Amputation

Amputation is detachment of a body part, such as an ear, finger, or foot. It is usually associated with a serious force or crushing injury, such as an animal bite. The immediate threats to life are bleeding and shock.

If a body part is detached, apply firm pressure to the site of the bleeding where the tissue loss has occurred. Manage any serious bleeding. Cover the wound with the cleanest available bandage, then wrap firmly. Do not attempt to reattach the detached body part. If a digit is hanging on by a small “bridge” of skin or muscle, attempt to bandage it without completing the separation.

If the body part can be easily recovered and the victim can be brought to a hospital within 6 hours of the injury, do the following:

1. Gently rinse the body part if the cut end is contaminated with dirt.

2. Wrap the body part in clean cloth or gauze and keep the covering moist. The ideal solution is saline (not ocean water, because of infection risk), if that is available; if not, fresh water will do. Do not immerse the part in a bag of water; merely keep the covering moist. Keep the body part cool by placing it on ice after wrapping it securely in a bandage, cloth, or towel. To avoid a frostbite injury, do not apply ice directly to the body part or immerse it in ice water.

3. Bring the body part with the victim to the hospital.

The application of a tourniquet to stop bleeding is essentially a decision to sacrifice the limb in order to preserve life. If any salvageable part of the limb is still attached, do not apply a tourniquet to stop bleeding until you have exhausted all pressure techniques. If the limb is completely severed and the bleeding is torrential, a tourniquet may be applied until the muscular walls of the arteries constrict and bleeding can be controlled by direct pressure. Tie a cloth or rope circumferentially an inch or two above the wound and tighten it just enough to allow direct pressure to stop the bleeding. After 5 to 10 minutes, loosen the tourniquet briefly to see if the bleeding can be controlled with pressure techniques alone.

Tags: amputation,wilderness medicine, outdoor medicine, healthline

Labels: amputation, bleeding, tourniquet

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Celox™ Hemostatic Granules

Lately, I've been publishing more posts than usual about products. The reason for this is that I have noticed a large number of innovative new ideas worthy of mention. Many times, I am made aware of the products by seeing them on display at a medical meeting, but sometimes I am contacted by the inventors, manufacturers, or distributors, or by a person who has noticed something new or used it successfully. I think it's important to bring these to your attention, so that you can try them out (if you wish) and form your own opinion.

Celox (hemostatic granules) is a new high performance hemostatic material that has been created to control high-volume arterial bleeding. Composed of a proprietary marine biopolymer (including Chitosan), it is is poured as a granular mixture into a bleeding wound, where it helps to facilitate blood clot formation without causing any tissue damage. It is felt to do this by aggregating negatively-charged red blood cells, which are attracted to the positively-charged granules. According to promotional material distributed by Sam Medical Products, the granules assist a clot to form within minutes without generating any heat, burning sensation, or rigid structure formation within the wound. A gelled mass formed by excess granules protects the clot and is easy to remove.

Chitosan is manufactured by chemical modification of chitin , which is the structural element in the exoskeleton ("external" skeleton) of crustaceans (crabs, shrimp, and so forth). It carries a positive charge, wherein lies its value for this particular application. Chitosan is not known to commonly invoke an allergic reaction, and can be sterilized. Notably, it is present in other products designed to control bleeding from wounds, such as bandages marketed by HemCon Medical Technologies Inc.

Celox™ works in hypothermic conditions and also on blood that has been heparinized (e.g., a person being treated with this category of "blood thinner" or, presumably, with enoxaparin [Lovenox]). There is no mention of whether or not it has been or would be expected to be effective if a victim is currently taking warfarin (Coumadin), which is a very common anticoagulant.

To apply Celox™, one pours the granules from a sterilized, sealed packet (15 grams or 35 grams) into the wound and then holds them in place with a gauze bandage for five minutes. A compression bandage, such as an elasticized wrap, is then wrapped over the gauze-covered wound and the victim is brought to medical care.

image courtesy of www.popsci.com

Tags: Celox, bleeding, hemorrhage, health, wilderness medicine, outdoor medicine, healthline

Labels: bleeding, Celox, hemostasis, hemostatic granules

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