Prehospital emergency response in a partial hand amputation with ulnar artery transection: a case report.

Abstract

Introduction: Approximately 50% of preventable trauma fatalities are associated with a lack of hemorrhage control and occur in the prehospital environment. The application and efficacy of traditional hemostatic techniques, such as tourniquets, gauze packing, and impregnated dressings, are frequently limited by factors including pain, risk of ischemia, wound configuration, and challenges associated with removal at definitive care.

Case report: We report the prehospital application of a hemostatic flowable biopolymer, Traumagel, in a 46-year-old male presenting with a partial hand amputation and complete transection of the ulnar artery. Following tourniquet application and initial hemostasis, Traumagel was deployed, permitting the safe release of the tourniquet, restoration of distal perfusion, and significant pain relief during a prolonged evacuation. The gel was removed in the operating room, and the arterial and metacarpal repairs were completed without complications or tissue loss.

Discussion and conclusion: This case exemplifies the seamless integration of hemostatic agents in conjunction with a tourniquet for the management of moderate-to-severe hemorrhage in a remote trauma environment. This prompt and comprehensive intervention for hemorrhage control in a remote location was crucial to an excellent patient outcome.