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The aterial system is a low-pressure system is presented in comparison of aortic pressure to a common city water supply. The pressure in city water pipes is around 45 PSI (pounds per square inch), yet with thumb pressure by itself you can simply end water coming from a hose. When you take into account that regular pressure in the arterial system, comparable is only 3 P.S.I, it's quite obvious that you can control the bleeding in any major vessel with very gentle pressure. A heavy hand applying enough pressure to hault a 45 P.S.I hose when put on a 1.5 P.S.I bleeder may further lacerate the vessel & and may add to a larger problem as opposed to solving it.

To control massive bloodflow:
1. Place your finger on a bleeding point and extract the small amount pressure thats necessary to hault the bleeding. While one finger maintians the bleeding, Be alert to analyze the area around you and prepare for definitive control of the hemorrhage. There is no place for frenzy and hurry at this time, to control the bleeding use finger pressure could be maintained for several hours if possible.
2. Make the exposure much better. Putting a clamp or any other type of vascular inside a hole to get a hold of massive bleeding damage all in the structures, As a result in mismanage placement while clamping or more cutting of blood vessels. You can get better exposure with proximal and distal cutting all along the blood vessel that's bleeding several CM's distance away from the bleeding.
3. Clamp down on the vessel that's bleeding on each side of the bleeding point and remove the hemostatic finger.
4. Repair or ligate the involved vessel.

Clamps can hold tissue securely over a prolonged period, fatique can come to be where static use of forceps happens. If you place Kocher clamps placed on the edges can hope show surfaces during spreading of adhesions. It's crutial to use a clamp to the gallbladder to stabile it also adjust the position during dissection. The choice of the clamps should be based upon the the fragility of the tissue and how much traction is necessary. Allis clamps & Kocher, with small jaws which give great pressure to a small area, is avaible for use of fascia but could be fatal for a lung or a bowel, you can prevent crushing or tearing by using lung clamps or Babcocks.

A vascular clamp like Atraumatic clamp is made to grab lightly in the most controling way, but gives the least force. Most vascular clamps have fine teeth, so that even with small pressure the jaws will not slid off the vessel. The fine teeth exerting pressure the jaws will not slip off the vessel. The fine teeth exerting pressure on a small portion of the circumference leaves most of the wall between the teeth under no crushing pressure at all. Vascular clamps are the best used when the operator has his own familiar surgical instruments. He can use the clamps with minimal pressure and still feel confident, doing this minimizes the cutting or crushing a vessel wall.