Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study
Abstract Background Motor vehicle collisions (MVCs) are a leading cause of injury and death worldwide. Up to 40% of casualties may become trapped and entrapment is associated with delayed care and worse outcomes. There is little national or international consensus guiding the care of physically trap...
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| Format: | Article |
| Language: | English |
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BMC
2025-08-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s13049-025-01449-5 |
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| author | Tim Nutbeam Rob Fenwick Ian Marritt Brian Lee Luke Staveley-Wadham Nigel Lang Louise Johnson Nicolas Mattock Jane Ogilvie Emily Foote Francis Screech Lara Lebeau-Humarau Caroline Leech |
| author_facet | Tim Nutbeam Rob Fenwick Ian Marritt Brian Lee Luke Staveley-Wadham Nigel Lang Louise Johnson Nicolas Mattock Jane Ogilvie Emily Foote Francis Screech Lara Lebeau-Humarau Caroline Leech |
| author_sort | Tim Nutbeam |
| collection | DOAJ |
| description | Abstract Background Motor vehicle collisions (MVCs) are a leading cause of injury and death worldwide. Up to 40% of casualties may become trapped and entrapment is associated with delayed care and worse outcomes. There is little national or international consensus guiding the care of physically trapped patients who cannot self-extricate. This study aimed to develop multidisciplinary consensus-based principles to optimise clinical and operational care for trapped patients following MVC. Methods A three-round Delphi study was conducted from January to March 2025, following the CREDES framework. A multi-professional steering group developed preliminary statements informed by literature review and expert consultation. Subject matter experts (SMEs) with operational experience in extrication, prehospital, and trauma care were recruited through stakeholder organisations. Statements were refined iteratively through SME feedback. Consensus was defined as ≥ 70% agreement or disagreement. Statements reaching consensus were removed from subsequent rounds; others were revised based on free-text feedback. Results Sixty-six SMEs participated, with high engagement across all three rounds. Consensus was achieved for 104 statements covering standardised extrication terminology, prioritisation of time-sensitive extrication for critically injured patients, minimisation of unnecessary on-scene interventions, emphasis on early psychological support for trapped casualties, and the importance of interdisciplinary communication and coordination. The consensus supports a paradigm shift towards rapid, patient-centred extrication, balancing clinical needs, operational realities, and psychological welfare. Conclusions This Delphi study establishes expert-endorsed principles for the care of physically trapped patients following MVCs. Adoption of these principles could reduce delays, strengthen multi-agency response and improve patient outcomes. Further work is required to validate the impact of these recommendations on clinical outcomes and to support their integration into practice through policy development, training, and evaluation. |
| format | Article |
| id | doaj-art-77d60287159f48ceae97cbfcc94937fd |
| institution | DOAJ |
| issn | 1757-7241 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj-art-77d60287159f48ceae97cbfcc94937fd2025-08-20T03:06:04ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-08-0133111110.1186/s13049-025-01449-5Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus studyTim Nutbeam0Rob Fenwick1Ian Marritt2Brian Lee3Luke Staveley-Wadham4Nigel Lang5Louise Johnson6Nicolas Mattock7Jane Ogilvie8Emily Foote9Francis Screech10Lara Lebeau-Humarau11Caroline Leech12IMPACT, Centre for Post-Collision Research Innovation and TranslationIMPACT, Centre for Post-Collision Research Innovation and TranslationUnited Kingdom Rescue Organisation, World Rescue Organisation, Humberside Fire and RescuePatient and Public Representative, IMPACT; Centre for Post-Collision Research Innovation and TranslationUniversity Hospitals Plymouth NHS TrustDevon Air AmbulanceLeeds Teaching Hospitals NHS Trust National Police Chiefs’ Council Scottish Fire and Rescue ServiceUniversity Hospitals Plymouth NHS TrustUniversity Hospitals Plymouth NHS TrustUniversity of PlymouthUniversity Hospitals Coventry & Warwickshire NHS TrustAbstract Background Motor vehicle collisions (MVCs) are a leading cause of injury and death worldwide. Up to 40% of casualties may become trapped and entrapment is associated with delayed care and worse outcomes. There is little national or international consensus guiding the care of physically trapped patients who cannot self-extricate. This study aimed to develop multidisciplinary consensus-based principles to optimise clinical and operational care for trapped patients following MVC. Methods A three-round Delphi study was conducted from January to March 2025, following the CREDES framework. A multi-professional steering group developed preliminary statements informed by literature review and expert consultation. Subject matter experts (SMEs) with operational experience in extrication, prehospital, and trauma care were recruited through stakeholder organisations. Statements were refined iteratively through SME feedback. Consensus was defined as ≥ 70% agreement or disagreement. Statements reaching consensus were removed from subsequent rounds; others were revised based on free-text feedback. Results Sixty-six SMEs participated, with high engagement across all three rounds. Consensus was achieved for 104 statements covering standardised extrication terminology, prioritisation of time-sensitive extrication for critically injured patients, minimisation of unnecessary on-scene interventions, emphasis on early psychological support for trapped casualties, and the importance of interdisciplinary communication and coordination. The consensus supports a paradigm shift towards rapid, patient-centred extrication, balancing clinical needs, operational realities, and psychological welfare. Conclusions This Delphi study establishes expert-endorsed principles for the care of physically trapped patients following MVCs. Adoption of these principles could reduce delays, strengthen multi-agency response and improve patient outcomes. Further work is required to validate the impact of these recommendations on clinical outcomes and to support their integration into practice through policy development, training, and evaluation.https://doi.org/10.1186/s13049-025-01449-5Road injuryEmergency medical servicesRescueExtricationTrappedPrehospital care |
| spellingShingle | Tim Nutbeam Rob Fenwick Ian Marritt Brian Lee Luke Staveley-Wadham Nigel Lang Louise Johnson Nicolas Mattock Jane Ogilvie Emily Foote Francis Screech Lara Lebeau-Humarau Caroline Leech Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Road injury Emergency medical services Rescue Extrication Trapped Prehospital care |
| title | Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study |
| title_full | Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study |
| title_fullStr | Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study |
| title_full_unstemmed | Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study |
| title_short | Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study |
| title_sort | optimising the care of the trapped patient following a motor vehicle collision a uk based delphi consensus study |
| topic | Road injury Emergency medical services Rescue Extrication Trapped Prehospital care |
| url | https://doi.org/10.1186/s13049-025-01449-5 |
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