We have seen it in reality on the news and in our television medical shows, a building collapses or a person is trapped in a car and they require a traumatic amputation of a limb. Traumatic amputation is an accidental or surgical amputation of a body part that is not planned and occurs outside of the hospital setting. The limbs most affected are the arms, ears, feet, fingers, hands, legs and nose. Partial amputations are when there is some tissue left connected to the amputated part of the body. Complete amputation is limbs being severed from the body.
Emergency medical teams see traumatic amputations usually as accidents with lawnmowers, automobiles, motorcycles, power tools and farm equipment. Common forms of traumatic amputation outside the hospital are called a crushing injury, guillotine and avulsion amputations. A critical step for emergency personal is to give emergency first aid to help save the severed part for possible reattachment.
Of course, saving the person is more important than recovering an amputated body part.
Possible complications of traumatic amputation are excessive bleeding, shock, infection, muscle shortening, pulmonary embolism, fat embolus and death. An embolus is an air bubble, amniotic fluid, a clump of bacteria, chemical, drugs, blood clot or a globule of fat. Fat emboli occur when fat enters the circulatory system after amputation or trauma and blocks a blood vessel. These are not blood clots, which are formed in a vein deep inside the body blocking blood flow. Symptoms of fat emboli may occur 1-3 days after an injury and hold a high mortality rate. Clinically, patients display pulmonary distress, fever, renal problems, rash and mental status changes. Symptoms depend on the location of the blocked arteries. Most display rapid breathing, shortness of breath, irregular heart rate and hypoxemia. Some require mechanical ventilation.
There is no specific therapy for fat embolism except prevention and early diagnosis. Supportive care with oxygen and ventilation, blood products, hydration, medications, and nutrition are treatments provided. Prompt surgical stabilization of any long bone fractures will reduce the risk of the fat emboli.
Journal of Anesthesiology: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ija/vol8n2/fat.xml
Medline Plus: http://www.nlm.nih.gov/medlineplus/ency/article/000006.htm
Pub Med: http://www.ncbi.nlm.nih.gov/pubmed/12650535
EMS Responder: http://www.emsresponder.com/features/article.jsp?id=3541&siteSection=16