Accidental Amputation - What to Do in an Emergency
Knowing what to do in the case of accidental amputation is essential, especially if you work with machinery or live on a farm. Following the correct steps immediately can prevent severe blood loss and can also increase the chances of saving the body part that was accidentally severed.
It goes without saying that, in the case of an accidental amputation, you should call the emergency services right away. Then, take immediate action to stabilize the patient and the severed body part to ensure the best possible outcome.
Emergency Care for an Accidental Amputation
If you or somebody you know suffers an accidental amputation, there are two clear priorities; asking for emergency assistance and stopping the bleeding. Take the following steps to maximize the chances of saving the person’s life, and—if possible—the limb:
1. Call Emergency Services
Do this immediately. In the United States, call 9-1-1.
2. Stop the Bleeding
Take immediate and decisive action if a person accidentally amputates a body part because severe bleeding is life-threatening. You may find that a complete amputation (a body part that has been completely removed or cut) doesn't bleed much. This is a bodily response to the trauma in which cut blood vessels shrink to prevent bleeding out. However, if there is more than a slow trickle of blood, take the following steps:
- If available, locate a bleeding control kit and put on sterile gloves before touching the wound. Do not waste time washing your hands. Keep the wound as clean as possible while acting quickly.
- Help the injured person lie down, and elevate the injured area above the head.
- Rip or cut any clothing that’s surrounding the wound.
- Apply steady direct pressure on the wound for a minute or so with gauze or folded clothing. If the material you use gets soaked through, add more without releasing the pressure. If there are any objects in the wound that you can't remove, apply pressure around them. The priority must be to maintain pressure on the wound without causing further injury until the person receives medical care. If the bleeding hasn't stopped after a minute or two and the injury is located on an arm or leg, you’ll need a tourniquet.
If the Bleeding Does Not Stop After Elevating the Wound and Applying Pressure
Apply a tourniquet as soon as possible if the injury is to an arm or leg. A tourniquet should be applied above the wound, between the wound and the heart. It is crucial to act quickly if you see that the bleeding isn't abating after elevating the wound and applying pressure. A person with an arterial bleed can bleed out in a matter of minutes, so apply a tourniquet as soon as possible.
If the Wound Is in a Place in the Body Where a Tourniquet Can’t Be Applied
A hemostatic dressing will also help stop bleeding by encouraging the blood to clot. Push it into the wound and maintain pressure for at least three to five minutes. Never apply hemostatic gauze to an eye or near the brain, such as near a severed ear or nose.
In the Case That the Wound Stops Bleeding
Mild bleeding should stop after around 15 minutes but may trickle for up to 45 minutes. If there is no sign of severe bleeding (blood that’s oozing, flowing, or squirting out):
- Cover the wound with a sterile dressing or any clean material you can find until professional help arrives to provide medical treatment.
- The patient may be in a state of shock due to the trauma of the injury they have sustained. Check for signs of shock, and try to treat it (more on this below).
3. Care for the Amputated Body Part
Caring for the amputated body part depends on whether it has been fully or partially amputated.
If the Body Part Is Completely Amputated
- The body part needs to travel with the injured person to a hospital; recover it if possible. If you can't find it, or it's hard to recover, try to transport it to the hospital as soon as you can.
- Gently rinse excess dirt or debris from the body part with clean water, but only rinse it; don't scrub or disturb the body part more than necessary.
- Transport the amputated part in a dry, sterile dressing or clean cloth, wrapped in a waterproof container or plastic bag.
Please note: Transport the plastic bag or waterproof container containing the body part on ice. Don't cover the body part with ice or submerge it in ice water as this can cause more damage. The body part should remain clean, cold and dry.
If the Body Part Is Partially Amputated
If the body part is only partly amputated, take the following steps:
- Elevate the injured area without moving it too much.
- Cover the injured area with a sterile gauze or clean cloth.
- Apply light pressure if the injured area is bleeding. While you want to slow blood loss, pressure needs to be light if the body part is still attached, to maintain blood flow to the partially amputated part.
- Try to gently splint the injured area to prevent unnecessary movement, which can further damage the area.
4. Look for Signs of Shock
Shock happens when there is a sudden drop in blood flow throughout the body. Shock is a serious condition because when a person is in shock, their organs don't receive enough blood or oxygen. Shock therefore must be treated quickly or it can lead to permanent organ damage. In extreme cases, shock can even lead to death.
How to Recognize if Someone Is in Shock
Symptoms may change from person to person but may include:
Changes to the Skin:
- Cool, clammy skin
- Pale or ashen skin
- A gray or bluish tinge to the lips or fingernails
Changes in Breathing:
- Rapid pulse
- Rapid breathing
- Nausea or vomiting
- Enlarged pupils
- Weakness or fatigue
- Dizziness or fainting
- Anxiousness or agitation
What to Do if Someone Goes into Shock While Waiting for the Emergency Services
Take the above steps to stop the bleeding first. In the case that you have followed all the steps but emergency help doesn't come before the injured person shows signs of shock:
- Begin CPR if the person shows no signs of life: is not breathing, or moving.
- Make the person comfortable by loosening tight clothing. Cover them with a blanket or whatever you have on hand to prevent them from getting cold.
- Don't let the person eat or drink anything.
Quick and Decisive Action Saves Lives
When treating someone with an accidental amputation, taking swift and decisive action with the emergency medicine techniques we’ve described in this article could save their life. It will also raise the chances of being able to save the limb. Your absolute priority must be to stop the bleeding as soon as possible.
Though medical advice is clear on the steps to take, it helps to review the steps regularly as accidental amputation can happen at any time and in any place. And while you might need to improvise to a certain extent with the materials that are available on the scene, purchasing a trauma kit ahead of time will ensure you have the most effective bleeding-control products on hand when you need them most.