Prioritising time-critical injuries and interventions for trapped motor vehicle collision patients: a Delphi study
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View abstract on PubMed
Summary
This summary is machine-generated.Expert consensus was reached on prioritising early interventions for physically trapped patients after motor vehicle collisions. This framework guides prehospital care, focusing on patient needs and feasible interventions.
Area Of Science
- Prehospital emergency medicine
- Trauma care
- Medical consensus development
Background
- Motor vehicle collisions frequently result in physically trapped patients with time-critical injuries.
- Limited prehospital consensus exists on injury prioritization and feasible early interventions for these patients.
- This study addresses the need for structured decision-making at the scene for trapped individuals.
Purpose Of The Study
- To develop expert consensus on injury categorization for trapped patients.
- To establish agreement on necessary and feasible early care interventions in the prehospital setting.
- To guide clinical and operational decision-making for emergency responders.
Main Methods
- A modified Delphi method involved a multidisciplinary expert panel (clinicians, paramedics, fire/rescue).
- Three rounds of statement refinement and rating were conducted, followed by a face-to-face consensus meeting.
- Consensus was defined as 70% agreement on statements regarding injury time sensitivity, intervention prioritization, and responder roles.
Main Results
- Consensus was achieved on 45 statements covering injury categorization, time-critical interventions, and multi-agency responsibilities.
- Strong endorsement for early analgesia, tranexamic acid, and environmental protection, contingent on training and governance.
- Broad support for expanding non-clinical responder scope of practice to address urgent patient needs.
Conclusions
- A framework for prioritizing early interventions in trapped patient care has been established.
- The consensus supports a patient-centered, capability-based prehospital approach emphasizing feasibility and urgency.
- Findings inform standard operating procedures, triage tools, and training frameworks, with a need for further research on assessment heuristics and implementation barriers.
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