Extremity and Penile Traumatic Amputations
Initial management and transfer workflow for traumatic extremity or penile amputation.
Updated: Current
AmputationExtremityPenile traumaBuncke ClinicTransferOn this page3 sectionsHide sections
⚠️ Contact Buncke Clinic for emergency microsurgical replantation: 415-565-6136.
📞
Transfer Center Contact: Buncke Clinic, 415-565-6136. Emergency microsurgical replantation is available 24/7.
🩸Immediate Treatment
▼- Control hemorrhage with direct manual compression
- Use tourniquet temporarily if compression fails
- Clarify other injuries and patient condition when calling transfer center
- Place large-bore IV in unaffected limb with normal saline keep-open
- Give cefazolin 1 g IV if not allergic
- Give tetanus toxoid 0.5 mL IM if no inoculation within last 5 years
- Do not inject digital blocks
- Keep patient NPO if surgery is desired
- Give aspirin 160 mg rectal suppository if not contraindicated
🧊Limb and Part Handling
▼- Apply dry sterile sponges to wound, cover with bulky sterile dressing, splint, and elevate
- Wrap amputated part in dry gauze, then place in sealed bag
- Place sealed bag on ice
- Do not use dry ice, bury in ice, wet the part, or use leaky containers
- Obtain X-ray of extremity and amputated part; do not delay transfer for labs
🚑Transportation
▼- Arrange helicopter or ambulance transfer immediately
- Transport patient supine
- Instruct patient to remain NPO and avoid tobacco during transfer
- Send X-rays, labs, and ED records; fax later if needed rather than delaying transfer
- Status
- AHS Official Protocol
- Source
- sites.google.com/view/hghtrauma/extremity-and-penile-traumatic-amputations
- Last reviewed / updated
- Current