Prolonged field care (austere emergency care) principles in UK paramedic practice

Prolonged field care (PFC) is a concept born and developed in the military. It was initially developed by special forces, where extraction and evacuation may be significantly delayed because of operational pressures.

The standard military definition is:

‘Field medical care applied beyond doctrinal planning timelines to decrease patient mortality and morbidity. Prolonged field care uses limited resources and is sustained until the patient arrives at the next appropriate level of care.’

The situation in UK civilian practice is far removed from that of special forces deploying in hostile areas. However, with patients now spending longer and longer in the backs of ambulances waiting to disembark at hospitals running over capacity, it may be time to embrace the principles of PFC.

While the transition from initial care to prolonged care is along a blurred line of ongoing care, some would argue that PFC commences once a primary assessment has been completed (Smith et al, 2021), after the golden hour (Keenan and Riesberg, 2017) or at any time when onward transit of a patient to the next appropriate level of care is delayed (Remley et al, 2021) (Table 1).