DESIGNATION OF CONDITION

Characterized by partial or complete dissection of body limbs or tissue.

EMPHASIS ON PATIENT CARE

Control hemorrhage; maintain adequate perfusion and oxygenation; preserve severed body parts.

FIRST RESPONDER AND BASIC PRE-HOSPITAL MANAGEMENT

1. Initial Management - Assess airway, breathing and circulation and manage as indicated.
2. Manage hemorrhage by appropriate methods.

• Cover remaining part with sterile dressings, saturate with saline, cover with dry dressings, and elevate the injured extremity.
• Wrap severed part in sterile gauze, preserving all amputated material. Dampen gauze   with sterile saline. Place in a watertight container, place container in ice water, if available. DO NOT FREEZE OR USE DRY ICE.
• Partial amputations should be dressed and splinted in alignment with the extremity to assure optimum blood flow.
• Focused H&P - History, physical exam, vital signs.
• Rapidly transport the patient and readily available amputated tissue to appropriate medical facility.

INTERMEDIATE and PARAMEDIC PRE-HOSPITAL MANAGEMENT

5. En-route, initiate one or two large bore IVs (determined by patient condition) of an isotonic solution infused at a flow rate to maintain adequate vital signs.
6. For use of narcotic analgesics, see Pain Management Protocols.