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Of course, Ralston only resorted to such a drastic measure after exhausting the more conventional means of escape during the five-day period he was stuck in the desert (during which time he kept hydrated by drinking his own urine).
And lest you think this sort of things only happens to adventurers in the wilderness, recall the similarly riveting story of Jonathan Metz, who just last month conducted a life-saving partial amputation on his arm, gangrenous after two days of being wedged behind his basement furnace.
Lessons of moral fiber and physical fortitude aside, what should you do on a practical level if your arm is trapped and there's no one around to help you? Surge Desk presents the following, medically sound, four-step guide to self-amputation:
Step 1: Think Before You Cut
If your arm is trapped under a heavy object, amputation should be your very last resort. Before you grab your multipurpose tool, think: Have you exhausted all possibilities for prying out your arm? Did you tell anyone where you were going? Do you have a way to call for help? Will someone miss you at dinner tonight? According to a New York City Emergency Medical Technician instructor, wait to amputate until you are positive no one will come looking for you, at least 48 hours. And, by all means, stay calm and stay loose -- if you do need to amputate, you'll need all your mental and physical strength.
Step 2: Tie It Up
Once you're certain you have no other options and decide that amputation is for you, the next thing you will have to do is cut off blood to the trapped limb. In order to do so, you'll need to fashion a tourniquet for yourself. A T-shirt or a bandanna will do nicely. (Ralston made his out of the insulated lining of his water bottle, though he forgot to apply it until he'd already started sawing away at his arm.)
Wrap the tourniquet around the arm, just above the entrapped region, and then tie it as tightly as you can. The goal here is to cut off the blood supply to the lower arm completely so you don't die of blood loss before making it back to civilization.
Step 3: Stay Sharp
Once your tourniquet is in place, you're ready to cut. Use the sharpest blade you can find -- a pocketknife, a really sharp rock, etc. Try to make the cut as cleanly and quickly as possible. If all the tools at hand are relatively dull, you may consider taking a page out of Ralston's book.
Because Ralston had been chipping away at the rock with the knife from his multipurpose tool over the previous five days (a smart though ineffective idea in this case -- see Step 1), his blade was not sharp enough to cut through bone. Instead, he levered his arm away from the rock, breaking both the radius and ulna, the two bones of the lower arm. Then, he sawed through the skin and muscle using the knife, and cut the tendons with pliers. When he got to the skinny nerve running up to his shoulder, Ralston said that it felt like "sticking my arm into ... a pot of liquid metal."
Regardless of the method you use, don't expect to ever get that arm back. The only person who could effectively sever a part of your body and then reattach it is a trained surgeon.
Step 4: Once you're free, look for help -- STAT!
Once you're free, don't stick around. Get help as quickly as possible. Even with a tourniquet, you could still die from blood loss or infection. Do not try to disinfect the wound. Even if you come across a clean-looking stream, you may unwittingly introduce additional pathogens to the region. Once you get to a hospital, a doctor will be able to clean it better than you ever will.
In Ralston's case, after he had freed himself from the boulder, he still had to rappel one-handed down a steep, 20-foot cliff before he could find anyone to help him. Even then, his pickup truck was eight miles away, across the desert in the mid-day sun. Luckily, he came across some hikers who gave him food and water, and soon, he was airlifted directly to a hospital.
Because a walk in the woods should not cost an arm and a leg, here are a few things to consider before planning your next outdoor adventure: First, always tell someone where you are going and when you expect to be back. That way, someone will know to look for you if you have an accident. Also, remember to go prepared. Pack water and food, a charged cell phone, and a blanket for warmth in case you must spend the night out in the wild. And, bring a pocketknife or multipurpose tool. Just in case.
Happy trails!
