STEP 2Manual compression of the liver

In case of active hemorrhage from the liver, the surgeon or ideally the assistant performs initial tamponade by manual compression for at least 10min. Then, two situations can be found:

1. When the hemorrhage can be controlled by manual compression, a competent team is available for appropriate assessment, and the patient is hemodynamically stable without hypothermia or acidosis, a one-step intervention leading to definitive surgical repair can be decided (see step 3).

2. When the hemorrhage is not controllable and hemodynamic instability, hypothermia, acidosis and coagulopathy occur, a liver packing (see step 9) with or without vascular control (see step 10) needs to be performed.

Compression Liver Control Hemorrhage

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