Update in combined musculoskeletal and vascular injuries of the extremities

Table 1 Hard and soft signs in combined musculoskeletal and vascular injuries of the extremities

Hard signs	Soft signs (or subtle signs)
Active pulsatile or massive bleeding	History of arterial bleeding at the trauma scene
Rapidly expanding or pulsatile hematoma	Proximity-related injury
Bruit/thrill	Neurologic findings from nerve adjacent to a named artery
Evidence of arterial insufficiency and ischemia (6P: Pallor; pain; paresthesia; paralysis; pulseless; poikilothermia)	Hematoma over a named artery
	Diminished unilateral distal pulse