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Systematic approach to delivering prolonged field care in a prehospital care environment
  1. Michael Smith,
  2. K Johnston and
  3. R Withnall
  1. RCI, RCDM, Birmingham, UK
  1. Correspondence to Professor Michael Smith, RCI, RCDM, Birmingham B15 2SQ, UK; mikesmith{at}


Background This 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.

Methods An 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.

Results The 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.

  • prolonged field care
  • algorithm
  • clinical guidelines for operations
  • end organ
  • sepsis

Statistics from


  • Contributors The authors would like to acknowledge the hard work and support from the prolonged field care working group.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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