Clinical Practice Radio - Episode 10 - Extrication

In this episode, the team explores the evolving approach to patient extrication, with insights from DFES rescue officer Andrew “Strunky” Strunk.

They unpack the evidence behind the Extrication in Trauma (EXIT) project, challenging long-held practices, particularly the low incidence of spinal cord injury, and the shift away from movement minimisation toward faster, patient-focused extrication.

A practical look at what’s changing on the ground, and how closer collaboration between paramedics and rescue crews is improving outcomes by getting patients to definitive care sooner.

References: 

• Nutbeam, T., Fenwick, R., Haldane, C., Leech, C., Foote, E., Todd, S., & Lockey, D. (2025). Extrication following a motor vehicle collision: a consensus statement on behalf of The Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 33(1), 3.
• Nutbeam, T., Fenwick, R., May, B., Stassen, W., Smith, J. E., Wallis, L., ... & Shippen, J. (2021). The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision-a biomechanical study using healthy volunteers. Scandinavian journal of trauma, resuscitation and emergency medicine, 29(1), 108.
• Nutbeam, T., Fenwick, R., Marritt, I., Lee, B., Staveley-Wadham, L., Lang, N., ... & Leech, C. (2025). Optimising the care of the trapped patient following a motor vehicle collision: A UK-Based Delphi consensus study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 33(1), 137.
• Hawkridge, K., Ahmed, I., & Ahmed, Z. (2022). Evidence for the use of spinal collars in stabilising spinal injuries in the pre-hospital setting in trauma patients: a systematic review. European Journal of Trauma and Emergency Surgery, 48(1), 647-657.