Prehospital amputation: a scoping review
Thursday, January 2, 2020
Where limbs or extremities become entrapped and it is not possible to extricate a patient in time to prevent death, or because of a deterioration or scene safety emergency, prehospital amputation is an option to enable extrication.
This study aimed to analyse accounts of prehospital amputation and identify factors that may influence practice as well as areas for further research.
A search of multiple databases (AMED, BNI, CINAHL, EMCARE, Google Scholar and PubMed) and additional literature for accounts of prehospital amputation was carried out.
Thirteen sources of evidence describing 20 cases of prehospital amputation (18) or dismemberment (2) in a variety of settings between 1975 and 2019 were identified. Prehospital amputation was reported following structural collapse (8), industrial accidents (6), road traffic crashes (5) and rail incidents (1). The procedure was undertaken for a range of reasons, including unsuccessful traditional extrication attempts (7), time-critical patient condition (6), a risk of further extrication attempts causing structural destabilisation (5) and dismemberment of deceased victims (2). The equipment used to perform the amputation was not reported in 14 cases. Outcomes were reported in 17 accounts, with all patients surviving to hospital.
Prehospital amputation is performed extremely rarely and accounts in the literature are limited. The situations and environments in which prehospital amputation is reported vary and specialist teams are often required. Further review of guidance and studies on techniques may be beneficial.
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for vising the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
Reading the Journal of Paramedic Practice counts towards your professional development
Develop your career
We provide professional information dedicated to paramedics covering training, education and jobs
Get the latest clinical information to ensure you are aware of the latest think and best practice in paramedicne
Already registered? - Sign in here