A trauma nurse outlines first aid care for traumatic amputation and methods to protect the first responder from unnecessary injury or blood exposure. In preparation, have clean latex or non-latex gloves in one’s purse, car and home first aid kits (replacing them yearly); sun glasses or ski goggles, and a scarf or similar item that can be used as a face shield to protect from blood spatters. 

Tend to the victim first, then deal with the severed body part.  Turn off machinery if there is any further risk to the victim or helper. An alert victim can apply clean, dry material with firm pressure while the responder quickly dons protective gloves and  glasses/face cover.  The victim should lie down with legs elevated if he feels faint or bleeding is severe (and no apparent head injury). 

Assess the victim for high priority conditions (i.e., airway, breathing).   Assess the amputation site.  Apply direct pressure to the wound with dry dressings and elevate the injured limb to a level above the heart. Sterile gauze pads are best, but any clean, dry item (towel, clothing, feminine sanitary pads) can be used.  If bleeding is not controlled, add direct pressure over the arterial pulse point proximal to the wound. Dry dressings are added atop blood-soaked cloths rather than disrupt any clotting. If available, use an elastic bandage or blood pressure cuff to add pressure proximal to the wound.  A tourniquet is only indicated for life-threatening situations, but prepare for such in the event other measures do not control bleeding.

Monitor vital signs. Determine the time and cause of injury and pertinent medical history (other conditions, medications that increase the risk of hemorrhage – including aspirin and supplements).

If the amputation is incomplete, position the dressings in a manner that also splints the injured body part.  If it is totally severed, wrap the part in a clean, dry dressing, and place it in a sealable plastic bag.  Immerse the bag in a larger bag or container with an ice slurry (3 parts water to one part ice).  Keep the severed part from freezing or getting wet, and make sure it accompanies the injured person to emergency care.

Pertinent information to report includes the nature/cause and time of the injury, all first aid measures including self-care before others came to help, assessment, including responses to first aid measures, and how the amputated body part was handled. 

(Laskowski-Jones L. Nursing2006;36(4):50-52.)

Comment:  For your annual staff first aid review. This added good tips for protecting oneself from unnecessary blood exposure.  Include sealable bags in your car first aid kit.
--J.O.