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Sedation and Field Amputation

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Textbook of Acute Trauma Care

Abstract

When a patient is physically trapped by a limb with imminent threat to life from cardiac arrest due to hypovolaemia, or a scene emergency such as fire or flooding, and there is no other method of rapid extrication then life-saving limb amputation may be necessary. Advanced prehospital practitioners should have the equipment, training and organisational governance to be able to undertake these rare time-critical procedures in the field. Whilst the actual surgical procedure of a guillotine amputation is very simple, the decision-making to undertake the procedure is more stressful and a successful outcome requires adequate preparation and briefing of the team. This chapter covers the key indications and considerations for field amputation including helpful advice to support the decision, as well as considerations before starting the procedure, after the patient has been extricated and after handover at hospital. This chapter describes the use of procedural sedation for amputation as well as other painful procedures which may be undertaken in the prehospital environment. Practitioners should have a comprehensive understanding of the pharmacology, dosing and potential side effects of the sedative drugs available in their formulary, as well as having experience and training to optimally provide sedation in the field.

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Author information

Authors and Affiliations

  1. Emergency Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

    Caroline Leech

  2. The Air Ambulance Service (TAAS), Rugby, Warwickshire, UK

    Caroline Leech

  3. Department of Anaesthesia, Nottingham University Teaching Hospitals NHS Trus, Nottingham, UK

    Jonathan Veitch

  4. 212 Field Hospital (Reserves), Sheffield, UK

    Jonathan Veitch

Authors
  1. Caroline Leech
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  2. Jonathan Veitch
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Correspondence to Caroline Leech .

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Editors and Affiliations

  1. Tactical Medical Wing, Royal Air Force, Brize Norton, Oxfordshire, UK

    Peter Lax

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Leech, C., Veitch, J. (2022). Sedation and Field Amputation. In: Lax, P. (eds) Textbook of Acute Trauma Care . Springer, Cham. https://doi.org/10.1007/978-3-030-83628-3_25

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  • DOI: https://doi.org/10.1007/978-3-030-83628-3_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-83627-6

  • Online ISBN: 978-3-030-83628-3

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