Amputation of a finger or hand , and what to do ?

1. By : Khaled Alkhodari 1 St. No. : 120130915
Contents
Introduction............................................................................................................2
First Aid...................................................................................................................2
Do.........................................................................................................................2
Do Not..................................................................................................................3
Doctor Examination ...............................................................................................3
Medical History ...................................................................................................3
Physical Examination and Immediate Care .......................................................3
Treatment:.............................................................................................................4
Done By : Khaled Alkhodari
St. No : 120130915
Under the supervision of : Dr. Mahmoud Qandeel

2. By : Khaled Alkhodari 2 St. No. : 120130915
Introduction1
Injuries to the fingertips are common in accidents at home, work, and play. They can occur when a
fingertip slams in a car door, while chopping vegetables, or even when clearing debris from a
lawnmower or snowblower.
Fingertip injuries can be crushing, tearing, or amputating injuries to the tips of fingers and thumbs.
Injury can include damage to skin and soft tissue, bone (distal phalanx), or to the nail and nailbed.
The tips of longer fingers tend to be injured more often because they are last to escape from harm's
way.
Fingertips are rich with nerves and are extremely sensitive. Without prompt and proper care, a
fingertip injury can disrupt the complex function of the hand, possibly resulting in permanent
deformity and disability.
To keep the amputated finger functional you should deal with it rapidly as the long-term outcome
for an amputee depends on early emergency and critical care management.
First Aid2
Do :
1. Check the person's airway (open if necessary); check breathing and circulation. If necessary,
begin rescue breathing, CPR, or bleeding control.
2. Try to calm and reassure the person as much as possible. Amputation is painful and very
frightening.
3. Control bleeding by applying direct pressure to the wound. Raise the injured area. If bleeding
continues, recheck the source of the bleeding and reapply direct pressure, with help from
someone who is not tired. If the person has life-threatening bleeding, a tight bandage or
tourniquet will be easier to use than direct pressure on the wound. However, using a tight
bandage for a long time may do more harm than good.
4. Save any severed body parts and make sure they stay with the person. Remove any dirty
material that can contaminate the wound, if possible. If possible, gently rinse the body part if
the cut end is dirty.
5. Wrap the severed part in a clean, damp cloth, place it in a sealed plastic bag and place the bag in
an ice water bath.
6. Do NOT directly put the body part in water without using a plastic bag.
7. Do NOT put the severed part directly on ice. Do NOT use dry ice as this will cause frostbite and
injury to the part.
8. If cold water is not available, keep the part away from heat as much as possible. Save it for the
medical team, or take it to the hospital. Cooling the severed part will keep it safe for
reattachment for about 18 hours. Without cooling, it will only remain safe for about 4 to 6
hours.
9. Keep the person warm.
1
Orthoinfo , http://orthoinfo.aaos.org/topic.cfm?topic=A00014
2
Medlineplus , http://www.nlm.nih.gov/medlineplus/ency/article/000006.htm

3. By : Khaled Alkhodari 3 St. No. : 120130915
10. Take steps to prevent shock. Lay the person flat, raise the feet about 12 inches, and cover the
person with a coat or blanket. Do NOT place the person in this position if a head, neck, back, or
leg injury is suspected or if it makes the victim uncomfortable.
11. Once the bleeding is under control, check the person for other signs of injury that require
emergency treatment. Treat fractures, additional cuts, and other injuries appropriately.
12. Stay with the person until medical help arrives.
DO NOT
 Do NOT forget that saving the person's life is more important than saving a body part.
 Do NOT overlook other, less obvious, injuries.
 Do NOT attempt to push any part back into place.
 Do NOT decide that a body part is too small to save.
 Do NOT place a tourniquet, unless the bleeding is life threatening, as the entire limb may be
harmed.
 Do NOT raise false hopes of reattachment.
Doctor Examination3:
Medical History
To plan your treatment, it is important for your doctor to know the circumstances of the injury.
Your doctor will want to know if you have any other medical problems, such as diabetes, and
whether you take any medications. Your doctor may ask several of questions:
 How and when did the injury happen?
 Is the injury on your dominant hand?
 What do you do for a living and for recreational activities?
 Have there been other hand problems caused by conditions like osteoarthritis, diabetes,
rheumatoid arthritis?
 Is your tetanus immunization current?
Physical Examination and Immediate Care
 Your doctor may give you an injection (digital block anesthesia) to relieve pain in the
affected finger.
 He or she will wash out (irrigate) the wound with a saline solution to make it easier to
see the wound clearly.
 He or she will look for exposed bone, missing tissue, and injury to the nail.
 After examining your finger, your doctor will thoroughly clean (debride) the wound,
removing dead tissue and contaminants. This will reduce the chance for infection.
 X-rays may be needed if your doctor suspects broken (fractured) bones.
 If blood has built up under the nail (subungual hematoma), your doctor may pierce the
fingernail to relieve the pressure.
 You may also need an antibiotic and/or a tetanus shot to prevent infection.
3
Orthoinfo , http://orthoinfo.aaos.org/topic.cfm?topic=A00014

4. By : Khaled Alkhodari 4 St. No. : 120130915
Treatment4:
The goals involved in the treatment of amputations of the upper extremity include the following:
preservation of the functional length, durable coverage, preservation of useful sensibility, prevention of
symptomatic neuromas, prevention of adjacent joint contractures, early return to work, and early
prosthetic fitting. These goals apply differently to different levels of amputation.
4
Medscape, http://emedicine.medscape.com/article/1238395-overview