Traumatic amputation and limb preservation

Although the nature and circumstances of traumatic amputation are beyond the control of pre-hospital emergency care providers, their actions on scene and during transportation may still have a great influence upon both morbidity and mortality. Familiarity with the body’s physiological response to major trauma and the military paradigm of treatment may well prove lifesaving, as will understanding the potential need for an aggressive approach to haemorrhage management (including the use of tourniquets) and rapid transportation to definitive care. Where appropriate, effective cooling of the amputated part will maximise the possibility for successful replantation (surgical reattachment), although a poor cooling technique is likely to cause further cellular damage through either freezing or tissue maceration.