Guidelines reviewed
Last updated 1 June 2026
NHS - First Aid
Click the link below and scroll down to Bleeding heavily
Page last reviewed: 15 March 2022
Next review due: 15 March 2025
Reviewed 15 Mar 2022 · next review Mar 2025
Resuscitation Council UK (RCUK)
Click the link below and open the Trauma Emergencies tab. Scroll down to Preservation of an amputated body part.
Authors
Barry Klaassen Lynn Thomas Nigel Barraclough Connor Gilronan Adam Mellett-Smith Jessica Rogers Isabelle Hamilton-Bower Adam Benson Clarke Published 27 October 2025
Published 27 Oct 2025
Summary
RCUK and the NHS agree that:
- The casualty’s life-threatening bleeding takes priority
- Emergency medical help should be summoned immediately
- The amputated body part should be retrieved, cooled (but not frozen), protected from direct contact with ice, and transported with the casualty
The main differences are:
RCUK 2025 provides more detailed guidance on both catastrophic bleeding (including tourniquet use) and preservation of the amputated part.
RCUK uniquely recommends labelling the container with the patient’s identity and relevant times (e.g. time of injury and when cooling began), reflecting the latest ILCOR Good Practice Statements (See FAQ’s and Resources section below).
NHS adds the practical instruction not to wash the amputated part, which is not explicitly stated in the RCUK guidance but is consistent with accepted trauma practice.
FAQs and Resources
Learn more about the evidence behind the RCUK guidelines
For trainers who would like more detailed information, the resource below explains how ILCOR reviews the latest research and develops international first aid recommendations. They include the scientific evidence reviews, treatment recommendations and the rationale behind current first aid guidance on amputated or avulsed body parts:
ILCOR – 2025 International Consensus on First Aid Science With Treatment Recommendations See pages 46-58: Preservation of Traumatic, Completely Amputated or Avulsed Body Parts
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