UTSW/BioTel EMS Training Bulletin 15-003
UTSW/ Parkland Field Amputation Team Activation (PDF Here)
- To provide procedural guidance to UTSW/BioTel EMS Providers for the activation of the UTSW/Parkland Field Amputation Team
- UTSW/BioTel Fire Department EMS agencies have significant patient extrication, urban search and rescue, and trauma care skills.
- Circumstances may arise during extrication or specialized rescue in which advanced medical procedures, such as field amputation, may be necessary.
- UTSW/BioTel EMS Providers may consult BioTel for possible activation of a specialized UTSW/Parkland Hospital team capable of performing field amputation: a surgeon, a trauma nurse, blood/blood products, specialized equipment and medications.
- At the request of either the Fire-Rescue scene Incident Commander or the senior EMS Provider on-scene, UTSW/BioTel EMS Providers shall contact BioTel for consultation.
- EMS Providers shall also follow their EMS agency-specific guidelines for notification of their chain-of-command with regard to this procedure.
- BioTel staff will consult with the BioTel Medical Director or Online Medical Control Physician.
- The UTSW/Parkland Field Amputation Team shall then be activated by BioTel, if such activation is determined to be appropriate.
- Goal: Field Amputation Team arrival on-scene within 30 minutes of activation.
- UTSW/BioTel EMS Providers shall provide the following minimum care to any patient for whom Field Amputation Team activation is considered:
- Active hemorrhage control with direct pressure and tourniquets, as needed;
- Establish two, large-bore IVs (or IO) in uninjured extremities, if possible:
- 250-mL fluid bolus (NS or LR), as needed, to maintain palpable radial pulse or SBP 90 mm Hg (avoid over-resuscitation)
- Keep the patient warm and calm:
- Judicious use of IV/IO analgesia and/or sedation
- Additional supportive care for shock, trauma and other conditions, consistent with UTSW/BioTel EMS Guidelines for Therapy, and per Online Medical Control.
- UTSW BioTel EMS Guidelines for Therapy:
- Treatment Guidelines
- Pain Management