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Ann Emerg Med. 2014 Jul;64(1):79-81. doi: 10.1016/j.annemergmed.2013.09.026. Epub 2013 Oct 23.

Temporization of penetrating abdominal-pelvic trauma with manual external aortic compression: a novel case report.

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Lawrence S. Bloomberg Faculty of Nursing, Masters of Nursing, Nurse Practitioner Program Student and Collaborative Program in Resuscitation Science, Faculty of Medicine at the University of Toronto, Toronto, Ontario, Canada.
Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.
Division of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada. Electronic address:


A young civilian man experienced multiple gunshots to the lower abdomen, pelvis, and thigh. These were not amenable to direct compression by a single rescuer. This report outlines the first case in the peer-reviewed literature of manual external aortic compression after severe trauma. This technique successfully temporized external bleeding for more than 10 minutes and restored consciousness to the moribund victim. Subsequently, external bleeding could not be temporized by a second smaller rescuer, or during ambulance transfer. Therefore, we also gained insights about the possible limits of bimanual compression and when alternates, such as pneumatic devices, may be required. Research is needed to test our presumption that successful bimanual compression requires larger-weight rescuers, smaller-weight victims, and a hard surface. It is therefore unclear whether manual external aortic compression is achievable by most rescuers or for most victims. However, it offers an immediate and equipment-free life-sustaining strategy when there are limited alternatives.

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