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Hard Signs of Vascular Injury Checklist
Vascular Evaluation
Hard Signs (Mandatory OR)
Soft Signs (Imaging Indicated)
Select Findings
Toggle the clinical findings to determine the next step in vascular management.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
In the setting of penetrating or blunt extremity trauma, vascular injuries are categorized into "Hard Signs" and "Soft Signs." The presence of any single Hard Sign is 92-95% predictive of a major vascular injury requiring operative repair. In these cases, the delay caused by obtaining a CTA (Computed Tomography Angiography) can lead to irreversible limb ischemia or exsanguination.
History of hemorrhage, Proximity to vessel, Stable hematoma, Nerve deficit
CTA or ABI first
Asymptomatic
No physical findings, distal pulses intact
Observation or ABI
Related Scores in Practice
In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Ankle Brachial Index (ABI), Mangled Extremity Severity Score (MESS), or the AAST Vascular Organ Injury Scale to formulate a comprehensive care plan.
