Figure clamp

Figure Legend: The drama of hemorrhage may lead to unwise maneuvers in the emergency room.  Blind clamping of bleeding structures without proximal tourniquet control is risky and may compound injury.  (1,2) This patient had inadequate control of bleeding despite multiple clamps placed by an inexperienced physician, who was successful in clamping the ulnar nerve and flexor carpi ulnaris tendon, but failed to control the large subcutaneous vein which was actually responsible for the bleeding.  Continued hemorrhage is often due to partial vessel lacerations, as in this partial laceration of the cephalic vein (3) and this partial laceration of the radial artery (4).  Ligation of structures without adequate visualization in the emergency room is also problematic as in this patient who had inadvertent ligation of the ulnar nerve within Guyon's canal.
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