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

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

Blog Article

Abstract Background Timely and effective pre-hospital management here 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 100w products 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.