Measuring the circumference of an extremity or the neck is a low-tech way for early detection of post-traumatic or postsurgical bleeding. If there is bleeding, then the circumference should gradually increase.

Patient selection: recent trauma or surgery involving the neck or an extremity



(1) Measure the circumference of target site in centimeters using a tape measure.

(2) Track the measurements over time.

(3) Monitor the site for other signs of bleeding (discoloration, change in function, etc)


change in circumference over time =

= ((current circumference) - (baseline circumference)) / (baseline circumference)



• In the absence of hemorrhage, the circumference should be stable.

• In the presence of bleeding, the circumference should gradually increase.

• Some trigger should be used (increase from 5-10%) to trigger a further evaluation.


Sources of variation:

(1) differences in where the measurements are taken. von Ahemen et al marked the initial path of the tape measure with an indelible marker.

(2) if the tape used for measurement can be stretched.

To read more or access our algorithms and calculators, please log in or register.