Skip to main content Accessibility help

The Development and Implementation of a Hospital Emergency Response Team (HERT) for Out-of-Hospital Surgical Care

  • Christopher Scott (a1), Brant Putnam (a2) (a3) (a4), Scott Bricker (a2) (a3) (a4), Laura Schneider (a2), Stephanie Raby (a5), William Koenig (a5) and Marianne Gausche-Hill (a1) (a6) (a4)...


Over the past two decades, Los Angeles County has implemented a Hospital Emergency Response Team (HERT) to provide on-scene, advanced surgical care of injured patients as an element of the local Emergency Medical Services (EMS) system. Since 2008, the primary responsibility of the team has been to perform surgical procedures in the austere field setting when prolonged extrication is anticipated. Following the maxim of “life over limb,” the team is equipped to provide rapid amputation of an entrapped extremity as well as other procedures and medical care, such as anxiolytics and advanced pain control. This report describes the development and implementation of a local EMS system HERT.

Scott C, Putnam B, Bricker S, Schneider L, Raby S, Koenig W, Gausche-Hill M. The development and implementation of a Hospital Emergency Response Team (HERT) for out-of-hospital surgical care. Prehosp Disaster Med. 2012;27(3):1-5.


Corresponding author

Correspondence: Christopher Scott, MD Department of Emergency Medicine Harbor-UCLA Medical Center 1000 W Carson St., Box 21 Torrance, CA 90509 USA E-mail


Hide All
1. Al-Shaqsi, S. Model of international Emergency Medical Services (EMS) systems. OMJ. 2010;25(4):320-323.
2. Stewart, RD, Young, JC, Kenney, DA, Hirschberg, JM. Field surgical intervention: an unusual case. J Trauma. 1979;19(10):780-783.
3. Kelly, JB, Thompson, AS, Gervin, AA. Field leg amputation by a paramedic. Prehosp Emerg Care. 1999;3(1):77.
4. Dunn, EL, Wynn, J, Polanco, L. A rare case of bilateral upper extremity field amputation. J Air Med Transp. 1989;8(11):4-5.
5. Ho, JD, Conterato, M, Mahoney, BD, Miner, JR, Benson, JL. Successful patient outcome after field extremity amputation and cardiac arrest. Prehosp Emerg Care. 2003;7(1):149-153.
6. Porter, KM. Prehospital amputation. Emerg Med J. 2010;27:940-942.
7. Blank-Reid, C, Santora, TA. Developing and implementing a surgical response and physician triage team. Disaster Manage Response. 2003;1(2):41-45.
8. Sharp, CF, Mangram, AJ, Lorenzo, M, Dunn, EL. A major metropolitan “field amputation” team: a call to arms…and legs. J Trauma. 2009;67(6):1158-1161.
9. Kampen, KE, Krohmer, JR, Jones, JS, Dougherty, JM, Bonness, RK. In-field extremity amputation: prevalance and protocols in Emergency Medical Services. Prehosp Disaster Med. 1996;11(1):63-66.
10. Jaslow, D, Barbera, JA, Desai, S, Jolly, T. An Emergency Department based field response team: case report and recommendations for a “Go Team.” Prehosp Emerg Care. 1998;2(1):81-85.
11. Foil, MB, Cunningham, PRG, Hale, JC, Benson, NH, Treurniet, S. Civilian field surgery in the rural trauma setting: a proposal for providing optimal care. J Natl Med Assoc. 1992;84:787-789.
12. The Los Angeles County EMS Agency Hospital Emergency Response Team Policy. Accessed February 7, 2011.
13. Cryer, HG, Hiatt, JR, Eckstein, M, et al. . Improved trauma system multicasualty incident response: comparison of two train crash disasters. J Trauma. 2010;68(4):783-789.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Scott supplementary material
Scott supplementary material

 Unknown (22 KB)
22 KB


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed