I just keep getting requests for this one. This 12 minute video is great for professionals in any discipline. It shows you how to use current technology to stay up to date with all the goings-on in your field. A must-view for every student, no matter how old or young you are!
Field Amputation for Trauma, Part 4
We’ve covered all the prep for field amputation over the past 3 days. Now, it’s time to do it. What equipment is needed? There are two principles: figure it all out in advance, and keep it simple.
It is crucial that the trauma program design and assemble equipment and drug packs in advance, otherwise critical equipment may not make it to the field. The pack needs to be conveniently located, have fresh instruments and batteries for the equipment, and should have essential anesthetics included. A sample list is available here, and I encourage you to modify it to suit your needs.
Paralytics, sedatives and analgesics are essential. I prefer vecuronium, midazolam and fentanyl, but there are many other choices. I would discourage the use of propofol because it is difficult to titrate outside the hospital and may contribute to hypotension.
The patient must be intubated prior to starting the procedure. This airway may be difficult due to patient positioning, so be prepared to perform a surgical airway. Finally, don’t assume that your patient will be nicely positioned supine. Rescue workers may need to support the patient (or you) if he or she is in an awkward position.
Finally, don’t assume that you will accompany the patient (and possibly their limb) back to the hospital. Based on the specific aircraft used, there may not be room available. You may return by ground transportation or another aircraft. That’s why your backup plan needs to be well thought out!
Resources:
Technology: Airbags For Motorcyclists?
A manufacturer of high-end protective gear for motorcycle and auto racing has developed a fully self-contained airbag system that can be worn. The airbag is easily zippered and connected into a compatible outer jacket, made only by Alpinestars (of course). The airbags expand in much the way that auto airbags do, and they offer protection to the back, shoulders, kidneys, chest, and upper abdomen. A set of colored LEDs on the left sleeve show the rider the status of the system at all times.
A built-in microprocessor samples a set of accelerometers 500 times per second. If any linear or rotational force occurs that is outside of allowed parameters, the airbags inflate well before any impact to the torso occurs. The system is powered by a rechargeable battery that allows for about 25 hours of riding time between charges.
Will this be adopted by the general riding public? Probably not in the near future. The airbag system costs over US $2000, and requires service every two years (US $225). And if it deployed? Another US $550 to repack it. But it’s just a matter of time before similar protective devices worn under a riding jacket make their way to the market at an affordable price.
Related posts:
Quick and Dirty: Posterior Hip Dislocation
Here’s a quick 5 minute video full of tips on diagnosing and managing this injury. Originally presented at Trauma Education: The Next Generation 2013.
This short YouTube video shows a day in the ED at the largest and busiest hospital in the world. The hospital is located in South Africa and is massive, with nearly 3000 beds and covering 173 acres. Over 2,000 patients per day are seen at the hospital, and a large number are trauma victims.
