AMPUTATIONS
ALL LEVELS
DESIGNATION OF CONDITION
Characterized by partial or complete dissection of body limbs or tissue
EMPHASIS ON PATIENT CARE
Control hemorrhage; maintain adequate perfusion and oxygenation; preserve severed body parts; expedite transport to definitive care
1. Primary Management - Assess airway, breathing and circulation and manage as indicated.
a. Apply direct pressure and wound packing
b. Apply tourniquet for hemorrhage that is anatomically amenable to tourniquet application
2. Secondary Management - History, physical exam, vital signs
a. Cover remaining part with sterile dressings, saturate with saline, cover with dry dressings, and elevate the injured extremity.
b. Wrap severed part in sterile gauze, preserving all amputated material. Dampen gauze with sterile saline. Place in a watertight container, place container in ice water, if available. DO NOT FREEZE OR USE DRY ICE.
c. Partial amputations should be dressed and splinted in alignment with the extremity to assure optimum blood flow.
d. Avulsed teeth should be wrapped in damp gauze for later insertion.
3. Rapidly transport the patient and readily available amputated tissue to appropriate medical facility. Consider the use of aeromedical evacuation early to expedite the transport process to definitive care.
AEMT / PARAMEDIC
1. In route, initiate IV/IO access, may use one or two large bore IV (determined by patient condition) of an isotonic fluid, infused at flow rate to maintain adequate end organ perfusion.
2. For use of analgesics, see Pain Management Treatment Guidelines.
ALL LEVELS
DESIGNATION OF CONDITION
Characterized by partial or complete dissection of body limbs or tissue
EMPHASIS ON PATIENT CARE
Control hemorrhage; maintain adequate perfusion and oxygenation; preserve severed body parts; expedite transport to definitive care
1. Primary Management - Assess airway, breathing and circulation and manage as indicated.
a. Apply direct pressure and wound packing
b. Apply tourniquet for hemorrhage that is anatomically amenable to tourniquet application
2. Secondary Management - History, physical exam, vital signs
a. Cover remaining part with sterile dressings, saturate with saline, cover with dry dressings, and elevate the injured extremity.
b. Wrap severed part in sterile gauze, preserving all amputated material. Dampen gauze with sterile saline. Place in a watertight container, place container in ice water, if available. DO NOT FREEZE OR USE DRY ICE.
c. Partial amputations should be dressed and splinted in alignment with the extremity to assure optimum blood flow.
d. Avulsed teeth should be wrapped in damp gauze for later insertion.
3. Rapidly transport the patient and readily available amputated tissue to appropriate medical facility. Consider the use of aeromedical evacuation early to expedite the transport process to definitive care.
AEMT / PARAMEDIC
1. In route, initiate IV/IO access, may use one or two large bore IV (determined by patient condition) of an isotonic fluid, infused at flow rate to maintain adequate end organ perfusion.
2. For use of analgesics, see Pain Management Treatment Guidelines.