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
- 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
- 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.
- Fentanyl for pain
- Morphine for pain
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