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FIELD SURGICAL KIT/AMPUTATION

FIELD SURGICAL KIT/AMPUTATION Last update 02/09

Introduction-

    In the rare event of a patient entrapment in which all resources have failed to successfully extricate the patient, or in which the patient's life is in immediate danger with prolonged extrication, field amputation of the trapped extremity should be considered. The Field Surgical Kit also carries equipment necessary to perform surgical airways, insertion of a chest tube, and placement of central venous access.

B. Procedure for Requesting

General Care

    1. Prior to instituting a request, ensure that a TRT unit has been dispatched and is en route.

    2. Either the Rescue OIC or Incident Commander can request that the Dispatch notify the Medical Director or Deputy Medical Director of the need for a possible field amputation or other advanced procedure.

    3. The Dispatch will make contact with a Medical Director as quickly as possible. Only the Medical Director, Deputy Medical Director, or their appointed representative, is authorized to conduct this procedure.

    NOTE: In the event the Medical Director or Deputy Medical Director is not available for transport to the scene, either may request the assistance of a Broward Health Hospital District Attending Trauma Surgeon or their designee.

    4. The identified physician will be transported to the scene in the most expeditious manner after consultation with the Incident Commander.

    5. The Incident Commander or designated physician must confirm that at least one Field Surgical Kit is available at the scene. Sources for a Field Surgical Kit include:

      a) One kit is located at each Air Rescue station.
      b) One kit is located at the EMS Captin.
      c) One kit is carried by the Technical Rescue Bureau.

    6. Once on scene, the physician will assess the situation at hand and make the decision regarding the requirement for amputation. The physician on scene will have the final say as to the appropriateness of a field amputation.

Certification Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure. Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations, or other mechanisms as deemed appropriate by the local EMS System.

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