Systematic approach to delivering prolonged field care in a prehospital care environment

Author:

Smith Michael,Johnston K,Withnall R

Abstract

BackgroundThis article describes a novel patient care algorithm which provides a Role 1 (R1) medic with a structured approach to delivering prolonged field care (PFC) in a resource-limited environment. PFC is a vital component of the operational patient care pathway providing the continuum of care from completion of a primary survey to the delivery to hospital care. Future operational environments are likely to have more fragile or extended lines of communication, potentially delaying evacuation to hospital care. This delay may lead to increases in patient morbidity and mortality. Effective PFC offers an opportunity to improve patient outcomes and help mitigate against this risk.MethodsAn initial prototype model of a PFC care process was developed using existing hospital-based guidance. A series of medical and trauma vignettes and best available evidence were used to refine the algorithm.ResultsThe algorithm has been designed be used in conjunction with patient specific clinical guidance making the approach generalisable for all patient groups. For UK military, clinical guidance is provided by clinical guidelines for operations. The algorithm can be downloaded into a convenient format to be used on mobile devices or printed as an aide memoire.

Publisher

BMJ

Subject

General Medicine

Reference24 articles.

1. Smith M , Johnstone K . Proposal for a systematic approach to delivering prolonged field care (PFC) in a prehospital environment. Defence Medical Scientific and Clinical Committee (DMSCC) meeting, 2018.

2. The Operational Patient Care Pathway (OPCP) . Ministry of Defence. Joint Services Publication JSP 950 Chapter 4. Available: https://www.gov.uk/government/publications/operational-patient-care-pathway [Accessed Jun 2019].

3. The Mortality Peer Review Panel: a report on the deaths on operations of UK Service personnel 2002–2013

4. Putting Role 1 First: The Role 1 Capability Review

5. Smith M , Withnall R . Developing prolonged field care (PFC) for contingency operations. J Trauma 2018;20.

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