Bleeding to Death from a Scalp Laceration – Part 2
Temporary control of a bleeding scalp laceration is usually obtained by compression of scalp against the skull. Direct finger pressure over the bleeding areas will stop the bleeding until more definitive means can be accomplished. Lack of enough hands to provide sustained and continous pressure and
fracture of the underlying skull are common reasons to use a temporary hemostatic device.
One type of hemostatic device often used is the Rainey clip. These are spring-loaded clips designed to stop bleeding (hemostasis) from scalp flaps during elective craniotomies (opening of the skull). If Rainey clips are not available, approximating the lacerated edges with a running, locked baseball stitch usually will slow bleeding significantly. If time is critical, bleeding scalp edges can be reapproximated and stapled.
Some scalp lacerations may be difficult to control in the emergency room and require a trip to the operating room, especially if the patient is hemodynamically compromised. Lacerations associated with an underlying fracture must be managed in the operating room.
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