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Eagle,
Was the leg amp so high that a tourniquet didn't have enough tissue left to cinch down on and compress the vessels? (higher than the one in the picture?)
Also, depending on the injury, the vessels may be visible and clampable. The femoral vessels at this level ride in a sheath and if you follow the anatomy, you might (??) be able to reach up the sheath and pull them down and if not, pack the track of the vessels as tightly as you can with a kerlex, israeli bandage, gauze, etc which can compress the vein which is the usual suspect in continued bleeding...the artery generally will spasm and stop on its own. You are right that there are dozens of muscle bleeders, some of pretty good size that also have to be dealth with....
Best bandage I saw for a really high thigh amp was 2 israeli bandages wrapped around the opposite hip and back around the amp site so that is crosses over and around the other side to create as much pressure and compression to the amp site since a tourniquet could not be used.
ss
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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