You encounter a casualty with a complete amputation about 6 inches below the knee during care under fire. What is the correct immediate action?

You encounter a casualty with a complete amputation about 6 inches below the knee during care under fire. What is the correct immediate action?

• A. Apply a tourniquet high and tight on the injured leg
• B. Check airway and breathing
• C. Elevate the limb and apply cold packs
• D. Apply a pressure dressing and monitor for signs of infection

Answer: (A)

In care under fire, stopping life-threatening bleeding comes first. A complete amputation of the leg leaves major arteries exposed and bleeding profusely, so the quickest and most reliable way to save the casualty is to apply a tourniquet high and tight on the remaining portion of the leg. Tighten it until the bleeding from the stump is controlled, and re-tighten if bleeding persists. This action buys critical time by preventing rapid blood loss. Airway and breathing are important, but they are addressed after hemorrhage control when there is time. Elevating the limb and cold packs don’t stop arterial hemorrhage quickly enough in this scenario. A pressure dressing alone isn’t sufficient for a complete amputation with active bleeding, and monitoring for infection is a later consideration after bleeding is controlled.

In care under fire, stopping life-threatening bleeding comes first. A complete amputation of the leg leaves major arteries exposed and bleeding profusely, so the quickest and most reliable way to save the casualty is to apply a tourniquet high and tight on the remaining portion of the leg. Tighten it until the bleeding from the stump is controlled, and re-tighten if bleeding persists. This action buys critical time by preventing rapid blood loss.

Airway and breathing are important, but they are addressed after hemorrhage control when there is time. Elevating the limb and cold packs don’t stop arterial hemorrhage quickly enough in this scenario. A pressure dressing alone isn’t sufficient for a complete amputation with active bleeding, and monitoring for infection is a later consideration after bleeding is controlled.