I really think there is some disconnect between what "surgery" and especially "field surgery" really entails.
It is often very simple and quick fixes. It is not a 3 hour scrub down with reconstruction.
Flying out to a facility would not create a situation for a "mobile" surgery. It would be the same bedside procedures available in the EDs of trauma centers.
I think it would be rather foolish to think that providing major surgery by some person decending from the air, or ground, or whatever, was suddenly going to start basically setting up a MASH.
However, some very simple skills, which are beyond the ability of EMS, could possibly make a difference.
The city of London has posted some very good numbers on field thoracotomy with penetrating trauma and the Israelis have touted it for years.
Aside from that specific procedure though, from surgical control of wounds, temporizing vascular shunts (I am particularly impressed by ones rigged from IV tubing) retroperitoneal packs, and a host of other "simple skills" I do see some benefit.
Especially maintaining perfusion or stoping bleeding so that resuscitation could be more effective.
I didn't think anyone was going to suggest reproducing a surgical theatre in a remote or mobile capacity.
This type of surgery is demonstrated as both life and limb saving, when you talk about cost, don't forget to factor in long term disability for survivors, life time medical costs, etc.
There is a big difference in lifestyle between a BKA and an AKA. Any idiot with a saw can cut off a limb, but there is benefit to saving as much of it as possible.
There is also a benefit in bringing some blood with you when you go to a major trauma in the field.
It is often very simple and quick fixes. It is not a 3 hour scrub down with reconstruction.
Flying out to a facility would not create a situation for a "mobile" surgery. It would be the same bedside procedures available in the EDs of trauma centers.
I think it would be rather foolish to think that providing major surgery by some person decending from the air, or ground, or whatever, was suddenly going to start basically setting up a MASH.
However, some very simple skills, which are beyond the ability of EMS, could possibly make a difference.
The city of London has posted some very good numbers on field thoracotomy with penetrating trauma and the Israelis have touted it for years.
Aside from that specific procedure though, from surgical control of wounds, temporizing vascular shunts (I am particularly impressed by ones rigged from IV tubing) retroperitoneal packs, and a host of other "simple skills" I do see some benefit.
Especially maintaining perfusion or stoping bleeding so that resuscitation could be more effective.
I didn't think anyone was going to suggest reproducing a surgical theatre in a remote or mobile capacity.
This type of surgery is demonstrated as both life and limb saving, when you talk about cost, don't forget to factor in long term disability for survivors, life time medical costs, etc.
There is a big difference in lifestyle between a BKA and an AKA. Any idiot with a saw can cut off a limb, but there is benefit to saving as much of it as possible.
There is also a benefit in bringing some blood with you when you go to a major trauma in the field.
Last edited by a moderator:
