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In-Field Extremity Amputation: Prevalence and Protocols in Emergency Medical Services

Published online by Cambridge University Press:  28 June 2012

Kathryn E. Kampen ,
Jon R. Krohmer ,
Jeffrey S. Jones ,
J.M. Dougherty  and
Robert K. Bonness
Kathryn E. Kampen
Affiliation:
Department of Emergency Medicine, Hackley Hospital, Muskegon, Michigan
Jon R. Krohmer*
Affiliation:
Department of Emergency Medicine, Butterworth Hospital, Grand Rapids, Michigan, and College of Human Medicine, Michigan State University, East Lansing, Michigan Kent County Emergency Medical Services, Grand Rapids, Michigan
Jeffrey S. Jones
Affiliation:
Department of Emergency Medicine, Butterworth Hospital, Grand Rapids, Michigan, and College of Human Medicine, Michigan State University, East Lansing, Michigan
J.M. Dougherty
Affiliation:
Akron General Hospital, Northeast Ohio University College of Medicine, Akron, Ohio
Robert K. Bonness
Affiliation:
Akron General Hospital, Northeast Ohio University College of Medicine, Akron, Ohio
*
EMS Medical Director, Kent County EMS, 678 Front, NW, Suite 235, Grand Rapids, MI 49594USA
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Abstract

Objective:

To determine current experience, attitudes, and training concerning the performance of in-field extremity amputations in North America.

Design:

Cross-sectional, epidemiological survey.

Participants:

Emergency medical services (EMS) directors from the 200 largest metropolitan areas in North America and attendees at the 1992 Mid-Year National Association of EMS Physicians Meeting.

Interventions:

The survey consisted of five questions focusing on demographic and operational data, the frequency of occurrence of the performance of in-field amputations, personnel responsible for performing the procedure, existing written protocols for the procedure, and the scope of training provided.

Results:

A total of 143 surveys was completed. Eighteen respondents (13%) reported a total of 26 in-field extremity amputations in the past five years. The most common cause for the injuries requiring amputations was motor-vehicle accidents. In the majority of cases (53.2%), trauma surgeons were responsible for performing the amputation, followed by emergency physicians (36.4%). Of respondents, 96% stated that there was no training available through their EMS agencies related to the performance of in-field extremity amputations. Only two EMS systems had an existing protocol regarding in-field amputations.

Conclusions:

The results suggest a need for established protocols to make the procedure easily accessible when needed, especially in large metropolitan EMS systems. This information should be emphasized during EMS training and reinforced through continuing education.

Keywords

EMS trainingextremity amputationsprehospital
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 1 , March 1996 , pp. 63 - 66
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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References

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