(A crocodile will roll its body when is has a firm grip, literally tearing off the extremity)
So you've come across a casualty who is missing a limb, the victim is losing alot of blood, passing in and out of consciousness and may die in a matter of minutes if you take no action to help them. Here's what you need to do:
- Locate any individual bleeding arteries on the stump. The arteries will bleed in pulsating spurts.
- Pinch off the larger arteries that are bleeding most. The brachial artery in the arm and femoral artery in the leg are the major blood vessels you should find. Someone (the victim, if conscious) needs to continue pinching while you go to step 3.
- Apply a tourniquet. Choose a strip of material atleast an inch wide and tie it around the stump as close as possible to the wet end. tighten it just enough to stem the bleeding but not so tight it damages viable tissue. Keep pinching the arteries. If emergency personnel are on thier way continue to 9. If you're beyong the reach of the emergency services continue.
- Tie off the ends of the blood vessels being pinched. Use Fishing line, dental floss or heavy thread in that order of preferance. Tie it good and hard with several knots as far up as possible.
- Clean the stump thouroughly, preventing infection is really important. pick out all foreign matter and wash the wound.
- Cauterize remaining bleeding points. Only do this if you are really beyond the reach of help, ie. a desert island or similar. Use a piece of heated metal to cauterize the bleeding blood vessels. do not worry about completely stopping all the bleeding, oozing bleeding will be controlable when the dressing is applied.
- Loosen the tourniquet. As you do so you will be able to detect if any more ties or cautery are needed. Do not leave the tourniquet on for more than 90 minutes or tissue in the stump may start to die.
- Dress the stump. coat the wound in any availiable antibiotic oitment (bacitracin or similar). Then tightly cover the stump with thick cloth or gauze. The tighter the dressing the less chance of sustained bleeding.
- Elevate the stump end as high as possible. This will allow gravity to assist in slowing further bleeding.
- Put an ice pack over the dressing and be ready to apply another tourniquet if rapid bloodloss resumes.
- Treat pain and shock caused by blood loss. Use any pain medication availiable and treat shock by giving the victim a liquid containing salt (chicken soup for example), this will help restore blood plasma.