Table 3 FPHC consensus statements

All patients with injury should be considered time dependent. Operational and clinical team members should work together to rapidly develop a bespoke patient centred extrication plan with the primary focus of minimising entrapment time

[IV D]

[4, 5, 10, 16, 17]C

Non-clinicians should be empowered to decide on the extrication mode and deliver this before the arrival of the clinical team

[IV D]

[18] C

Self-extrication or minimally assisted extrication should be the standard ‘first line’ extrication for all patients who do not have contraindications

[III D]

[5, 7, 10, 16] C

Self-extrication decision making for non-clinicians should use an appropriate tool, such as U-STEP OUT

[IV D]

C

Patients who cannot independently self-extricate may benefit from assisted self-extrication

[IV D]

[8] C

In fully conscious patients who do not have neurology it is not necessary to provide manual inline stabilisation in the vehicle

[IV D]

[19, 20] C

If hard neurological signs are present on initial assessment the patient should have a rapid extrication with gentle patient handling

[IV D]

[4] C

Collars reduce neck movement. They should be applied prior to extrication when indicated and removal considered when the extrication phase is complete

[III D]

[11, 20] C

Vehicle relocation, including vehicles in which patients are trapped should be implemented if this will reduce entrapment time

[IV D]

[2] C

Rescuers should be aware that clinical observations may prolong entrapment time and as such should be kept to a minimum

[IV D]

[17, 21] C

Clinical care during entrapment should be limited to necessary critical interventions to expedite safe extrication

[IV D]

[17, 21] C

If a pelvic binder is indicated this should be applied after the process of extrication is complete

[IV D]

S

The psychological impact of extrication should be considered and support mechanisms implemented

[III D]

[6, 7] S

FRS services /brigades and ambulance trusts should ensure regular joint multidisciplinary learning, sharing and case review opportunities

[IV D]

C