Extrication following a motor vehicle collision: a consensus statement on behalf of The Faculty of Pre‑hospital Care, Royal College of Surgeons of Edinburgh

Scand J Trauma Resusc Emerg Med, 2025 · DOI: https://doi.org/10.1186/s13049-024-01312-z · Published: January 1, 2025

Simple Explanation

Traditional extrication techniques prioritize limiting movement to prevent spinal cord injuries. However, new evidence suggests this approach may not always be the best. This study presents updated recommendations for extrication, emphasizing faster, patient-centered care. The U-STEP OUT algorithm is endorsed as a decision-making tool to help responders determine the best extrication method.

Study Duration

Not specified

Participants

43 subject matter experts

Evidence Level

Level IV, Consensus Statement

Key Findings

1
Self-extrication is now considered the preferred initial approach when appropriate.
2
The focus is shifting from absolute movement minimization to reducing extrication time.
3
Interdisciplinary collaboration and enhanced training are crucial for effective extrication.

Research Summary

This consensus statement introduces a new approach to extrication, prioritizing time-sensitive and patient-centered care over strict movement minimization. The recommendations advocate for empowering both clinical and non-clinical responders and improving interdisciplinary training and communication. Further research is needed to assess the broader implementation of these guidelines and to understand the psychological impacts of entrapment.

Practical Implications

Empowering Responders

The U-STEP OUT algorithm empowers both clinical and non-clinical responders to make informed decisions, reducing entrapment time and improving patient outcomes.

Interdisciplinary Training

Policymakers should support interdisciplinary training between emergency services to ensure shared language and decision-making tools.

Bystander Care

Policy-makers will need to consider what impact this statement has on enabling bystander and non-clinician led care for the trapped patient.

Study Limitations

1
The study relies on retrospective reviews and lacks randomized controlled trials.
2
The focus is heavily on UK-based stakeholders, limiting generalizability to other international contexts.
3
The anonymized voting approach may have limited open debate during the consensus day.

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