# Medics Cut Off Trapped Man's Arm



## MMiz (Aug 10, 2008)

*Medics Cut Off Trapped Man's Arm*

KANSAS CITY, Mo. -- Emergency crews rushed to a shipping company late Wednesday night after a worker got stuck in a machine.

Fire officials said the man got his arm stuck in a piece of machinery at Arrowhead Container on Clary Road just before midnight.

*Read more!*

How the heck would a medic amputate an arm?  Is that even in the protocols?


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## mikie (Aug 10, 2008)

Yeah, I just read that article....I kinda want to see pictures/video of how this was done...

I'm surprised they didn't have surgeons do the amputation, being in Kansas City, I know there's a trauma center around

Perhaps they had docs talk them through the amputation?


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## Onceamedic (Aug 10, 2008)

Depends on what was left of the arm.  If it was hanging on by a few shreds of tendon and/or muscle, it would not be a difficult thing to do.  I don't know of any ambulance that carries a bone saw, so my guess is that the arm was pretty well gone.


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## reaper (Aug 10, 2008)

The article is not very specific on details. Just because the medic told the news that "we had to amputate the arm", may not mean they did the procedure. Most times they do bring a surgeon to do it, unless it is a very rural area.

As Kaisu stated, it may have been hanging by skin and just needed to cut that to remove it.


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## VentMedic (Aug 10, 2008)

Paramedics sometime talk to the press and give out all the gorey and death details before the hospital has a chance to notify the family.   Even though our PD and security staff try to keep media away or ask for courtesy until a spokesperson issues a press release, there is always someone from the EMS crew willing to talk to the media and can't wait to unload the patient so they can find the reporters.    I often believe it is so they can get the credit for the rescue and not be mistaken for a FF or lumped into the FD category.  It appears to be more of a benefit to the Paramedic and not the patient or their family. 

Family members and friends who happen to recognize a person's car or equipment at their place of employment are notified by the media first and EMS providers wanting some air time.   EMS agencies and ambulance companies are slow to enforce some basic policies or at least ask their staff to exercise some consideration for the patients and their families before disclosing all the details for the "if it bleeds it leads" stories.


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## mikie (Aug 10, 2008)

This probably sounds horrible, but could you use the 'jaws of life' (cutter) to amputate? 

and ya, you guys are probably right about the details in the article (or lack thereof)


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## MagicTyler (Aug 10, 2008)

VentMedic said:


> Paramedics sometime talk to the press and give out all the gorey and death details before the hospital has a chance to notify the family.




Confidentiality???? Illegal???


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## CFRBryan347768 (Aug 10, 2008)

MagicTyler said:


> Confidentiality???? Illegal???



What is their to confide no personal info or any refreance to a specific individual was given. Now if they had said Michael Angelo from Africa they would be introuble. Sorry for the very very lame example. LOL


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## karaya (Aug 10, 2008)

VentMedic said:


> Paramedics sometime talk to the press and give out all the gorey and death details before the hospital has a chance to notify the family. Even though our PD and security staff try to keep media away or ask for courtesy until a spokesperson issues a press release, there is always someone from the EMS crew willing to talk to the media and can't wait to unload the patient so they can find the reporters. I often believe it is so they can get the credit for the rescue and not be mistaken for a FF or lumped into the FD category. It appears to be more of a benefit to the Paramedic and not the patient or their family.
> 
> Family members and friends who happen to recognize a person's car or equipment at their place of employment are notified by the media first and EMS providers wanting some air time. EMS agencies and ambulance companies are slow to enforce some basic policies or at least ask their staff to exercise some consideration for the patients and their families before disclosing all the details for the "if it bleeds it leads" stories.


 
What do you base this on?  Opinion or fact?  I'm researching a story for an upcoming article that I'm writing and I've found quite the opposite.  EMS agencies in particular have been taking a very back seat to contributing to news stories chiefly due to HIPAA fears.  Even when PHI is not disclosed they (EMS agencies, etc.) seemed very reluctant to discuss anything with the media.  Now the fire services... that's another chapter.


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## VentMedic (Aug 10, 2008)

karaya said:


> What do you base this on?  Opinion or fact?  I'm researching a story for an upcoming article that I'm writing and I've found quite the opposite.  EMS agencies in particular have been taking a very back seat to contributing to news stories chiefly due to HIPAA fears.  Even when PHI is not disclosed they (EMS agencies, etc.) seemed very reluctant to discuss anything with the media.  Now the fire services... that's another chapter.




Fact.  Ever watch the news or read the newspaper?  Frontline EMS personnel get their 15 minutes of fame quite frequently by appearing or being quoted in the news.   There are still some that haven't gotten the confidentiality memo or get too caught up in the excitement of the moment.   

It also depends on how far you want to extend the confidentiality since there have been many patient events that just happened discussed here on the forum with enough information about the provider to figure out where it is.  Some also like to post a news article in which they just appeared in the paper and then discuss the patient/event.    Recently on another forum we had a "friend of the family" pop in to discuss medical details of a recent event involving the death of a patient that the forum members were discussing from a news article.   It would be rather harsh to be surfing the net and find members of an EMS community discussing your loved one in detail or in a point of view that may not be flattering.


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## mikie (Aug 10, 2008)

CFRBryan347768 said:


> W Now if they had said Michael Angelo from Africa they would be introuble.



Michelangelo is from Italy!


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## karaya (Aug 10, 2008)

VentMedic said:


> Fact. Ever watch the news or read the newspaper?


 
Myself being a journalist and photographer, I do watch the news and read the newspaper daily (particularly news involving EMS) and I disagree with your assessment of front line EMS personnel getting their "15 minutes of fame" quite frequently.  As I stated in my earlier thread, my research does not support at all your findings.

When you state the word "confidentiality", what are you talking about? PHI as it relates to HIPAA?  As far as medics on the news, etc., if their provider is a "covered entity" as defined by HIPAA, then all they need to be concerned about is PHI.

The "medics" as stated in the article are not quoted by name and only in third party.  They could be medics from a non-covered entity such as fire service EMS with no transport service and therefore not bound by HIPAA.


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## VentMedic (Aug 10, 2008)

karaya said:


> The "medics" as stated in the article are not quoted by name and only in third party.  They could be medics from a non-covered entity such as fire service EMS with no transport service and therefore not bound by HIPAA.




And that is how they get their mugs or statements into the news.  

No, they do not give the name, SS# or policy # of the insurance but they do provide medical data, if it is interesting, at scene with a car or house identifiable in the background.  So there is the loop hole.   Some in EMS like to jump in if they can before the FD "takes the credit".     

If you don't know of it to be a problem, why are you researching it?  Has this been a problem prior to me making my statement? 

What is your hypothesis?  How are you doing your research?    How many media sources are you using?  Who are your sources?  What are your qualifiers?  Must the Paramedic be mentioned by full name?  What are your variables?   From what point of view are you writing this from?  Is this statistical or merely "observational opinion"?  How objective is it?  Pro EMS? Anti FD?  Is this another scientific article for JEMS?


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## mycrofft (Aug 10, 2008)

*technically speaking...*

1. Knock out pt.
2. Apply TK.
3. Disarticulate joint with Swiss army knife.

I never talk to the press, and you can quote me....no, kidding, I did media relations during a strike once and I write little articles for the local CERT rag. I felt and feel my job is to take care of pt's, if I want to "talk" to folks I come here. Every single time I or any coworker was quoted or written about, it was wrong, made a better yarn but wrong. I'm truly confident our forum cohort is an example of better reportage than that! (And I'm NOT being sarcastic).


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## Hastings (Aug 10, 2008)

Yes, field amputation is deep, deep down in the protocols. I've never seen it performed on a living patient yet. Thankfully, it doesn't typically come up. However, if someone is trapped, and there simply isn't time for extrication...life before limb. Literally. In this case, I disagree with the action. But field amputation IS a real thing. 

Oh, and how? Not surgically. It's not a pretty procedure.


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## karaya (Aug 11, 2008)

VentMedic said:


> And that is how they get their mugs or statements into the news.


 
Okay, what's wrong with that? I've got some thoughts on this, but I'd like to hear yours.



VentMedic said:


> No, they do not give the name, SS# or policy # of the insurance but they do provide medical data, if it is interesting, at scene with a car or house identifiable in the background. So there is the loop hole. Some in EMS like to jump in if they can before the FD "takes the credit".


 
Similar question as above. What is the problem for EMS to interface with the media as long as PHI is not being discussed? It seems okay for the FD to do this, but why not EMS?



VentMedic said:


> If you don't know of it to be a problem, why are you researching it? Has this been a problem prior to me making my statement?


 
In short, no. Quite the opposite of what you're thinking. The general scope of the article(s) discuss the decline and poor quality of EMS marketing in the past decade. Media interaction (lack of) is just one of the subjects. 



VentMedic said:


> What is your hypothesis? How are you doing your research? How many media sources are you using? Who are your sources? What are your qualifiers? Must the Paramedic be mentioned by full name? What are your variables? From what point of view are you writing this from? Is this statistical or merely "observational opinion"? How objective is it? Pro EMS? Anti FD? Is this another scientific article for JEMS?


 
You answer a question with questions? You should be a politician. You still haven't answered my question about confidentiality and I've already answered these questions to my editors.


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## VentMedic (Aug 11, 2008)

karaya said:


> You answer a question with questions? You should be a politician. You still haven't answered my question about confidentiality and I've already answered these questions to my editors.



Just curious as to what you consider "research".  That term is tossed around very loosely.   

Yes, I did answer your question about confidentiality and you even quoted it. 


> Originally Posted by VentMedic  View Post
> No, they do not give the name, SS# or policy # of the insurance



There are other state statutes on the books to consider besides HIPAA which is another loosely used term and often not fully understood. 

As far as just any member of the EMS/Rescue team talking to the media, I just find that in bad taste and disrespectful to the family members if they are the last to know, after the rest of the media viewers, the details of their loved one's injury or death.

But, if it bleeds, it leads and as long as there is fuel for the fire, one cannot fault the reporters for doing their job.  It is, however, up to the medical professionals to exercise discretion when discussing what they see and hear at scene.


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## ride2k (Aug 11, 2008)

Hastings said:


> Yes, field amputation is deep, deep down in the protocols. I've never seen it performed on a living patient yet. Thankfully, it doesn't typically come up. However, if someone is trapped, and there simply isn't time for extrication...life before limb. Literally. In this case, I disagree with the action. But field amputation IS a real thing.
> 
> Oh, and how? Not surgically. It's not a pretty procedure.




Well, bringing things back to the subject... wow.
Do you know exactly how they accomplish this task? What they use to amputate? I think I'm going to try to look it up online or something.


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## karaya (Aug 11, 2008)

VentMedic said:


> Just curious as to what you consider "research". That term is tossed around very loosely.


 
Fair question. Don't think of my research in a scientific sense. For the sake of this discussion, consider my research as background in the journalistic sense. It involved interviews with numerous EMS providers, a couple of media / journalism professors, one (so far) marketing specialist in EMS, as well as my own collection of data that I've gathered from news feeds. 



VentMedic said:


> Yes, I did answer your question about confidentiality and you even quoted it.


 
Okay fair enough; I didn't take that as an answer to my question. My mistake.



VentMedic said:


> There are other state statutes on the books to consider besides HIPAA which is another loosely used term and often not fully understood.


 
I can assure you that I DO fully understand HIPAA. I have personally spent an enormous amount of time and money over the past five years educating myself to this monster that has caused such hysteria in this industry. No other privacy ruling or law has had such a prolific impact on EMS as HIPAA. Yes, some states do have other laws, but many have been circumvented by the more stringent HIPAA. Exceptions to this would be state "open record" laws in which HIPAA does not supersede.



VentMedic said:


> As far as just any member of the EMS/Rescue team talking to the media, I just find that in bad taste and disrespectful to the family members if they are the last to know, after the rest of the media viewers, the details of their loved one's injury or death.


 
I agree with you 110%. This is why talking to the media should be left to a trained PIO from the EMS provider. 



VentMedic said:


> But, if it bleeds, it leads and as long as there is fuel for the fire, one cannot fault the reporters for doing their job. It is, however, up to the medical professionals to exercise discretion when discussing what they see and hear at scene.


 
You're right about bleeding and leading and this will always be a catalyst for headline news. The media did not invent this concept, they just respond to what their readers and viewers want. We are a society with an appetite for other's tragedy. Just like what this thread is about. The amputation of a limb in the field absolutely fascinates and we want to know more.


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## Hastings (Aug 11, 2008)

ride2k said:


> Well, bringing things back to the subject... wow.
> Do you know exactly how they accomplish this task? What they use to amputate? I think I'm going to try to look it up online or something.



The only time I've seen it done, a hacksaw.

Not kidding.

http://publicsafety.com/article/article.jsp?id=3541&siteSection=4


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## Jon (Aug 12, 2008)

This is a local case, a few years back:
http://forums.firehouse.com/archive/index.php/t-79411.html
Here is the thread I started here when it happened: http://www.emtlife.com/showthread.php?t=2585

another thread:
http://www.emtlife.com/showthread.php?t=5713


In my area, UPenn and Pennstar have a protocol for getting a surgical team to the scene if needed.

Shock Trauma out of Baltimore also has a scene team. It is assisted by the MDSP Aviation folks.


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## Jon (Aug 12, 2008)

mikie333 said:


> This probably sounds horrible, but could you use the 'jaws of life' (cutter) to amputate?
> 
> and ya, you guys are probably right about the details in the article (or lack thereof)



I think that use of the O-Cutters would probably cause crushing, etc of the tissues... and would probably not be the preferred method.


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## Buzz (Aug 12, 2008)

One of my prior instructors mentioned there being a CE class on field amputations. 


I believe it was something along the lines of using a scalpel to cut all the tissue you could, and then using whatever available to cut the bone.


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## zacdav89 (Aug 12, 2008)

I just couldn’t grasp the idea of hacking off the rest of a patients arm with something like the sawzall we carry on our rigs. glad its not in my scope.


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## Hastings (Aug 12, 2008)

zacdav89 said:


> I just couldn’t grasp the idea of hacking off the rest of a patients arm with something like the sawzall we carry on our rigs. glad its not in my scope.



Thankfully, there is almost no circumstance when it would be necessary. At least, not of a living patient. And it should be such a last resort that there is no question as to whether it's necessary or not, and all other options have been exhausted. It's a very permanent thing, even if the amputated limb is preserved properly and reattached. As always, just be prepared and learn about it. I hope no one here ever has to do it - I hope *I* never have to do it - but I know that I'm prepared to if it's necessary.

That is, once you're of sufficient level.


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## rescuerich (Aug 13, 2008)

Had a patient once lost most of the right arm to abrasion at the elbow in a roll over,  Her hand was trapped in the crushed top of the car. Had to use shears to cut what little skin was keeping he trapped. FD brought hand in 20 min.s after our arrival at ER. Doc.s sewed back on and shes happy they did, short arm and all.


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