Field Amputations and the Need for Trauma System Readiness

The Rare Field Amputation

Class Description:This presentation will be an interactive, case based discussion regarding prolonged vehicle/structural entrapment requiring field amputation. Both provide longer than usual transport times to definitive care. A major focus will be on the rare occurrence of an entrapped patient needing surgical intervention on scene and will highlight the collaborative efforts between Ryder Trauma surgeons, TRU Nurses, Pharmacists, the Army Trauma Training Department, local EMS and USAR agencies. The overall goal is to improve readiness for both EMS and trauma/ER programs with field amputation kit and maintenance recommendations. Establishing relationships with trauma experts can increase skill and awareness to rapidly identify injury and provide lifesaving interventions at scene and during transport. This effort should stand as a recommendation for outside trauma programs, and EMS agencies to collaboratively develop and standardize their process as an inclusive trauma system. Case based scenarios will help participants better understand the process and objectives when requesting a physician on-scene. This session is appropriate for pre-hospital emergency care providers, hospital providers and non-clinical emergency management personnel.

Presenter: Luis Derosa RN, EMT-P, CBRN

Bio: Luis DeRosa Jr. is the Outreach / Injury Prevention Coordinator for the Ryder Trauma Center (Ryder) and Miami Burn Center at Jackson Memorial Hospital. Ryder is an Adult and Pediatric Level 1 Trauma Center and ABA verified burn center. Luis has been with Jackson since 2007 and has worked in the Emergency Department, Trauma / Burn ICU, and the Trauma Resuscitation Unit (TRU) at Ryder which serves as the entry point for trauma & burn victims throughout Miami-Dade County, South Florida, and Caribbean. This high volume unit is also home to the nation’s only US Army Trauma Training site for Forward Surgical Teams deploying to combat. Luis (non-military) has proudly supported this unique military/civilian partnership throughout his years with army instructor orientation, mock traumas, and team clinical in the TRU. Luis is a licensed Paramedic as well and enjoys working with EMS to improve patient outcomes. He has lead multiple educational EMS initiatives throughout South Florida, with a focus on trauma and burns. One of his initiatives focuses on Recreational Water Sport traumatic injury including his Perineal Hydrostatic Jetstream Injury or “Phji” (pronounced fee-jee) water trauma project, which focuses on the rare and severe MOI caused by the PWC propulsion (pending publication Pan-American Journal of Trauma). To date, he has educated hundreds of Ocean Rescue and EMS providers throughout South Florida, including the US Coast Guard and Florida Fish & Wildlife agencies. He has also presented nationally at the US Lifesaving Association Nat’l Board of Directors Meeting, the Society of Trauma Nurses, and the Emergency Nurses Association conference. He recently achieved a major milestone with the inclusion of Perineal Hydrostatic Jetstream Injury into MDC trauma alert criteria (the Miami Dade County Fire Chief and Medical Directors Committee approved Luis’ recommendations 9/2024). Luis is an ABLS instructor and was selected by the Miami-Dade County Healthcare Coalition Burn Annex Task Force as a Subject Matter Expert (SME) regarding burn mass casualty incidents (BMCI). In 2021, Luis was selected to the ABA’s Advanced Burn Life Support (ABLS) Advisory Committee – helping to review and update the latest (2022) ABLS Provider manual. In 2023, Luis was also selected by the Board of Certification for Emergency Nursing (BCEN) as a subject matter expert (SME) for the Certified Burn Registered Nurse (CBRN) Passing Point Study, which is the final step in developing the world's first-ever burn nursing specialty certification. Luis is also a member of a federal disaster response team (NDMS) Trauma Critical Care Team with multiple disaster and special event deployments. Luis is also active in teaching “Stop the Bleed” to the public and is both an instructor for ATCN and course director for TNCC. Luis has interests in improving documentation and decreasing mouse clicks for nurses in an emergency setting, improving trauma department workflow, and the request for field amputation of the entrapped trauma patient - preparedness is vital for both EMS and Trauma Centers (especially NURSING). On his spare time, Luis enjoys spending time with his wife and 3 Kids to “trauma disconnect.” Occasionally, you can find him on social media educating and engaging those interested in trauma.

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