Extrication, getting out of trouble!

This interesting paper looks at what the delaying factors are in getting patients out of vehicles which have been involved in an incident.

The factors were identified from on scene examination for over 150 incidents with data being collected from the on site commander as well as logging time details from the walkie-talkie conversations that occurred in relation to the removal of the patient.

The mean time was 33 minutes, with a range of 10–124 minutes for extrication- the authors identified 7 factors that contributed to making it take longer to extricate the patient from the vehicle. Out of interest, what do you think they are?

The knowledge of the time taken and complicating circumstances are important clinical pieces of information that have to be factored in when managing a patient, especially in the secondary setting remote from the scene. Trauma management is about managing changes in the patient's pathophysiology so insight into the problems the patient faced in the prehospital setting is vital.

The big needle or the little needle

Arterial blood gas sampling can be a painful process with …