Immediate treatment
- elevate the trauma site and cover with a thick saline-soaked dressing
- wrap the amputated part in a sterile towel or plastic bag (eg a sandwich bag)
- surround the bag with ice but prevent direct contact between ice and tissue
- transport the bag with the patient to hospital urgently
- emphasize to the patient that the decision to reimplant will be made by the admitting surgeons
- tissues vary in viability when cold and ischaemic: fingers 6 hours hands 3-6 hours arms 3 hours
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