Hemostasis – Temporary Hemostasis
What is Hemostasis?
Hemostasis refers to the body’s physiological process (or surgical techniques) used to stop bleeding.
Temporary Hemostasis – Definition
Temporary hemostasis refers to emergency or provisional measures used to control bleeding until definitive surgical repair is possible.
These are crucial in trauma, accidents, or pre-hospital settings.
Basic Principles of Temporary Hemostasis
Fast, non- invasive or semi- invasive
Must buy time for proper surgery or definitive control
Aim is to reduce blood loss, maintain hemodynamic stability, and prevent shock
Types of artifical hemostasis: • Non surgical: Vasoprotective substanced (e.g. vitamin C) Vasoconstrictors (adrenalin, noradrenalin) Anti- thrombocytoytics Coagulants Antifibrinolytics
Techniques of Temporary Hemostasis
1. Digital Compression
Simple but effective method, pressing artery with fingers
Two types:
- In loco laesionis: at the site of injury
- In loco selectionis: at a more proximal control point
Common arterial sites:
A. subclavia (above clavicle)
A. carotis communis (neck)
A. axillaris (beneath armpit)
A. femoralis (inguinal region)
2. Compressive Bandage
Elastic or gauze bandage tightly wrapped over a wound
Applied directly over bleeding site to tamponade the vessels
Often used for venous or capillary bleeding
3. Tourniquet Application
Compresses entire limb circulation to stop arterial flow
Types:
- Esmarch band (rubber tourniquet developed by Friedrich von Esmarch)
- Manual or pneumatic tourniquets
Must be applied proximal to the bleeding site
Used only for short durations (≤ 2 hours) to avoid ischemia and nerve damage
4. Maximal Flexion / Limb Positioning
Adelmann’s method: full flexion of the limb to kink the artery and stop flow
Especially useful for popliteal or cubital fossa bleeding
5. Tamponade
Packing the wound with gauze or hemostatic materials
Especially useful in:
- Deep cavity wounds
- Neck
- Axilla
- Groin
Can be combined with direct pressure or bandage
6. Catheter- Based (Intravascular) Techniques
After Seldinger technique via the femoral artery, catheter can introduce:
- Hemostatic agents
- Gel foam / embolic particles
- Used in interventional radiology for inaccessible bleeds
Key Considerations
These methods do not replace surgical control.
Must always monitor for distal pulse, skin color, and time applied (especially for tourniquets).
Remove tourniquet slowly, under medical supervision.