Sedation and Field Amputation. In: Lax, P
Leech, Caroline
Leech, Caroline
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Leech, C., Veitch, J
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Publication date
2022
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Abstract
When a patient is physically trapped by a limb with imminent threat to life from cardiac arrest due to hypovolaemia, or a scene emergency such as fire or flooding, and there is no other method of rapid extrication then life-saving limb amputation may be necessary. Advanced prehospital practitioners should have the equipment, training and organisational governance to be able to undertake these rare time-critical procedures in the field. Whilst the actual surgical procedure of a guillotine amputation is very simple, the decision-making to undertake the procedure is more stressful and a successful outcome requires adequate preparation and briefing of the team. This chapter covers the key indications and considerations for field amputation including helpful advice to support the decision, as well as considerations before starting the procedure, after the patient has been extricated and after handover at hospital. This chapter describes the use of procedural sedation for amputation as well as other painful procedures which may be undertaken in the prehospital environment. Practitioners should have a comprehensive understanding of the pharmacology, dosing and potential side effects of the sedative drugs available in their formulary, as well as having experience and training to optimally provide sedation in the field.
Citation
Leech, C., Veitch, J
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Article