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  » First Aid  »  Amputations
Amputation - the severing of any body part - is a serious medical emergency. Fortunately, the majority of amputations involve only small parts, such as a fingertip rather than arms or legs. In general, when the tip of a finger or toe is cut off, minor bleeding occurs without major blood loss. These cases can generally be managed easily with the application of a pressure dressing and the transportation of the victim and the amputated body part to the hospital. More serious amputations almost always entail significant blood loss and possible shock and other injuries.

TREATMENT
  • If the person loses consciousness, check for a pulse and breathing. If appropriate, administer CPR to maintain an open airway, breathing, and circulation. Do not waste time; this is a life-threatening situation.
  • Control bleeding by applying pressure directly to the wound using gauze pads or a clean cloth and elevate the injured extremity. Once the bleeding has been controlled, place several layers of gauze over the severed area and bandage the layers firmly in place. If the bleeding is not controlled by direct pressure, apply pressure to the large feeding artery above the amputation.
  • Avoid applying a tourniquet except as a last resort in controlling massive hemorrhaging. A tourniquet severely increases the risk of tissue damage, reduces the chances for successful reimplantation of the severed part, and may necessitate further amputation of the injured extremity.
  • Observe for signs of shock and other injuries. Have the victim lie down with legs slightly elevated. Cover to keep him warm.
HOW TO APPLY A TOURNIQUET
  • First make certain that bleeding cannot be controlled with direct pressure or by means of pressure points.
  • Use any flat, 1- or 2-inch-wide piece of cloth long enough to go twice around the arm or leg. Rolled bandaging is ideal, but a belt, scarf, strip torn from a shirt, or other similar material may also serve as a tourniquet.
  • Place the tourniquet just above the edge of the wound. Do not allow it to touch the wound. If the wound is very close to a joint or directly below a joint, place the tourniquet directly above the joint.
  • Wrap the tourniquet tightly twice around the limb and tie a half-knot.
  • Place a short, strong stick, ruler, screwdriver, or similar rigid object on top of the half-knot and tie a full knot over it. Note the time when you apply the tourniquet.
  • Twist the stick until the bleeding has slowed enough to clot. Secure the stick in place.
  • Do not loosen the tourniquet unless a physician tells you to do so.
  • As soon as the bleeding is controlled, check for and attend to any other serious injuries, such as fractures, wounds, or damage to the spine, chest, or abdomen. After tending to these, pick up the severed limb and wrap it, ideally in sterile gauze or a towel moistened with saline solution or water, double wrapped in clean, plastic bags.
Place the wrapped part on ice, if possible. If sterile cloth and plastics are not available, a clean cloth, shirt, or other material can be used.
  • As soon as possible, take the person to the nearest hospital emergency room, preferably to a hospital or medical center that has a surgery team skilled in microsurgery and reimplantation. Advances in reimplantation techniques in recent years have greatly improved the chances of successfully rejoining severed limbs.