Field Amputation

[mfc2257 464]

Notwithstanding people's opinions on the particular department in the quote from below OR the merits of high speed chases, I'm curious to know if Westchester County has the capability via WCMC or any other medical institution to perform an in field amputation to facilitate a rescue. See quote below from Kentland, MD's webpage regarding a recent incident.

From www.kentland33.com

Friday, March 26, 2010

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Minutes before midnight shots rang out on Central Avenue in the area of Fire Communications. PG Police saw a car of juveniles shooting and pursued them in a high speed chase reaching 120mph just before the car lost control at Addison Road and James Farmer Way. Units from 8 (Seat Pleasant) arrived on scene to find a vehicle that had splintered a telephone pole into pieces leaving three trapped and 1 ejected. The ejected victim was found to be priority 4 and units started to remove the door and roof to free the driver. The backseat passengers were pinned under the dash and after an extended extrication Battalion 1 requested the "GO TEAM" be flown to the scene for amputation. At this time Rescue Engine 33 was special called to the scene by the Duty Chief. The Rescue Engine responded with 5 to the scene arriving at 12:56 and began working on freeing the trapped occupants. Within 5 minutes the occupants were freed, the "GO TEAM" was cancelled and Kentland Volunteers returned to service at 1:03 AM.

Edited April 2, 2010 by mfc2257

[ems-buff 81]

Notwithstanding people's opinions on the particular department in the quote from below OR the merits of high speed chases, I'm curious to know if Westchester County has the capability via WCMC or any other medical institution to perform an in field amputation to facilitate a rescue. See quote below from Kentland, MD's webpage regarding a recent incident.

From www.kentland33.com

Friday, March 26, 2010

-

Minutes before midnight shots rang out on Central Avenue in the area of Fire Communications. PG Police saw a car of juveniles shooting and pursued them in a high speed chase reaching 120mph just before the car lost control at Addison Road and James Farmer Way. Units from 8 (Seat Pleasant) arrived on scene to find a vehicle that had splintered a telephone pole into pieces leaving three trapped and 1 ejected. The ejected victim was found to be priority 4 and units started to remove the door and roof to free the driver. The backseat passengers were pinned under the dash and after an extended extrication Battalion 1 requested the "GO TEAM" be flown to the scene for amputation. At this time Rescue Engine 33 was special called to the scene by the Duty Chief. The Rescue Engine responded with 5 to the scene arriving at 12:56 and began working on freeing the trapped occupants. Within 5 minutes the occupants were freed, the "GO TEAM" was cancelled and Kentland Volunteers returned to service at 1:03 AM.

While I do think that field amputation are few and far between, it MAY HAVE BEENfeasible before life net a.k.a. stat-flight move air 1 from WMC to orange county, but now it would seem to be a waste of time.

[JJB531 652]

While I do think that field amputation are few and far between, it MAY HAVE BEENfeasible before life net a.k.a. stat-flight move air 1 from WMC to orange county, but now it would seem to be a waste of time.

I don't think that the fact that there is no longer a Medevac located at WMC equates to the consideration of a field amputation being a "waste of time". You're not going to fly a Physician to a scene if it's 10 minutes from the hospital. While I don't know of any written understanding between any EMS agencies in this area and a Medical facility to provide such a service, I'm sure that if it came down to it, you could contact Westchester Medical Center or another Trauma Center to see if it could be arranged, but definetly a good question.

[Guest alsfirefighter]

I'm on the same page as JJB with his comments. Why would anyone have to be flowing to a scene to do this when driving is more often more expedient? So it still is feasible if needed and any general surgeon knows how to amputate extremities not just trauma surgeons as they are done fairly often in local hospitals.

The situation would have to be pretty extreme in order for me to consider this as I'd have to exhaust all options prior to even to consider it and a MVA I would but that car into pieces if necessary. Most field amputations I've heard of have involved severe crush injuries where there was too much material to remove to get that that would need to be removed/manipulated/cut etc. This is where such action would be clearly warranted as not only would extrication be impossible within several hours if not days in addition to the problems encountered with crush syndrome which has a very high mortality percentage in relation to injury time.

[helicopper 1,050]

While it does seem to be a good idea to know where you could get such assistance and have a pre-plan for it, this is definitely one that will get dusty on the shelf.

From the limited information in the "article" on the call it would seem that calling for the heavy rescue earlier would have been a better call since they got the victim(s) out in less than 10 minutes after arrival.

I'd love to hear what the thought process was and gain an understanding of the damage involved (to both the vehicles and the victims) to learn why they thought field amputation. I wouldn't think of that right off the bat.

[mfc2257 464]

While it does seem to be a good idea to know where you could get such assistance and have a pre-plan for it, this is definitely one that will get dusty on the shelf.

From the limited information in the "article" on the call it would seem that calling for the heavy rescue earlier would have been a better call since they got the victim(s) out in less than 10 minutes after arrival.

I'd love to hear what the thought process was and gain an understanding of the damage involved (to both the vehicles and the victims) to learn why they thought field amputation. I wouldn't think of that right off the bat.

The Heavy Squad from 8 was already on the job. Rescue Engine 33 was added as the second Squad.

[WstPrideEng92 3]

The Heavy Squad from 8 was already on the job. Rescue Engine 33 was added as the second Squad.

A friend of mine living at a house in PG spoke with one of the medics that was on scene and he told him that the 3 kids were literally all pinned under the dash. I guess the whole dash incased them. He said doing a dash role was not an option because it would have compromised the patients even more. I'm not sure how they ended up getting them out but will try to get more info.

[ny10570 745]

FDNY EMS has an on call medical director at all times with the ability to perform field amputations. However this is set up more for collapse rescue type situations. We even have one extremely passionate doc that has his bone saw in his vehicle at all times. Although that may serve a dual purpose for his QA/QI interviews.