Prehospital Field Amputation Leads to Improved Patient Outcome

From JEMS:

The American College of Emergency Physicians’ stance on procedural sedation is that it’s acceptable to perform in the ED without any indication of specific agents.12 However, recommended monitoring includes EtCO2 and standard telemetry.

In preparation for significant hemorrhage, the patient was administered plasma and packed red blood cells. Prehospital blood product administration is a controversial topic. There are conflicting data likely due to multiple confounding factors such as flight time and varying injury severity leading to blood product administration. Prehospital blood product transfusion appears to confer an early survival advantage but no difference in overall survival.13

Furthermore, long flight times and head injury are factors that complicate the determination of survival advantage with blood product administration.14 Although there are many practical matters such as storage and temperature regulation, with the appropriate protocols, carriage of blood products appears to be a safe, effective way of resuscitation in the short term.13

INSARAG, which is an organization coordinated under the United Nations, recommend that an entrapped limb should be amputated as distally as possible without endangering the patient or rescue team.4 This is consistent with what was done in the field.

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