain and simple. Best advice, don't get shot"

Kauboy- "Without the proper tools, skill, and setting, there's no saving a severed main artery or the limb it's feeding"

SOCOM42- "I had an artery cut in my lower leg, they applied a tourniquet, went up in the leg with a hemostat and pulled the artery down and tied it off"

MisterMills357- "I have read that Quik Clot can stop arterial bleeding, the granuals or the gauze can both do that. The gauze is good for filling holes, it can be stuffed into them"

Paraquack- "Heavy, direct pressure on the wound, plus raising the extrmity above the heart can do a lot. If not, it's time to use a tourniquet"

NewRiverGeorge- "The movie Blackhawk Down has a scene similar where the artery retracts"

Piratesailor- Hate to say it but in SHTF, you die.Unless you have a nurse or doctor right there that has some experience with this type of injury.At best you'd lose the limb. At worse, you're dead"

E-Cric- "You will do no good in any trauma scenario trying to tie off the open ends. As many on here have said, the most important thing to do is apply Direct pressure, assess if a TQ is needed ( Venous or Arterial), and apply the TQ, ETB or pressure dressing"

SAR-1L- "..a torch would no doubt cause more tissue damage, not to mention expose more damaged tissue to infection"_

So, correct me if I'm wrong but the blood will be spurting out of the open end like a hosepipe and the victim will bleed out quick unless we tourniqet the limb and get him to a surgical unit where the surgeons can tie off the open end of the artery and save his life and the limb, is that right?

But if there are no surgeons available we'd have to leave the tourniquet on and have to try to tie off the open end with thread, is that right?

PS- i just remembered, there'll be TWO open ends, one above AND one below the sever point, things just got a helluva lot more complicated..


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## Crunch (Dec 12, 2019)

Eyeball said:


> So, correct me if I'm wrong but the blood will be spurting out of the open end like a hosepipe and the victim will bleed out quick unless we tourniqet the limb and get him to a surgical unit where the surgeons can tie off the open end of the artery and save his life and the limb, is that right?
> 
> But if there are no surgeons available we'd have to leave the tourniquet on and have to try to tie off the open end with thread, is that right?
> 
> PS- i just remembered, there'll be TWO open ends, one above AND one below the sever point, things just got a helluva lot more complicated..


A completely severed blood vessel will normally retract and constrict on its own which helps limit blood loss. First aid measures of pressure, elevation, wound packing, and/or a TQ is usually enough to stop the hemorrhaging until natural coagulation does its job and a clot forms. Left unrepaired, for a limb anyway, it's largely a question of whether enough circulation remains afterwards to keep the tissue distal (further from the heart) to the injury perfused. If not, then the tissue slowly dies and gangrene is the result.

Worse maybe is the case where a vessel (especially an artery) is torn or ripped lengthwise but still connected, that's usually when people bleed out because the vessel can't retract and constrict on it's own. In that case, after the 'medic' stops the hemorrhaging then the 'surgeon' has to decide whether to tie (ligate) it or try to repair it. If tying it off, only one end needs to be done, the proximal (closer to the heart) end for an artery and the distal end for a vein.

Chapter 55 in volume 2 of "Primary Surgery" is a great reference to learn more IMO. It's detailed enough to describe the problem(s) and basic procedure(s), but not so complex that it requires a medical degree just to read and comprehend most of it. https://www.ghdonline.org/surgery/discussion/primary-surgery-trauma-volume-2-2/


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## SAR-1L (Mar 13, 2013)

Eyeball said:


> Okay muchachos let's have a sitrep-
> My thread starter question was- *What if an artery or vein is severed?*


As knowledgeable as many of the members of this forum are, have you ever considered getting some formal training or going to a B-CON class?
No offense I just really think based on your posts it would benefit you more than an internet forum based education.

Respectfully.


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## Eyeball (Nov 8, 2020)

SAR-1L said:


> As knowledgeable as many of the members of this forum are, have you ever considered getting some formal training or going to a B-CON class?
> No offense I just really think based on your posts it would benefit you more than an internet forum based education.
> Respectfully.


You're probably right mate, for example this lucky kid was presented to the landlord's daughter in 'The Wicker Man' so she could teach him things; he probably learnt more in a single night with her than with reading dozens of 'how to do it' manuals..


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## MisterMills357 (Apr 15, 2015)

Prepared One said:


>


That was a good episode on SNL, when it was still funny.


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## MisterMills357 (Apr 15, 2015)

Eyeball said:


> Okay muchachos let's have a sitrep-
> My thread starter question was- *What if an artery or vein is severed?*
> 
> And here's a condensed summary of replies so far (in appropriate blood-red ink haha)-
> ...


The reason that I went with Qwik Clot, is because is shold fill up some empty space, and hopefully stop up both ends of an artery.

I have seen a bleed out, and it took about 2 minutes. It is fast.

I would rather have Quick Clot granuals or gauze in me than anything short of a tournaquit.

I don't have a good answer, because applying a tornaquit takes time, even if you are using your own belt.

The patient will probably die when, an artery is cut in two, and retracts.


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## Eyeball (Nov 8, 2020)

MisterMills357 said:


> The reason that I went with Qwik Clot, is because is shold fill up some empty space, and hopefully stop up both ends of an artery.
> I have seen a bleed out, and it took about 2 minutes. It is fast.


Yeah Quick Clot sounds a good idea..


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