Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-rz424 Total loading time: 0.323 Render date: 2021-02-25T19:13:48.909Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Extreme Measures: Field Amputation on the Living and Dismemberment of the Deceased to Extricate Individuals Entrapped in Collapsed Structures

Published online by Cambridge University Press:  08 April 2013

Abstract

Collapsed structures, typically as a result of earthquakes, may result in individuals entrapped by their limbs under heavy structural elements. In addition, access to living persons may be blocked by the deceased. Individuals are often critically ill by the time they are found, and rapid extrication is warranted. This and other factors may necessitate field amputation of an extremity on a living person or dismemberment of the deceased to achieve a rescue. Although case reports have described industrial, mining, and transportation accidents, few discuss this potential in collapsed structures. Also, few specifically outline the indications or the decision process and associated administrative procedures that should be addressed before conducting these procedures. This report presents a review of the literature along with a limited case series. A discussion regarding relevant decision making is provided to encourage the development of protocols. An international consensus statement on these procedures is provided.

(Disaster Med Public Health Preparedness. 2012;6:428-435)

Type
Special Focus
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2012

Access options

Get access to the full version of this content by using one of the access options below.

References

1.de Bruycker, MGreco, DAnnino, I, et alThe 1980 earthquake in southern Italy: rescue of trapped victims and mortality. Bull World Health Organ. 1983;61(6):10211025.Google ScholarPubMed
2.Noji, EKArmenian, HKOganessian, A. Issues of rescue and medical care following the 1988 Armenian earthquake. Int J Epidemiol. 1993;22(6):10701076.CrossRefGoogle ScholarPubMed
3.de Ville de Goyet, C. Stop propagating disaster myths. Prehosp Disaster Med. 1999;14(4):213214.CrossRefGoogle ScholarPubMed
4.Barbera, JAMacintyre, AG.Urban search and rescue. Emerg Med Clin North Am. 1996;14(2):399412.CrossRefGoogle ScholarPubMed
5.Cone, DC. Rescue from the rubble: urban search & rescue. Prehosp Emerg Care. 2000;4(4):352357.CrossRefGoogle ScholarPubMed
6.Macintyre, AGBarbera, JASmith, ER. Surviving collapsed structure entrapment after earthquakes: a “time-to-rescue” analysis. Prehosp Disaster Med. 2006;21(1):417, discussion 18-19.CrossRefGoogle ScholarPubMed
7.Macintyre, AGBarbera, JAPetinaux, BP. Survival interval in earthquake entrapments: research findings reinforced during the 2010 Haiti earthquake response. Disaster Med Public Health Prep. 2011;5(1):1322.CrossRefGoogle ScholarPubMed
8.Jagodzinski, NAWeerasinghe, CPorter, K. Crush injuries and crush syndrome—a review: part 1: the systemic injury. Trauma. 2010;12:6988.CrossRefGoogle Scholar
9.Sever, MSVanholder, RLameire, N. Management of crush-related injuries after disasters. N Engl J Med. 2006;354(10):10521063.CrossRefGoogle ScholarPubMed
10.International Search and Rescue Advisory Group (INSARAG). Guidelines and Methodology. Geneva, Switzerland: Field Coordination Support Section (FCSS), Office for Coordination of Humanitarian Affairs (OCHA), United Nations; 2010:9298.Google Scholar
11.Finch, PNancekievill, DG. The role of hospital medical teams at a major accident. Anaesthesia. 1975;30(5):666676.CrossRefGoogle Scholar
12.Stewart, RDYoung, JCKenney, DAHirschberg, JM. Field surgical intervention: an unusual case. J Trauma. 1979;19(10):780783.CrossRefGoogle Scholar
13.Ebraheim, NAElgafy, H. Bilateral below-knee amputation surgery at the scene: case report. J Trauma. 2000;49(4):758759.CrossRefGoogle ScholarPubMed
14.Ho, JDConterato, MMahoney, BDMiner, JRBenson, JL. Successful patient outcome after field extremity amputation and cardiac arrest. Prehosp Emerg Care. 2003;7(1):149153.CrossRefGoogle ScholarPubMed
15.Dunn, ELWynn, JPolanco, L. A rare case of bilateral upper extremity field amputation. J Air Med Transp. 1989;8(11):45.CrossRefGoogle Scholar
16.Jaslow, DBarbera, JADesai, SJolly, BT. An emergency department-based field response team: case report and recommendations for a “go team.” Prehosp Emerg Care. 1998;2(1):8185.CrossRefGoogle ScholarPubMed
17.Kelly, JBThompson, AS IIIGervin, AA. Field leg amputation by a paramedic. Prehosp Emerg Care. 1999;3(1):77.Google ScholarPubMed
18. McNicholas, MJRobinson, SJPolyzois, I, et al“Time critical” rapid amputation using fire service hydraulic cutting equipment. Injury Int J Care Injured. 2011;42:13331335.CrossRefGoogle Scholar
19.Snook, R. Extrication of trapped casualties. Br Med J. 1969;4(5681):478480.CrossRefGoogle ScholarPubMed
20.Foil, MBCunningham, PRGHale, JCBenson, NHTreurniet, S. Civilian field surgery in the rural trauma setting: a proposal for providing optimal care. J Natl Med Assoc. 1992;84(9):787789.Google ScholarPubMed
21.Sharp, CFMangram, AJLorenzo, MDunn, EL. A major metropolitan “field amputation” team: a call to arms … and legs. J Trauma. 2009;67(6):11581161.CrossRefGoogle Scholar
22.Porter, KM. Prehospital amputation. Emerg Med J. 2010;27(12):940942.CrossRefGoogle ScholarPubMed
23.Kampen, KEKrohmer, JRJones, JSDougherty, JMBonness, RK. In-field extremity amputation: prevalence and protocols in emergency medical services. Prehosp Disaster Med. 1996;11(1):6366.CrossRefGoogle ScholarPubMed
24.Osmond-Clarke, H. Emergency amputations: lower limb. Ann R Coll Surg Engl. 1967;40(4):216218.Google ScholarPubMed
25.Clasper, J, Lower Limb Trauma Working Group. Amputations of the lower limb: a multidisciplinary consensus. J R Army Med Corps. 2007;153(3):172174.CrossRefGoogle ScholarPubMed
25.Kirkup, JR. Interpretations of amputation by society, patients, and surgeons. In: A History of Limb Amputation. New York, NY: Springer; 2007: chap 9:96109.Google Scholar

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 4
Total number of PDF views: 65 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 25th February 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Extreme Measures: Field Amputation on the Living and Dismemberment of the Deceased to Extricate Individuals Entrapped in Collapsed Structures
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Extreme Measures: Field Amputation on the Living and Dismemberment of the Deceased to Extricate Individuals Entrapped in Collapsed Structures
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Extreme Measures: Field Amputation on the Living and Dismemberment of the Deceased to Extricate Individuals Entrapped in Collapsed Structures
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *