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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Cranial Nerve VI Palsy Emergency

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miércoles, 28 de septiembre de 2016

Field amputations

SCANCRIT.COM - September 28, 2016 - By K
"A paper in EMJ compares various methods for performing field amputations. I can’t say I ever had to do one myself. However, some of the people I work with have performed amputations on rapidly deteriorating entrapped trauma victims.
Most them have relied on the standard Gigli technique where they scalpel the soft tissues and cut the bone with the Gigli saw. Apparently it is painfully slow, especially as it is performed on a trauma patient that is super sick. One colleague recommends using the firemens’ pneumatic cutters...
  • The Reciprocating saw was the fastest, achieving amputation at 22 seconds with high quality cuts. Unfortunately it resulted in significant spraying and aerosolisation of blood and tissue that would require a visor and a FFP3-grade breathing protection.
  • The Holmatro achieved amputation at 53 seconds. Some remaining soft tissue was cut with trauma shears. This technique resulted in the worst quality cuts as it resulted in significant bone splintering and soft tissue injury.
  • The Hacksaw required 22 seconds and resulted in excellent quality cuts. Authors noted that this technique required someone stabilising the leg.
  • The Gigli saw technique required 91 seconds.
Hacksaw  Reciprocating sawThe Jaws of Life baby!  Gigli
Take-home message
The Jaws of Life cutters is a reasonable alternative to the Gigli as it is much faster. The reciprocating saw less so given the aerosolisation and risk of contamination."