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In-field extremity amputation: prevalence and protocols in emergency medical services
K E Kampen1, J R Krohmer, J S Jones
1Department of Emergency Medicine, Hackley Hospital, Muskegon, Michigan, USA.
Prehospital and Disaster Medicine
|December 9, 1995
Summary
In-field extremity amputations are rare but require established protocols and training for emergency medical services (EMS) personnel. Current training and protocols are significantly lacking, indicating a critical need for improvement in EMS systems.
Area of Science:
- Emergency Medicine
- Surgical Procedures
- Public Health
Background:
- In-field extremity amputations are critical interventions in emergency medical services (EMS).
- Limited data exists on the current practices, attitudes, and training for these procedures in North America.
Purpose of the Study:
- To assess the current experience, attitudes, and training related to in-field extremity amputations within North American EMS systems.
- To identify gaps in protocols and training for this emergency procedure.
Main Methods:
- A cross-sectional, epidemiological survey was conducted.
- The survey targeted EMS directors in the 200 largest North American metropolitan areas and attendees of the 1992 National Association of EMS Physicians Meeting.
- Key data collected included procedure frequency, personnel involved, existing protocols, and training scope.
Main Results:
- 143 surveys were completed, with 18 respondents reporting 26 in-field amputations over five years, primarily due to motor-vehicle accidents.
- Trauma surgeons and emergency physicians most frequently performed these amputations.
- A significant gap was identified: 96% reported no available training, and only two EMS systems had protocols.
Conclusions:
- There is a clear need for standardized protocols for in-field extremity amputations in large metropolitan EMS systems.
- Training and continuing education for EMS personnel must incorporate this critical procedure.
- Establishing protocols will improve accessibility and standardization of care during emergencies.