Evidence-Based Management of Acute Hand Injuries in Urgent Care (Trauma CME)

Points & Pearls Excerpt

• Most bleeding due to hand injuries can be controlled with direct pressure. If direct pressure fails to control bleeding, a tourniquet or inflated blood pressure cuff can provide temporary hemorrhage control while emergent ED transfer is arranged.
• Hard signs of vascular injury such as bright-red pulsatile bleeding; expanding hematoma; a cold, pulseless extremity; or a palpable thrill require ED transfer and consultation with a vascular surgeon.
• The motor and sensory function of the radial, median, and ulnar nerves may be rapidly assessed with a set of simple maneuvers. (See Figure 3 and Figure 4.)
• Hand flexor tendons (FDP, FDS) are assessed individually. (See Figure 5.)