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Journal Article

Citation

Nutbeam T, Brandling J, Wallis LA, Stassen W. BMJ Open 2022; 12(9): e063798.

Copyright

(Copyright © 2022, BMJ Publishing Group)

DOI

10.1136/bmjopen-2022-063798

PMID

36127106

Abstract

OBJECTIVE: To explore patient's experience of entrapment and subsequent extrication following a motor vehicle collision and identify their priorities in optimising this experience.

DESIGN: Semistructured interviews exploring the experience of entrapment and extrication conducted at least 6 weeks following the event. Thematic analysis of interviews.

SETTING: Single air ambulance and spinal cord injury charity in the UK.

PARTICIPANTS: 10 patients were recruited and consented; six air ambulance patients and two spinal cord injury charity patients attended the interview. 2 air ambulance patients declined to participate following consent due to the perceived potential for psychological sequelae.

RESULTS: The main theme across all participants was that of the importance of communication; successful communication to the trapped patient resulted in a sense of well-being and where communication failures occurred this led to distress. The data generated three key subthemes: 'on-scene communication', 'physical needs' and 'emotional needs'. Specific practices were identified that were of use to patients during entrapment and extrication.

CONCLUSIONS: Extrication experience was improved by positive communication, companionship, explanations and planned postincident follow-up. Extrication experience was negatively affected by failures in communication, loss of autonomy, unmanaged pain, delayed communication with remote family and onlooker use of social media. Recommendations which will support a positive patient-centred extrication experience are the presence of an 'extrication buddy', the use of clear and accessible language, appropriate reassurance in relation to co-occupants, a supportive approach to communication with family and friends, the minimisation of onlooker photo/videography and the provision of planned (non-clinical) follow-up.


Language: en

Keywords

accident & emergency medicine; spine; trauma management

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