Emergency Care for an Accidental Amputation

Amputation is the removal of a body part. This can be done by a doctor in a hospital setting, such as when a foot must be amputated because of diabetes complications. But amputation may also happen during an accident.

An amputation may be complete (the body part has been completely removed) or partial (some of the body part has been removed, but some of it remains attached to the rest of the body).

Sometimes amputated parts can be successfully reattached. The success of the reattachment depends on:

• What body part was amputated.
• The condition of the amputated part.
• The time since the amputation happened and the person got medical care.
• The general health of the injured person.

Take these actions to help someone who has had an accidental amputation.

1. Call emergency services.
2. Stop the bleeding. A complete amputation may not bleed very much. The cut blood vessels may spasm, pull back into the injured part, and shrink. This slows or stops the bleeding. If there is bleeding, do the following:
   • Wash your hands well with soap and water, if available.
   • Put on medical gloves before applying pressure to the wound. If gloves are not available, to apply pressure you can:
     • Use many layers of fabric, plastic bags, or whatever you have between your hands and the wound.
     • Have the person hold their own hand over the wound, if possible, and apply pressure to the injured area.
     • Use your bare hands to apply pressure only as a last resort.
   • Have the injured person lie down with the area propped up (elevated).
   • Remove or cut clothing from around the wound.
   • Remove any jewelry from the general area of the wound so if the area swells, the jewelry will not affect blood flow.
   • Remove any visible objects from the wound. Do not attempt to clean out the wound at this point.
   • Press firmly on the wound with gauze or a clean cloth. If you don't have gauze or a clean cloth, use the cleanest material available.
     • If there is an object in the wound, apply pressure around the object, not directly over it.
   • Apply steady, direct pressure for 10 to 15 minutes. This can seem like a long time.
     • Resist the urge to peek after a few minutes to see whether bleeding has stopped.
     • If blood soaks through the cloth, apply another one without lifting the first.
     • Note: If you have been trained on how to use a tourniquet correctly, you can use that method for severe bleeding.
3. If needed, continue direct pressure and get help.
   • If moderate to severe bleeding has not slowed or stopped, continue direct pressure while getting help.
   • Mild bleeding usually stops on its own or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for a little longer.
   • Do all you can to keep the wound clean and avoid further injury to the area.
4. Watch for signs of shock. The trauma of the accident or severe blood loss can cause the person to go into shock.
5. Care for the amputated body part.

• If the body part was completely amputated:
  • Recover the amputated body part, if possible, and transport it to the hospital with the injured person. If the part can't be found right away, transport the injured person to the hospital and bring the amputated part to the hospital when it is found.
  • Gently rinse off dirt and debris with clean water, if possible. Do not scrub.
  • Wrap the amputated part in a dry, sterile gauze or clean cloth.
  • Put the wrapped part in a plastic bag or waterproof container.
  • Place the plastic bag or waterproof container on ice. The goal is to keep the amputated part cool but not to cause more damage from the cold ice. Do not cover the part with ice or put it directly into ice water.
• If the body part was partially amputated:
  • Elevate the injured area.
  • Wrap or cover the injured area with a sterile dressing or clean cloth.
  • Apply pressure if the injured area is bleeding. This will slow the bleeding until the person receives medical care. You don't want to cut off the blood flow to the partially amputated part, so pressure needs to be light—just enough to slow blood loss.
  • Gently splint the injured area to prevent movement or further damage.