A Delphi study of rescue and clinical subject matter experts on the extrication of patients following a motor vehicle collision

Abstract

Background Approximately 1.3 million people die each year globally as a direct result of motor vehicle collisions (MVCs). Following an MVC some patients will remain trapped in their vehicle; these patients have worse outcomes and may require extrication. Following new evidence, updated multidisciplinary guidance for extrication is needed. Methods This Delphi study has been developed, conducted and reported to CREDES standards. A literature review identified areas of expertise and appropriate individuals were recruited to a Steering Group. The Steering Group formulated initial statements for consideration. Stakeholder organisations were invited to identify subject matter experts (SMEs) from a rescue and clinical background (total 60). SMEs participated over three rounds via an online platform. Consensus for agreement / disagreement was set at 70%. At each stage SMEs could offer feedback on, or modification to the statements considered which was reviewed and incorporated into new statements or new supporting information for the following rounds. Stakeholders agreed a set of principles based on the consensus statements on which future guidance should be based. Results Sixty SMEs completed Round 1, 53 Round 2 (88%) and 49 Round 3 (82%). Consensus was reached on 91 statements (89 agree, 2 disagree) covering a broad range of domains related to: extrication terminology, extrication goals and approach, self-extrication, disentanglement, clinical care, immobilisation, patient-focused extrication, emergency services call and triage, and audit and research standards. Thirty-three statements did not reach consensus. Conclusion This study has demonstrated consensus across a large panel of multidisciplinary SMEs on many key areas of extrication and related practice that will provide a key foundation in the development of evidence-based guidance for this subject area.

Understanding people’s experiences of extrication while being trapped in motor vehicles: a qualitative interview study

“…The principles outlined in box 1 have been shared with national-level stakeholders in the area of rescue and clinical practice. The principles have been made available to a panel of subject matter experts to inform a Delphi study; consensus was reached on all of these principles and they have been adopted for incorporation into operational and clinical guidance 43…”

“…The principles have been made available to a panel of subject matter experts to inform a Delphi study; consensus was reached on all of these principles and they have been adopted for incorporation into operational and clinical guidance. 43 Further research should focus on the medium-term and long-term sequelae of debriefing by rescue services.…”

Research on cross regional emergency material scheduling algorithm based on seed optimization algorithm

“…The mathematical model for optimizing the scheduling of cross regional emergency material dispatch vehicles is constructed, determining the path at the current point and moving target 27 . Combining with the spatial distribution intensity of cross regional emergency material dispatch vehicles, the difference goal planning parameter between individuals i and j is obtained as .…”