Amputation of distal fingertip from self-harm (bite injury)

Treatment

• Unknown

Disposition

• Unknown

Authors:

• Elliot Williams, Paramedic Woodburn Ambulance

Editors:

• David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center

Diagnosis

• Finger amputation
• Self-harm
• Psychosis

Differential Diagnosis

• Trauma
• Self-mutilation
• Dementia
• Psychosis
• Hypovolemic shock

Patient Workup

• History
• Physical exam

Editor’s Notes

In teaching this case, I would focus on self-abuse and state of mind. Did she bite her finger off because of untreated, underlying pain? If so, is her pain not being adequately managed? After the first intervention of bleeding control, splinting and bandaging, care should focus on assessing level of coherence. A mental status exam should be completed. Assess the patient’s medications, adherence to prescriptions and possible side effects. I would ask her if she did this herself. And, if so, why?

-David Tauber, AS, EMT-P, Yale New Haven Sponsor Hospital Program