Pressure Points Technique for Traumatic Proximal Axillary Artery Hemorrhage: A Case Report

Guy Avital, Chaim Greenberger, Asaf Kedar, Regina Pikman-Gavriely, Maxim Bez, Ofer Almog, Avi Benov

Prehosp Disaster Med. 2022 Dec 16:1-4.

Introduction: While the pressure points technique for proximal hemorrhage control is long known, it is not recommended in standard prehospital guidelines based on a study showing the inability to maintain occlusion for over two minutes.

Main symptom: This report details a gunshot wound to the left axillary area with complete transection of the axillary artery, leading to profuse junctional hemorrhage and profound hemorrhagic shock.

Therapeutic intervention: Proximal pressure of the subclavian artery was applied against the first rib (the pressure points technique) and maintained for 28 minutes.

Outcomes: Cessation of apparent bleeding and excellent, enduring physiologic response to blood transfusion were observed.

Conclusion: The pressure points technique can be life-saving in junctional arterial hemorrhage and should be reconsidered in prehospital guidelines.