Emergency Care for an Accidental Amputation

Topic Overview

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 is completely removed or cut off) or partial (much of the body part is cut off, but it remains attached to the rest of the body).

In some cases 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 and receiving medical care.
• The general health of the injured person.

What to do

If you witness an amputation:

• Call emergency services.
• 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:
  • If available, wash your hands with soap and water and put on latex gloves. If gloves are not available, use many layers of clean cloth, plastic bags, or the cleanest material available between your hands and the wound.
  • Have the injured person lie down and elevate the site that is bleeding.
  • Remove any visible objects in the wound that are easy to remove, and remove or cut clothing from around the wound.
  • Apply steady direct pressure for a full 15 minutes. If blood soaks through the cloth, apply another one without lifting the first. If there is an object in the wound, apply pressure around the object, not directly over it.
  • If moderate to severe bleeding has not slowed or stopped, continue direct pressure while getting help. Do all you can to keep the wound clean and avoid further injury to the area.
  • 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 up to 45 minutes. Use the Check Your Symptoms section to determine your next steps.
• Check and treat for shock. The trauma of the accident or severe blood loss can cause the person to go into physiologic shock. Signs of physiologic shock include:
  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like the person may pass out.
  • Feeling very weak or having trouble standing up.
  • Being less alert. The person may suddenly be unable to respond to questions, or he or she may be confused, restless, or fearful.
• Emotional stress from the event may cause symptoms such as lightheadedness or fainting. This is sometimes called "emotional shock." Lightheadedness and fainting from emotional stress may be confused with physiologic shock.

Care for the completely amputated body part

• 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.

Care for the part of the body where the amputation happened

• Stop the bleeding.
• Elevate the injured area.
• Wrap or cover the injured area with a sterile dressing or clean cloth until medical treatment is received.

Care for a partially amputated body part

• 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.