Vascular, tendon and nerve injuries

In severe haemorrhage:

• control with local pressure (not tourniquet)
• elevate the arm and hand
• do not use artery forceps blindly (may compromise repair)
• refer for vascular reconstruction

Suspect nerve injury and refer:

• if wound overlies a known nerve
• all cut wrists
• if sensation is altered distally (some sensation often remains initially
• if severe pain or an electric sensation at the time
• if there is arterial bleeding where the artery is known to run with a major nerve eg ulnar nerve at the wrist

Refer tendon injuries to A/E dept (see trauma to ligaments)