Following an MVC some patients will remain trapped in their vehicle; these patients have worse outcomes and may require extrication. Following new evidence, updated multidisciplinary guidance for extrication is needed.
What We Did
This is a Delphi study of experts nominated by key stakeholders in clinical and operational extrication practice. A Delphi study iterative multi-stage consensus research technique where the experts interact anonymously from each other; developing and subsequently approving or rejecting statements reflecting different aspects of extrication practice. In this study 60 experts were nominated by the National Fire Chiefs Council (NFCC), the United Kingdom Rescue Organisation (UKRO), the National HEMS Research & Audit Forum (NHRAF), the College of Paramedics (CoP), the Pre-Hospital Trainee Operated Research Network (PHOTON) and the Faculty of Prehospital Care (FPHC).
What We Found
Consensus was reached on 91 (89 agree, 2 disagree) statements covering a broad range of domains related to: extrication terminology, extrication goals and approach, self-extrication, disentanglement, clinical care, immobilisation, patient-focused extrication, emergency services call and triage, and audit and research standards. These statements were summarised into a consensus document which was adopted by all stakeholder groups.
What This Means
This study has demonstrated consensus across a large panel of multidisciplinary SMEs on many key areas of extrication and related practice that will provide a key foundation in the development of evidence-based guidance for the extrication of patients following a motor vehicle collision.
Authors
Tim Nutbeam, Rob Fenwick, Jason E. Smith, Mike Dayson, Brian Carlin, Mark Wilson, Lee Wallis and Willem Stassen