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What to do in case of hand trauma?

The Hand Center of Toulon ensures SOS hand emergencies 24/7. A surgeon is present at the center during the day from 8 a.m to 7.30 p.m, from monday to friday and from 9 a.m to 7.30 p.m on saturday and sunday. After the closure of the center, a telephone call is made by a surgeon of the team. In case of trauma of the hand, you can either:

– Call the emergency number SOS Hand at +33 (0)4 94 03 07 07: a surgeon will tell you what to do (which can save you a long wait unnecessary).

– Go directly to SOS Hand Emergencies , at private hospital Saint Jean (you must be accompanied)

– Call public emergency service (SAMU Center :15), where you will be oriented according to the severity of your injuries.

Before you go to SOS hand emergencies

  • Do not panic ; wounds in the hand are often very impressive but do not present a vital risk.
  • Call the SOS Hand Center or the SAMU Center (15) to have instructions.
  • Wash the wound with water and soap and apply a dressing without using disinfectant dye like Betadine © or eosin.
  • Do not use a tourniquet.
  • Keep your hand elevated.
  • Stop any solid or liquid feeding and do not smoke (this could delay anesthesia); note the time of the last meal or drink.
  • Ask someone to take you to the hand emergencies department .

Emergency measures

In case of a frank wound

  • Wash the wound with water and soap.
  • Put a bandage (or a clean towel) and keep your hand up.
  • Contact the SOS Hand Center at +33 (0)4 94 03 07 07.

In case of a burn

  • For a chemical or thermal burn, put under running water for 15 minutes.
  • Put a bandage (or a clean towel) and keep your hand up.
  • Contact the “15” or the SOS Hand Center.

In case of a complete amputation

  • Gather all cut fragments in a tissue and place them in a waterproof plastic bag.
  • Close the bag and put it in a box containing ice. The closed bag must float on the icy water like a buoy.
  • Wrap the amputated end in a compressive dressing. Raise your hand. Do not put a tourniquet.
  • Never throw a fragment that seems destroyed. The surgeon can use certain components.

In case of an incomplete amputation

  • Wrap the injured part in a compressive dressing.
  • Relieve, if possible, the hand by immobilizing it on a splint.
  • Contact the Hand Center as soon as possible at +33 (0)4 94 03 07 07.

In case of a fractured limb

  • Immobilize the hand or the fractured segment on a rigid support. For example, put the wrist on a piece of stiff cardboard and put a tight band round.
  • Keep your hand or upper limb in an elevated position.
  • Contact the Hand Center at +33 (0)4 94 03 07 07 .

In case of a bite

  • Wash the wound under the tap with water and soap.
  • Put a bandage (or a clean towel) and keep your hand up.
  • Contact the Hand Center at +33 (0)4 94 03 07 07.
  • Try to identify the animal (or its owners, if it is a domestic animal) to check for vaccinations.

In case of an accident in a child

  • Wash the wound under tap water with water and soap.
  • Put a bandage (or a clean towel) and keep the hand up.
  • Contact the Hand Center.
  • If (s)he suffers a lot, administrate a suppository of paracetamol.

Emergency management

When you arrive at the SOS Hand Emergency Center, you will first have to register in order to fill out your medical file. You will then be referred to a surgeon who will receive you for consultation to examine and evaluate your wound.

Complementary examinations may be performed if the surgeon deems it necessary (radiography, ultrasound, blood test, etc.).

At the end of this assessment, the surgeon will inform you of the diagnosis and its seriousness and will judge the necessity and the urgency of a surgical intervention as well as the type of management (outpatient or hospitalization) taking into account the gravity your injury, your surroundings and your geographical distance.

If the treatment is not surgical, the surgeon may prescribe analgesics, anti-inflammatories, an orthosis, rehabilitation care, a work stoppage …

Emergency surgical intervention

If an intervention is decided, you will fill out a form including among others questions about your antecedents, your treatments, your allergies and your consent for the intervention.

The surgeon will be able to answer all your questions about the intervention and the follow-up.

You will be accompanied in the pre-anesthesia room where an anesthetist will ensure the absence of anesthetic contraindications. The modalities of anesthesia will be explained to you; most often it is loco-regional anesthesia avoiding general anesthesia, much heavier.

After the intervention

The nurse will make a first dressing to protect your scar and prevent bleeding that is common during the hours following the procedure.

Depending on the type of wound, an orthosis may be necessary and will be made by a orthotist in the center of the hand.

After the intervention, documents will be given to you:

  • a detailed operating report
  • post-operative instructions regarding dressing care, rehabilitation, orthosis …
  • a prescription of analgesics
  • an antibiotic prescription if necessary
  • a stoppage of work if necessary
  • a postoperative consultation appointment

After a post-operative care, you can either go to your room if you are hospitalized, or go home with your companion if you are outpatient.