An injury to the femoral artery is a severe medical emergency. This major blood vessel, located in the thigh, carries a substantial volume of blood, meaning any damage can lead to rapid and extensive blood loss. While dangerous, survival is possible with immediate intervention and prompt professional medical care.
The Femoral Artery’s Role
The femoral artery is a major blood vessel extending from the upper thigh near the groin to the back of the knee. It branches off the external iliac artery and serves as the primary conduit for oxygen-rich blood to the entire lower limb. This artery also has branches, such as the deep femoral artery, which supplies blood to the hip, buttocks, and deep thigh tissues.
An injury to this artery is immediately life-threatening due to the volume and pressure of blood it carries. If severed or significantly damaged, blood can rapidly lead to massive hemorrhage. This swift blood loss can quickly cause hypovolemic shock, a condition where the body loses so much blood or fluid that the heart cannot pump enough blood to the body, leading to organ failure and death.
Factors Affecting Survival
Several elements significantly influence the outcome. The precise location and depth of the wound play a substantial role; injuries higher up in the thigh, closer to the torso, are more dangerous due to the larger diameter of the artery and the greater volume of blood flow. Whether other structures, such as veins or nerves, are also damaged can complicate the injury. For instance, if the femoral vein, which runs alongside the artery, is also injured, blood loss can be even more substantial.
The individual’s overall health and their blood’s clotting ability are also influential factors. A person with pre-existing clotting disorders or who is on anticoagulant medications may experience more severe and prolonged bleeding. The immediate availability of assistance and the swiftness of aid impact survival rates. Time to definitive surgical treatment is a predictor of limb amputation rates; delays of more than six hours significantly increase the risk.
Immediate Life-Saving Actions
Controlling bleeding requires immediate action. The primary and most effective method for controlling severe external bleeding is direct pressure on the wound. This involves using a clean cloth, gauze, or even a bare hand to press firmly and continuously on the injury site. The goal is to compress the damaged blood vessels and promote clotting.
Maintaining steady pressure for at least five to ten minutes without interruption is necessary to stop bleeding by promoting clotting. If the initial material becomes soaked with blood, additional layers should be placed on top without removing the original dressing. Elevating the injured limb above the level of the heart, if possible and if there is no suspected bone fracture, can also help reduce blood flow to the area.
If direct pressure alone is insufficient to control severe, spurting, or pulsating bleeding, a tourniquet may be necessary as a last resort. A tourniquet should be placed two to three inches above the wound, between the injury and the heart, and tightened until the bleeding stops. It is important to note the time of tourniquet application, as it should not be left in place for longer than two hours if possible. Simultaneously, calling emergency services immediately is important, as professional medical attention is required for survival.
Professional Medical Intervention and Recovery
Upon arrival at a medical facility, patients require immediate and specialized professional medical intervention. Emergency surgery to repair the damaged artery is often the first course of action. This procedure, known as endarterectomy or bypass, involves repairing the artery, sometimes using a synthetic patch or a section of vein from another part of the body to restore blood flow. Blood transfusions are commonly administered to replace lost blood volume and stabilize the patient’s condition.
Post-operative care involves close monitoring for potential complications. These can include wound infections, which may require antibiotic treatment or further surgical cleaning. There is also a risk of arterial thrombosis, where a blood clot forms within the repaired artery, or nerve damage depending on the extent of the initial injury.
Limb ischemia, a lack of blood flow to the limb, can occur if the repair is not fully successful or if complications arise. Long-term rehabilitation, including physical therapy, may be necessary to regain full function of the affected limb. Prompt and effective medical care is the primary determinant for a positive outcome and recovery.