Re: MDs for field amputations/abgl-response

["David Steele" <DSTEELE1@mn.rr.com>]

The last amputation that was done on our freeway system was done I believe
with a standard hacksaw by an ED doc.  The accident was a few minutes away
from the level one trauma center.  The first doc on the scene was to big to
get into the compartment so they had to get the smallest doc on duty to go
to the scene...

Now I am in no way advocating training to do amputations in the field.  It
would be one of those procedures that you wouldn't do enough of to stay
current in.  However I don't believe by going to med school qualifies you to
do a amputation either.  I have always said you could train anyone to do
procedures in our industry and this isn't any different.  We could be
trained to do this.  It would be an emergent procedure, Life saving
procedure, you surely wouldn't worry about your stump closure..  Who do you
think did them during Vietnam??  talk with some of those hero's in the
field.  I can guarantee you they weren't physicians...

So now that we know we can do them..  should we.....  Again..  I think it
boils down to can you stay current in the procedure..  or in your training
and what is the industry standard.  I don't think you probably could stay
current, nor is the industry standard to let aeromedical crews (RN,Medics)
do amputations in fields (that I am aware of).

Now to the question.

We don't have a procedure at our program either.  I am also sure it would be
a goat rope (new term for me)..  We probably would fly to one of our level 1
trauma centers and pick up a ED doc a minute away (airport based service)
and proceed to scene.  They would be responsible to bring their own
craftsman tools.

David Steele
email   dsteele1@mn.rr.com




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