Specific stretchers enhance rapid extraction by tactical medical support teams in mass casualty incidents.

Abstract

OBJECTIVE\nIn mass casualty incidents where the threat is on-going, victim evacuation remains a challenge: fast extraction while respecting spinal immobilisation and haemorrhage control. Different devices can be used but their suitability has not been compared.\n\n\nMETHODS\nWe conducted a simulation study comparing eight extraction devices with a randomisation of the order of testing. Five teams, consisting of four officers, evacuated a single victim in five steps: device s deployment, loading the victim, carrying the victim along a corridor, negotiating a corner passage and a descent by staircase. Primary outcome was the emergency extraction time, from deployment to the first obstacle. Secondary outcomes included ease of transport and victim s stability, rated from 1 (worst) to 10 (best).\n\n\nRESULTS\nOne hundred and sixty simulations were carried out. The median emergency extraction time was 16.7 [IQR: 11.6-24.9] seconds. The three speediest devices were the firefighters worn , snogg and flexible tarp , taking 9.7 [8.1-11.0], 11.7 [10.9-15.4] and 12.2 [11.2-17.9] seconds respectively (p\u2009<\u20090.0001). Regarding the ease of transport, the three best-evaluated devices were the firefighters worn , strap and flexible tarp with 10 [9-10], 9 [8-9] and 8 [8-9] respectively (p\u2009<\u20090.0001). Considering stability reported by simulated victims, the three best-evaluated devices were the inflated stretcher , flexible tarp and firefighters worn with 8.0 [7.8-9.0], 8.0[7.0-8.0] and 6.5 [6.0-7.0] respectively.\n\n\nCONCLUSION\nDevices were not equivalent in terms of extraction time and suitability criteria. For rapid extraction of victims from danger zones, the firefighter s worn and flexible tarp , as very simple stretchers, seem to be the most appropriate devices.