Extrication Consensus Statement FPHC; Roadside to Resus
Nov 14, 2024
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Tim Nutbeam, an expert in extrication techniques and lead author of the Faculty of Pre-Hospital Care's consensus statement, discusses urgent topics surrounding motor vehicle collisions. With over a million deaths yearly, he emphasizes the need for improved extrication practices. The conversation delves into tailored emergency protocols, the role of multidisciplinary training, and innovative recommendations for spinal injury management. Nutbeam also highlights the importance of compassionate care and swift actions during emergencies to enhance patient outcomes.
Motor vehicle collisions account for 1.2 million deaths annually worldwide, necessitating improvements in patient care and extrication protocols.
The new Consensus Statement emphasizes a collaborative approach among emergency response teams to enhance efficiency and patient outcomes during extrication.
Deep dives
Epidemiology of Motor Vehicle Collisions
Motor vehicle collisions remain a significant public health concern, with approximately 1.2 million deaths attributed to them worldwide each year, making it the leading cause of death among children and young adults aged 5 to 29. In the UK alone, around 1,500 fatalities occur annually, in addition to 60,000 cases of severe injuries resulting from these incidents. The data highlights the urgency to enhance patient care in such situations, especially considering that many patients may face lengthy extrication processes, either being physically or medically trapped. Understanding the different scenarios leading to entrapment is crucial for developing effective guidelines for improving extrication protocols.
Redefining Extrication Practices
Extrication is defined as the process of safely removing an injured individual from their vehicle after a collision. While some patients are physically trapped within the wreckage, a far greater number are medically trapped, meaning they could exit the vehicle but are unable to do so due to pain or potential injury. Current guidelines emphasize the importance of minimizing patient entrapment time and adopting a bespoke, patient-centered approach to extrication. This involves assessing each situation to determine the best method of extrication, which may vary significantly based on the specific circumstances surrounding the incident.
Self-Extrication as a Priority
A critical insight from recent research is the emphasis on encouraging self-extrication whenever possible, as it often leads to the quickest and safest outcomes for patients. The guidelines advocate that minimally assisted extrication should be the standard approach for patients who do not have contraindications for self-removal. This approach is grounded in evidence showing that self-extrication reduces spinal movement and can significantly decrease extrication times. The decision-making process should integrate the use of assessment tools to evaluate a patient's ability to self-extricate, ensuring both safety and efficiency.
Collaborative Multidisciplinary Approaches
The necessity for collaboration among various emergency response teams is highlighted, advocating for regular joint training and case review sessions. Effective extrication is not solely the responsibility of clinical personnel; non-clinicians, such as firefighters, should also be empowered to make critical extrication decisions early in the process. This shift in responsibility aims to expedite patient assessment and care while minimizing delays caused by unclear communication. Building a foundation for shared learning and mutual understanding across disciplines is essential for optimizing patient outcomes in the critical moments following a motor vehicle collision.
Motor vehicle collisions or road traffic collisions are a massive problem worldwide. Data from the World Health Organisation reports that there are around 1.2 million deaths every year and this is the leading cause of death internationally for children and young adults aged 5-29 years.
In the UK there are around 1,500 deaths annually and also around 60,000 patients with significant and life changing injuries, which is 7 patients every hour!! So anything we can do to improve patient care following an MVC is definitely a worthwhile venture.
We’ve looked at Extrication here on the podcast before but we’re back on it again because today the Faculty of Pre Hospital Care have released their Consensus Statement on Extrication Following a Motor Vehicle Collision.
The statement builds on the work from the EXIT project and the research that has helped inform our understanding of multiple factors of extrication. The statement will inform a change of practice for both clinicians and non-medical responders and in this episode we run through the statement with two of it’s authors and discuss the practical applications.
Make sure you take a look at the new Consensus Statement itself and the background evidence which is all linked to on the website.
Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon, Rob & James
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