ORCID

Abstract

Background Motor vehicle collisions (MVCs) are a leading cause of injury and death worldwide. Up to 40% ofcasualties may become trapped and entrapment is associated with delayed care and worse outcomes. There is littlenational or international consensus guiding the care of physically trapped patients who cannot self-extricate. Thisstudy aimed to develop multidisciplinary consensus-based principles to optimise clinical and operational care fortrapped 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 expertconsultation. Subject matter experts (SMEs) with operational experience in extrication, prehospital, and traumacare 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 fromsubsequent 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 104statements covering standardised extrication terminology, prioritisation of time-sensitive extrication for criticallyinjured patients, minimisation of unnecessary on-scene interventions, emphasis on early psychological support fortrapped casualties, and the importance of interdisciplinary communication and coordination. The consensus supportsa paradigm shift towards rapid, patient-centred extrication, balancing clinical needs, operational realities, andpsychological welfare.Conclusions This Delphi study establishes expert-endorsed principles for the care of physically trapped patientsfollowing MVCs. Adoption of these principles could reduce delays, strengthen multi-agency response and improvepatient outcomes. Further work is required to validate the impact of these recommendations on clinical outcomesand to support their integration into practice through policy development, training, and evaluation.

Publication Date

2025-08-11

Publication Title

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Volume

33

Issue

1

ISSN

1757-7241

Acceptance Date

2025-07-31

Deposit Date

2025-10-10

Funding

This study is funded by a charitable grant from the Road Safety Trust. The Road Safety Trust had no role in the design, data collection, analysis or writing of this manuscript.

Keywords

Emergency medical services, Extrication, Prehospital care, Rescue, Road injury, Trapped

Download

Share

COinS