Emergency Field Amputation in a Resource‑Limited Setting: A Case Report

Abstract Background Emergency field amputation is an exceptionally sporadic but potentially life-saving intervention in extreme trauma scenarios, particularly in resource-limited environments. Case Presentation We describe a 16-year-old male with a severe crush injury to the proximal thigh, entrapped in industrial machinery. After prolonged, unsuccessful extrication efforts and worsening risk of hemorrhagic shock, a trauma team performed an on-site high-thigh guillotine amputation under ketamine sedation. The patient was stabilized and transferred to a tertiary center for definitive care and rehabilitation. Discussion This case illustrates key challenges in rural trauma care, including decision-making under pressure, ethical consent acquisition, multidisciplinary coordination, and procedural improvisation. The case also highlights the absence of structured field amputation protocols in civilian EMS systems. Conclusion Emergency field amputation should be included in trauma training and protocol development, particularly in rural or industrial settings. Structured algorithms, simulation training, and ethical frameworks are essential to optimize outcomes in rare but high-stakes scenarios.