Pre-hospital management of penetrating neck injuries: derivation of an algorithm through a National Modified Delphi.

Autor: Simpson C; Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, South Nutfield, Surrey, RH1 5YP, UK.; St Georges Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK.; PHOTON, Pre-Hospital Trainee Operated Research Network, London, UK., Tucker H; Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, South Nutfield, Surrey, RH1 5YP, UK.; St Georges Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK., Griggs J; Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, South Nutfield, Surrey, RH1 5YP, UK. jogriggs@aakss.org.uk.; Faculty of Health Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK. jogriggs@aakss.org.uk., Gavrilovski M; Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, South Nutfield, Surrey, RH1 5YP, UK.; St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK., Lyon R; Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, South Nutfield, Surrey, RH1 5YP, UK.; Faculty of Health Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK., Hudson A; Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, South Nutfield, Surrey, RH1 5YP, UK.; St Georges Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2024 Dec 02; Vol. 32 (1), pp. 123. Date of Electronic Publication: 2024 Dec 02.
DOI: 10.1186/s13049-024-01291-1
Abstrakt: Background: Timely and effective pre-hospital management of penetrating neck injuries (PNI) is critical to improve patient outcomes. Pre-hospital interventions in patients with PNI can be especially challenging due to the anatomical injury site coupled with a resource-limited environment. Nationally, in the United Kingdom, no consensus statement or expert agreed guidance exists on how to best manage PNI in the pre-hospital setting.
Method: We conducted a national modified e-Delphi study with subject matter experts (SMEs) from multiple professional specialities with experience in the management of PNI. Pre-identified SMEs were contacted and consented prior to participation allowing for a remotely conducted Delphi using REDCap and Microsoft Teams. In Round 1, statements drawn from the literature base were distributed to all SMEs. Round 2 comprised a facilitated and structured discussion of the statements and then an online survey provided final ratification in Round 3. Of the participating SMEs consensus was set a priori at 70%.
Results: Of the 67 pre-identified SMEs, 28 participated, resulting in a response rate of 42%. From the first two rounds, 19 statements were derived with every statement achieving consensus in Round 3. Subsequently, an algorithm for the pre-hospital management of PNI was developed and agreed with SME consensus.
Conclusion: Curation of national consensus statements from SMEs aims to provide principles and guidance for PNI management in a complicated patient group where pre-hospital evidence is lacking. Multi-professional national consensus on the best approach to manage these injuries alongside a novel PNI management algorithm aims to optimise time critical care and by extension improve patient outcomes.
Competing Interests: Declarations. Ethics approval and consent to participate: The project met the National Institute for Healthcare Research (NIHR, UK) criteria for service evaluation and formal ethical approval was waived. All SMEs gave informed consent and responses were kept anonymous as far as possible, aside from the facilitated discussion in Round 2. Consent for publication: Not applicable. Competing interests: The authors declare that they have no conflicts of interest.
(© 2024. The Author(s).)
Databáze: MEDLINE