Traumatic amputation (Severe Extremity Vascular Trauma) involves a loss of the arms, legs or any body part because of an accident or injury. Traffic accidents are the most common cause of traumatic amputation. Upper limb (arms, fingers) amputations accounted for the vast majority (68.6%) of all trauma-related amputations occurring during the study period.3 Motorcycle and bicycle riders are also at high risk for this injury.1
HOW IT IS SUSTAINED
The blood vessels, both arteries and veins, appear to have some flexibility, which results in fewer incidences of blunt injuries to the extremities (arms and legs) following trauma. The walls of blood vessels protect the patient from both stretch-type injuries and minor stab wounds, which heal gradually in most cases. Moreover, the smooth muscle layer in the vessel walls also offers mild protection from traumatic amputation or even death due to ongoing hemorrhage.2
The fingers, toes, arms and/or legs completely or partially severed from the rest of the body with severe pain and bleeding are obvious symptoms of traumatic amputation at the site of a road accident.3
In cases of traumatic amputations, medical work-up must be done immediately so that there is more probability that the severed body part can still be reattached. The first aid goal is the same as open wounds: to control massive loss of blood.
- First and foremost, the person must be calmed down and reassured as much as possible. Amputation is extremely frightening and painful. Panic might cause further injury. Identify and locate all the affected areas of injuries caused by the vehicular accident.
- Wash the affected and surrounded area with soap and running warm water. The surrounding areas must be pat dry. This will reduce infection. Removal of loose debris or dirt can also be done.
- Laying the person down, with his/her feet (if not severed) raised about 12 inches, can also reduce the chances of fainting. This position will prevent shock.
- If bleeding still occurrs, apply direct pressure using a sterile bandage, clean cloth or any piece of clothing. When the eyes are affected, never apply direct pressure as it may cause further damage. The hands can be used if the stated beforehand are not available.
- If the bleeding seeped through the material applied directly for pressure on the wound, do not remove the material but instead, just place an additional layer or more over the first material. It is done to prevent more blood loss and exposure to infection.
In addition, the severed body part must be with the person at all times. Cleaning or removal of debris can be done by rinsing with cold water. To preserve the amputated body part while waiting for medical help, it should be wrapped with a moist, clean (sterile as much as possible) cloth, sealed in a clean plastic bag immersed with cold water. This procedure can still make the body part viable for the next 18 hours. If cold water is not accessible, the body part must be kept away from heat as much as possible. Without cooling, the body part can only be reattached within 4-6 hours. In addition, if fractures are present, the person must not be permitted to move unless necessary.
When driving, traffic regulations must always be obeyed.4 Seatbelt usage is a major safety component which will significantly help prevent traumatic amputation.3
1 Bull JP. Disabilities caused by road traffic accidents and their relation to severity scores. Accident Analysis & Prevention
Volume 17, Issue 5, October 1985, Pages 387-397.
2 Bjerke HS. Extremity Vascular Trauma. Medscape. Department of Surgery, University of Missouri-Kansas City School of Medicine; Medical Director of Trauma Services, Research Medical Center; Clinical Professor, Department of Surgery, Kansas City University of Medicine and Biosciences Last accessed November 2011. http://emedicine.medscape.com/article/462752-overview#showall
3 MedLine Plus. Amputation – Traumatic/Limb Loss. U.S. Department of Health and Human Services. U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD. Last accessed November 2011. http://www.nlm.nih.gov/medlineplus/ency/article/000006.htm http://www.nlm.nih.gov/medlineplus/limbloss.html
4 World Health Organization. Road traffic injuries publications and resources. Geneva. 2004. Last accessed November 2011. http://www.who.int/violence_injury_prevention/publications/road_traffic/en/index.html