Femoral Artery Laceration: Emergency Recognition and Response

Anatomy

The femoral artery runs through the femoral triangle (mid-inguinal point) down the medial thigh. It is the main arterial supply to the lower limb. Large caliber → rapid exsanguination if severed.

Mechanisms of Injury

• Penetrating trauma (knife, gunshot).
• Blunt trauma (fracture displacement, crush).
• Iatrogenic (cardiac catheterization, arterial line).

Signs & Symptoms

• Pulsatile, bright red bleeding (may be concealed in thigh).
• Expanding hematoma, palpable thrill/bruit.
• Pallor, pulselessness, paresthesia, paralysis, poikilothermia (5 Ps) distal to injury.
• Hypovolemic shock: tachycardia, hypotension, altered mental status.

Immediate First Aid

1. Call 911.
2. Direct pressure proximal to wound (femoral triangle).
3. Elevate leg.
4. If uncontrolled: apply tourniquet high on thigh (commercial or improvised); note time.

Definitive Care

Emergency surgical exploration, vascular repair (primary anastomosis, interposition graft), fasciotomy if compartment syndrome suspected.