Amputation / Re-Impalnt
PTRC for Replant Evaluation:
Cleanly cut amputations to:
- Thumb proximal to or at the inter-phalangeal joint (joint below thumb nail)
- Multiple digits proximal to mid-phalanx (middle bone of finger)
- Complete or partial hand
- Upper extremity – shoulder to wrist
- Amputation in a child (excluding pad avulsions)
- Amputation of the penis
PEDS:
- For any amputation in a child (excluding finger pad avulsions), make BHC for destination.
Patient does not meet Replant Criteria if (Nearest PCR or PTRC):
- Crush injury w/ amputation
- Amputations at multiple levels (multiple amputations of same body part)
- Fingertip amputations
- Single finger in an adult (Excluding the thumb)
- Self-mutilation w/ prior self-mutilation attempts
- Amputations greater than 6 hours old
NOTE:
- Leg amputations are not considered replant criteria, but leg amputations at or above the knee should be considered for transport to nearest trauma center for trauma stabilization.
MEDICATIONS:
- Fentanyl for pain
- Morphine for pain
TREATMENT:
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For bleeding that cannot be controlled by direct pressure, apply tourniquet and tighten incrementally to least amount of pressure required to stop or limit bleeding.
-
Apply hemostatic dressing or sterile saline moistened dressing to amputated area for uncontrolled bleeding.
**Base Hospital Contact if meets re-implant criteria
**Contact Base to determine which re-implant center is up for the day