Pre-hospital amputation SOP

Question 1

Outline the contents of the amputation SOP

Answer 1

Rare intervention. Need a deep understanding of the level of entrapment, and how it may be released in a controlled or rapid way.

Covers:
- Indications
- Techniques

Question 2

What are the indications for pre-hospital amputation?

Answer 2

• Immediate risk to entrapped patient due to scene safety issue
• Deteriorating patient who will die during the time taken to extrication
• Non-salvageable limb which is delaying extrication
• Deceased patient blocking access to other casualties

Question 3

Describe the approach and technique of amputation

Answer 3

• Top cover call
• Consent patient if awake
• Consider sedation/PHEA
• Take pre and post photos
• Tourniquet
• Incise using scalpel, divide using tough cuts
• Gigli saw/tough cuts for bone
• Haemostasis
• Chitogauze and dressing
• Abx and TXA
• Limb in bag
• Convey to MTC

Debrief and D&D