Question 1 · Scene Safety & Extrication · Easy
After a low-speed collision a driver is sitting in an undamaged passenger cell with both doors opening freely, but cannot get out because of severe pain from an obviously deformed ankle. Using the Oxford Handbook of Pre-Hospital Care definitions, how is this entrapment classified?
- AActual entrapment
- BMechanical entrapment
- CStructural entrapment
- DRelative entrapment
- ENot an entrapment
Show answer
Answer: D
Relative entrapment
The Oxford Handbook distinguishes two kinds of entrapment. In actual entrapment the patient is physically held in the vehicle or area by the structure impinging on their body, for example by the dashboard after a collision or by fallen masonry. In relative entrapment the patient is not physically trapped but is unable to extricate themselves as a result of their injuries or the pain associated with them. This driver, in an intact cell with free-opening doors but unable to get out because of a painful deformed ankle, is relatively entrapped. 'Mechanical' and 'structural' entrapment are not the Handbook's terms, and both describe being held by the vehicle, which is the actual entrapment this driver does not have. Calling it no entrapment at all misses that he cannot get out unaided. The distinction matters for planning: the ABC notes that limbs sometimes appear more trapped than they really are and may be freed once adequate analgesia has been provided, and the Faculty of Pre-Hospital Care extrication consensus asks teams to build a plan focused on minimising entrapment time.
Where this comes from
- Oxford Handbook of Pre-Hospital Care
- Ch. 13 Patient rescue and transportation · Immobilization and extrication: entrapment, relative entrapment · p. 700“The patient is not physically trapped but is unable to extricate themselves”
- Ch. 13 Patient rescue and transportation · Immobilization and extrication: entrapment, actual entrapment · p. 700“physically held in the vehicle or area by the structure impinging on their body”
- ABC of Prehospital Emergency Medicine
- Ch. 21 Trauma: Extrication of the Trapped Patient · Tricks of the trade: limbs that appear trapped · p. 114“Sometimes limbs appear more trapped than they really are”
- Ch. 21 Trauma: Extrication of the Trapped Patient · Tricks of the trade: analgesia · p. 114“may be freed once adequate analgesia has been provided”
- Extrication following a motor vehicle collision: consensus statementRoyal College of Surgeons of Edinburgh, Faculty of Pre-Hospital Care, November 2024 (Nutbeam, Fenwick, Haldane, Leech, Foote, Todd, Lockey)·Recommendation 1: minimising entrapment time“with the primary focus of minimising entrapment time”Open PDF at page 6