Check the casualty’s blood circulation and nerve function distal to (below) the wound during the tactical field care phase.

If possible, compare the area below the wound to the same area on the uninjured limb. If a pulse cannot be felt below the wound or other indications of impairment are present, evacuate the casualty as soon as possible after life-saving procedures have been completed in order to save the limb.

Assume that blood circulation and/or nerve function below the wound is impaired if:

a. There is no pulse below the wound or the pulse is weaker than the pulse in the uninjured limb.

b. The skin and/or nail beds below the wound are bluish (cyanosis).

c. The skin below the wound is cooler to the touch than the same area on the uninjured limb.

d. The portion of the limb below the wound is numb or has decreased sensation when compared to the same area on the uninjured limb. (The casualty must be conscious and able to think clearly in order to make this test.)

e. Motor function of the limb below the wound is lost. (The casualty must be conscious and able to think clearly in order to verify that he cannot move his hand and fingers or cannot move his feet and toes.)