Injury to an anatomically associated nerve.
+Hypotension.
+Associated fracture.
+A palpable thrill.
+Proximity to a major vessel.
Hard signs of peripheral vascular injury include: a pulse deficit, pulsatile bleeding, an expanding hematoma, an audible bruit, a palpable thrill, or distal ischemia. Soft signs include a stable hematoma, injury to an anatomically related nerve, unexplained hypotension, a history of hemorrhage, proximity to a major vascular structure, or a complex fracture.