Citations
Altmetric:
Journal Title
Book Title
Publication Volume
Publication Issue
Publication Begin Page
Publication End Page
Publication Number of Pages
Abstract
Abstract published with permission.
Background: 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. Aims: This study aimed to analyse accounts of prehospital
amputation and identify factors that may influence practice as well as areas
for further research. Methods: A search of multiple databases (AMED, BNI,
CINAHL, EMCARE, Google Scholar and PubMed) and additional literature for
accounts of prehospital amputation was carried out. Results: 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.
Conclusion: 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.