While praising the efforts of medical teams involved in helping the injured in Christchurch, Waikato Hospital's emergency department clinical director, Dr John Bonning said emergency amputations where people were pinned under objects were extremely rare in New Zealand.
"You don't have X-rays so you might not know if they've broken their neck or these sorts of things when you're managing an anaesthetised, unconscious patient," he said.
"There are huge dangers in sedating an undifferentiated patient, a lot of the drugs can make their blood pressure plummet and if they are in true clinical and traumatic shock they can go into cardiac arrest on you."
Dr Bonning, who also chairs the New Zealand Faculty of the Australasian College for Emergency Medicine, said the operations were not done with as much "delicacy", as they were in the sterile environs of an operating theatre.
"It's quite a different kettle of fish and it's only done in a state of desperation. For a start the rubble cannot be moved and the patient will be in huge amounts of pain so you would have to sort out a field operating area by presumably putting up some kind of tent. You would need an anaesthetist, a surgeon, assistance in monitoring drugs and a good blood supply - the logistics are enormous," he said.
"But this will be made difficult because it is outside, there will be dust, there could be rain and wind and the person might be in a position where they can't lie down. You'd need blood available for blood loss presumably because you have to cut through large blood vessels and those sorts of things. It's real war-zone stuff."
Dr Bonning said broken or crushed limbs were generally the last thing medics would be worried about and he believed it was very unlikely those trapped in the rubble would have isolated limb injuries.
"It's more the injuries to the internal organs, your head, your chest or your neck. A person could have a ruptured liver and it's very difficult to manage such an unstable patient," he said.
"You can't X-ray things. You don't know what's broken because you can't see. It's absolute desperation stuff only done as an absolute last resort."
