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    Prehospital amputation: a scoping review

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    Author
    Gander, Bradley cc
    Keyword
    Pre-hospital Amputation
    Entrapment
    Extrication
    Confined Spaces
    Pre-hospital Care
    Emergency Medical Services
    Journal title
    Journal of Paramedic Practice
    
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    Show full item record
    URI
    http://hdl.handle.net/20.500.12417/785
    DOI
    10.12968/jpar.2020.12.1.6
    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.
    ae974a485f413a2113503eed53cd6c53
    10.12968/jpar.2020.12.1.6
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