82 168 Definition Severance of a body part, most frequently caused by a power tool, heavy machinery (such as farm machine), or heavy industrial equipment. Characteristics Bone and other body tissues often are exposed. Bleeding and shock can be apparent, with complications of infection and disability. Policy Give employee immediate treatment in the occupational health unit or obtain emergency re- sponse personnel assistance. Preserve the severed part and take steps to enhance its viability. Arrange for immediate transport to the hospital. Objectives Clinical Assessments and Interventions Referral for Medical Action Amputation ● Immediate medical evaluation and treatment (i.e., transport to hospital). Follow-up Actions ● Counsel employee regarding reha- bilitation, disability management, safety measures, and return to work. ● Evaluate employee for possible job transfer or reassignment/job restriction depending on affected part. Discuss work restrictions with management if necessary. ● Provide support and referral to EAP if needed. Institute emergency action. Preserve severed part. ● Ensure airway patency. ● Reassure and calm individual. ● Control bleeding by applying firm pressure, and elevate extremity and use pressure points as needed. ● Give oxygen as indicated. ● Treat for shock as indicated (see Guideline 113, Shock, page 226). ● Support and immobilize the affected part in a functional position and keep employee at rest. ● Cleanse and irrigate wound with sterile saline. ● Clean off any gross foreign matter. ● Cover wound with sterile gauze or ABD pads. ● Wrap severed part in a sterile gauze or towel moistened with sterile saline (a clean sheet for large limb). Do not immerse severed part in any solution. ● Maintain anatomical position of the part. ● Place severed part in a waterproof (plastic) bag or container and seal. ● Keep severed part cool by placing the bag or container inside another ice-filled container or container with ice and water. Do not freeze the part. ● Record time affected part was severed and give severed part to emergency personnel. ● Arrange for immediate transport of employee and severed part to the hospital. ● Notify health care transporters if suspected foreign bodies are in the wound. ● Do not compromise employee’s life to save the part. Guideline continues on next page