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What to do in case of amputation |
Causes of amputation
Amputations are generally due to laboral
accidents (in factories, construction sites, agriculture,...) or
traffic accidents; less commonly, they are due to other
types of accidents (domestic, adventure sports ,...).
What to do
 Immediately
after the amputation
- First, maintain the
patient hemodynamically stable; in other words,
control the bleeding.
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- Stop bleeding by compressing
the bleeding area.
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Avoid torniquets or other methods that
aim to stop bleeding but compromise the
conservation of the blood vessels: only use
these methods in cases of heart or respiratory
failure.
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- Venous
access and hemodynamic stabilization,
with plasma expanders because patients sometimes
have bled severely and can enter shock and even
die, even when it the situation doesn't seem so
serious at first.
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- Cover the victim with a
black to prevent the loss of body heat.
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- Wash the stump with
saline solution and cover it with a
semi-compressive bandage. This will usually be
enough to stop the bleeding.
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- Was the amputated
segment with saline solution and wrap it with
bandages that have been moistened with saline
solution. Place the amputated segment in a
plastic bag and then in a container with ice and
water and close the lid tightly. This will keep
the temperature at 4 ºC and
avoid freezing.
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Avoid direct contact betwee the amputated
fragment and the ice--freezing will make reimplantation
inviable.
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In cases with subtotal amputations1,
avoid ice and the rotation of fragments.
1
Complete traumatic amputation is
defined as the total separation of a segment or member
from the rest of the body. In subtotal or partial
amputation, some of the connecting soft tissue remains,
but the main vessels and at least 75% of the soft
tissues are completely cut.
Transfer
to the Hospital
- Transfer the patient to the
nearest hospital as soon and as fast as possible,
because it is essential to maintain the patient
stable.
At
the Hospital
- Preoperative workup (blood tests
including coagulation, ultrasonography, chest X-ray,...)
- Initiate administration of
analgesics and serotherapy
- Hemodynamic stabilization
- Initiate antibiotic prophylaxis by
administering 2g IV amoxicillin-clavulanic acid
followed by 1g/8h (if the patient is allergic: IV clindamycin 300mg/6h)
- Vacuna antitetànica i toxoide antitetànic (500UI)
- Avoid heparinization
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Responsible for the information:
Dr. Jorge Serrano - jserrano@tauli.cat
Hospital de Sabadell's Traumatology and Orthopaedics Department
Last update: 15/12/2008 |
