title: Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies: report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict.
abstract: Limb amputations are frequently performed as a result of trauma inflicted during conflict or disasters. As demonstrated during the 2010 earthquake in Haiti, coordinating care of these patients in austere settings is complex. During the 2011 Humanitarian Action Summit, consensus statements were developed for international organizations providing care to limb amputation patients during disasters or humanitarian emergencies. Expanded planning is needed for a multidisciplinary surgical care team, inclusive of surgeons, anesthesiologists, rehabilitation specialists and mental health professionals. Surgical providers should approach amputation using an operative technique that optimizes limb length and prosthetic fitting. Appropriate anesthesia care involves both peri-operative and long-term pain control. Rehabilitation specialists must be involved early in treatment, ideally before amputation, and should educate the surgical team in prosthetic considerations. Mental health specialists must be included to help the patient with community reintegration. A key step in developing local health systems the establishment of surgical outcomes monitoring. Such monitoring can optimizepatient follow-up and foster professional accountability for the treatment of amputation patients in disaster settings and humanitarian emergencies.
authors.affiliation: Division of General Surgery, University of British Columbia, Vancouver, British Columbia, Canada. drlisaknowlton@gmail.com
authors.forename: Lisa Marie
authors.initials: LM
authors.lastname: Knowlton
authors.forename: James E
authors.initials: JE
authors.lastname: Gosney
authors.forename: Smita
authors.initials: S
authors.lastname: Chackungal
authors.forename: Eric
authors.initials: E
authors.lastname: Altschuler
authors.forename: Lynn
authors.initials: L
authors.lastname: Black
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Burkle
authors.forename: Kathleen
authors.initials: K
authors.lastname: Casey
authors.forename: David
authors.initials: D
authors.lastname: Crandell
authors.forename: Didier
authors.initials: D
authors.lastname: Demey
authors.forename: Lillian
authors.initials: L
authors.lastname: Di Giacomo
authors.forename: Lena
authors.initials: L
authors.lastname: Dohlman
authors.forename: Joshua
authors.initials: J
authors.lastname: Goldstein
authors.forename: Richard
authors.initials: R
authors.lastname: Gosselin
authors.forename: Keita
authors.initials: K
authors.lastname: Ikeda
authors.forename: Andree
authors.initials: A
authors.lastname: Le Roy
authors.forename: Allison
authors.initials: A
authors.lastname: Linden
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Mullaly
authors.forename: Jason
authors.initials: J
authors.lastname: Nickerson
authors.forename: Colleen
authors.initials: C
authors.lastname: O'Connell
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Redmond
authors.forename: Adam
authors.initials: A
authors.lastname: Richards
authors.forename: Robert
authors.initials: R
authors.lastname: Rufsvold
authors.forename: Anna L R
authors.initials: AL
authors.lastname: Santos
authors.forename: Terri
authors.initials: T
authors.lastname: Skelton
authors.forename: Kelly
authors.initials: K
authors.lastname: McQueen
mesh_terms: D000673:Amputation, Traumatic; D003226:Congresses as Topic; D004189:Disaster Planning; D004190:Disasters; D005121:Extremities / Q000293:injuries; D006801:Humans; D007258:Informed Consent; D023821:Limb Salvage; D008499:Medical Records / Q000592:standards; D010348:Patient Care Team; D010351:Patient Discharge; D014754:Violence