What We Did
We recruited patients via the Devon Air Ambulance and the spinal injury charity Aspire. All of the patients had been extricated following a motor vehicle collision. The patients who were recruited by Aspire had spinal cord injuries. An expert qualitative interviewer and psychotherapist interviewed each of the participants. Themes from the interviews were collated and patient priorities identified.
What We Found
The main theme across all participants was that of the importance of communication; successful communication to the trapped patient resulted in a sense of well-being and where communication failures occurred this led to distress. The data generated three key subthemes: ‘on-scene communication’, ‘physical needs’ and ‘emotional needs’. Specific practices were identified that were of use to patients during entrapment and extrication.
What This Means
Extrication experience was improved by positive communication, companionship, explanations and planned postincident follow-up. Extrication experience was negatively affected by failures in communication, loss of autonomy, unmanaged pain, delayed communication with remote family and onlooker use of social media. Recommendations which will support a positive patient-centred extrication experience are the presence of an ‘extrication buddy’, the use of clear and accessible language, appropriate reassurance in relation to co-occupants, a supportive approach to communication with family and friends, the minimisation of onlooker photo/videography and the provision of planned (non-clinical) follow-up.
Authors
Tim Nutbeam, Janet Brandling, Lee A Wallis and Willem Stassen