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Cadaveric Prehospital Amputation: Which Reciprocating Saw Blade Offers the Most Efficient Amputation

Published online by Cambridge University Press:  11 September 2023

Russell Baker Open the ORCID record for Russell Baker [Opens in a new window] ,
Patrick Popieluszko Open the ORCID record for Patrick Popieluszko [Opens in a new window] ,
Sara Mitchell ,
Sunny Baker  and
William Weiss
Russell Baker
Affiliation:
Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, Texas USA
Patrick Popieluszko*
Affiliation:
Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, Texas USA
Sara Mitchell
Affiliation:
Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, Texas USA
Sunny Baker
Affiliation:
Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, Texas USA
William Weiss
Affiliation:
Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, Texas USA Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, El Paso, Texas USA
*
Correspondence: Dr. Patrick Popieluszko, MD 4801 Alberta Ave. Suite B3200 El Paso, Texas 79905 USA E-mail: papopiel@ttuhsc.edu
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Abstract

Objective:

Field amputations are a low-frequency, high-risk procedure. Many prehospital personnel utilize the reciprocating saw. This study compares the efficiency, speed, and degree of tissue damage of different reciprocating saw blades found commercially.

Methods:

Amputations were performed on two human cadavers at different levels of the upper and lower extremities. Four different blades were used, each with a different teeth-per-inch (TPI) design. The amputations were timed, blade temperature was recorded, subjective operator effort was obtained, amount of splatter was evaluated, and an orthopedic physician evaluated the extent of tissue damage and operating room repair difficulty.

Results:

The blade with fourteen TPI was superior in overall speed to complete the amputations at 1.07 seconds per one centimeter of tissue (SD = 0.49 seconds) and had the lowest fail rate (0/8 amputations). The three TPI, six TPI, and ten TPI blades all required a “rescue” technique and were slower. The blade with fourteen TPI caused the least amount of tissue damage and was deemed the easiest to repair. Secondary outcomes demonstrated the fourteen TPI blade had generated the least amount of heat and produced the least amount of splatter. All blades had a perceived effort of “easy” to complete the amputation.

Conclusion:

While all blades were able to achieve an amputation, the overall recommendation is use of a fourteen TPI blade. It did not require any rescue techniques, provided the most straightforward amputation to repair, had the least amount of biohazard splatter and temperature increase, and was the fastest blade overall.

Keywords

amputationprehospitalreciprocating sawtrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 5 , October 2023 , pp. 595 - 600
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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