Control measure

Use casualty transport equipment

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Control measure knowledge

Under the ‘LAST’ acronym, Transport is the final element to facilitate the casualty receiving appropriate and definitive medical care. It should provide the removal of casualties to a place of relative safety. It is important to remember that the casualty should be protected from any harm during this part of the operation.

Information that may be relevant and important for casualties to be safely and effectively transported, should be passed to the medical responders as part of the casualty handover. For further information refer to Handover of a casualty to a medical responder.

Rescues may need to be carried out using fire and rescue service equipment for extricating or transporting the casualty. The use of suitable equipment such as basket stretchers, scoop stretchers or equivalent should be considered.

Any equipment used should aim to reduce manual handling issues for personnel, while also reducing the risk of deterioration of the casualty’s condition. Making a request for suitable resources or equipment from other agencies should be considered.

Stretchers

When using stretchers, the following points should be addressed:

The stretcher and associated equipment must be fit for its intended use
The stretcher and associated equipment must always be used within a safe system of work
Consideration of additional loading in the rescue environment due to the use of emergency responders as stretcher attendants
The need for physical protection to prevent injury of the casualty
Warm clothing or covering for the casualty to prevent hypothermia

Generally, unconscious casualties and those with major or spinal injuries should be transported by stretcher in a horizontal position; movement in a vertical position should only be used temporarily in order to negotiate obstacles.

Motorised vehicles

It may be beneficial to consider the use of suitable motorised vehicles to assist personnel to extricate and transport the casualty. Requests for suitable resources or vehicles from other agencies should be considered.

The benefits of using motorised vehicles to transport casualties include:

Improved access and egress to the scene of operations
Reduced impact on the ongoing operations of other fire and rescue services or other agencies
To prevent deterioration of the casualty
Reduction in manual handling issues

There may be restrictions, such as insurance arrangements, on fire and rescue service vehicles being used to transport casualties to a place of relative safety, including hospitals. Fire and rescue services should have a corporate policy that clearly states whether this practice is allowed or prohibited. If it is allowed, the policy should include clear guidelines about when it would be an appropriate and justified action.

Strategic actions

Fire and rescue services should:

Ensure that relevant personnel are aware of the casualty transport equipment available, and how to request it
Ensure that relevant personnel are aware of the motorised casualty transport available, and how to request it
Have a corporate policy that clearly states whether fire and rescue service vehicles can or cannot be used to transport casualties

Tactical actions

Incident commanders should:

Consider using appropriate fire and rescue service equipment to extricate or transport the casualty
Consider requesting appropriate equipment from other agencies to extricate or transport the casualty
Consider using appropriate motorised vehicles to transport the casualty
Consider requesting appropriate motorised vehicles from other agencies to transport the casualty
Follow service policy regarding the transportation of casualties in fire and rescue service vehicles

TRAINING SPECIFICATION

Knowledge and understanding

Control measure element	Learning outcome
Removing casualties to a place of relative safety	Understand: The need to protect the casualty from harm while they are being transported The need to provide medical responders with casualty information that may affect their safe and effective transportation How to use fire and rescue service equipment for extricating or transporting the casualty The need to reduce manual handling issues for personnel How to request suitable resources or equipment from other agencies to transport the casualty
Stretchers	Understand: That stretchers and associated equipment must be fit for their intended use That stretchers and associated equipment must be used within a safe system of work The loading impact on the environment when using stretchers The need to prevent injury of or hypothermia in casualties That stretchers should be used in a horizontal position; vertical positioning should be limited to temporary use to negotiate obstacles
Motorised vehicles	Understand: The benefits of using suitable motorised vehicles to assist with extrication and transport of casualties How to request suitable resources or vehicles from other agencies to transport the casualty The service’s policy on using fire and rescue service vehicles to transport casualties to a place of relative safety, including hospitals

Control measure element

Learning outcome

Removing casualties to a place of relative safety

Understand:

The need to protect the casualty from harm while they are being transported
The need to provide medical responders with casualty information that may affect their safe and effective transportation
How to use fire and rescue service equipment for extricating or transporting the casualty
The need to reduce manual handling issues for personnel

How to request suitable resources or equipment from other agencies to transport the casualty

Stretchers

Understand:

That stretchers and associated equipment must be fit for their intended use
That stretchers and associated equipment must be used within a safe system of work
The loading impact on the environment when using stretchers
The need to prevent injury of or hypothermia in casualties
That stretchers should be used in a horizontal position; vertical positioning should be limited to temporary use to negotiate obstacles

Motorised vehicles

Understand:

The benefits of using suitable motorised vehicles to assist with extrication and transport of casualties
How to request suitable resources or vehicles from other agencies to transport the casualty
The service’s policy on using fire and rescue service vehicles to transport casualties to a place of relative safety, including hospitals

NOS knowledge and understanding

You need to know and understand:
Technical
K 12 Capabilities and limitations of personal protective and operational equipment used during search, rescue and casualty care K 17 Relevant search and rescue procedures K 20 Appropriate casualty handling techniques
You need to know and understand: 2161
K Hazards associated with the features, construction and technology of the vehicle/machinery during the extrication process K Principles of dynamic risk assessment K How the characteristics of the scene affect the dynamic risk assessment, including vehicle flow, live rails and people at the scene K Relationship between the types of impact and the consequences on the casualties K The principles of stabilising the scene and the reasons for doing so K Principles and methods of primary survey/casualties assessment K Principles of initial casualty care K The importance of establishing and maintaining communication with all persons involved K Hazards in the extrication process that may put the casualties/crew at risk K Purpose, use and limitations of equipment used to extricate K Principles of the plan B and plan A strategy K Techniques for handling casualties taking into consideration their known or potential injuries K Roles and responsibilities of other partner agencies involved in the incident K The importance of scene preservation
Extricate casualties from situations of entrapment.
K 1 Hazards associated with the features, construction and technology of the vehicle/machinery during the extrication process K 2 Principles of dynamic risk assessment K 3 How the characteristics of the scene affect the dynamic risk assessment, including vehicle flow, live rails and people at the scene K 4 Relationship between the types of impact and the consequences on the casualties K 5 The principles of stabilising the scene and the reasons for doing so K 6 Principles and methods of primary survey/casualties assessment K 7 Principles of initial casualty care K 8 The importance of establishing and maintaining communication with all persons involved K 9 Hazards in the extrication process that may put the casualties/crew at risk K 10 Purpose, use and limitations of equipment used to extricate K 11 Principles of the plan B and plan A strategy K 12 Techniques for handling casualties taking into consideration their known or potential injuries K 13 Roles and responsibilities of other partner agencies involved in the incident K 14 The importance of scene preservation
Respond to emergencies as a part of a multi-agency response at the strategic (gold) level
K The availability of relevant resources
Respond to emergencies at the tactical (silver) level
K Types of resources which may be required and how they can be obtained
Respond to emergencies at the operational (bronze) level
K Roles, responsibilities and information needs of organisations involved in response K Types of facilities which may be established to meet the needs of individuals affected by emergencies

Practical application

Control measure element	Learning outcome
Consider using appropriate fire and rescue service equipment to extricate or transport the casualty	Demonstrate the ability to: Use appropriate procedures and equipment to extricate or transport casualties
Consider requesting appropriate equipment from other agencies to extricate or transport the casualty	Demonstrate the ability to: Consider the need for resources or equipment from other agencies to extricate or transport the casualty Request resources or equipment from other agencies to extricate or transport casualties
Consider using appropriate motorised vehicles to transport the casualty	Demonstrate the ability to: Use suitable motorised vehicles to assist with the transportation of casualties
Consider requesting appropriate motorised vehicles from other agencies to transport the casualty	Demonstrate the ability to: Request suitable resources or vehicles from other agencies to transport casualties
Follow service policy regarding the transportation of casualties in fire and rescue service vehicles	Demonstrate the ability to: Adhere to service policy, which should clearly state whether the practice of transporting casualties in fire and rescue service vehicles is allowed or prohibited Ensure that if the service policy allows for fire and rescue service vehicles to be used for transporting casualties, that guidelines about when it would be an appropriate and justified action are followed

NOS performance criteria

You must be able to:
Rescue life involved in incidents
P 9 Select equipment which can be safely used to rescue life and operate it in line with its safety and operating instructions P 11 Help to take casualties to a place of safety in line with incident control procedures
You must be able to: 2146
P Contribute to dynamic assessment of risk to crew and casualties P Contribute to the identification of an appropriate B and A plan P Inform and reassure the casualties about the extrication process P Stabilise the scene of the incident using approved methods P Assess condition of the casualties and provide necessary care P Maintain on-going communication with incident commander and on-scene medical personnel in relation to condition of casualties and progress of extrication P Protect the casualty from the effects of the extrication process P Manage hazards associated with the extrication to minimise the risk to the casualty and those involved in the extrication P Use appropriate techniques and equipment to access casualties P Use appropriate techniques and equipment to remove casualties to a place of safety P Preserve evidence to support the investigation of the incident where this does not conflict with the extrication of the casualties P Complete all necessary records in relation to the use and testing of extrication equipment
Extricate casualties from situations of entrapment.
P 1 Contribute to dynamic assessment of risk to crew and casualties P 2 Contribute to the identification of an appropriate B and A plan P 3 Inform and reassure the casualties about the extrication process P 4 Stabilise the scene of the incident using approved methods P 5 Assess condition of the casualties and provide necessary care P 6 Maintain on-going communication with incident commander and on-scene medical personnel in relation to condition of casualties and progress of extrication P 7 Protect the casualty from the effects of the extrication process P 8 Manage hazards associated with the extrication to minimise the risk to the casualty and those involved in the extrication P 9 Use appropriate techniques and equipment to access casualties P 10 Use appropriate techniques and equipment to remove casualties to a place of safety P 11 Preserve evidence to support the investigation of the incident where this does not conflict with the extrication of the casualties P 12 Complete all necessary records in relation to the use and testing of extrication equipment
Respond to emergencies as a part of a multi-agency response at the strategic (gold) level
P Review the scale of required resources and confirm their availability in accordance with organisational requirements
Respond to emergencies at the tactical (silver) level
P Confirm actions to implement tactics are carried out, taking into account impacts on individuals, communities and the environment in accordance with organisational requirements P Determine priorities for allocating available resources in accordance with organisational requirements P Anticipate future resource needs, taking account of possible escalations of emergencies in accordance with organisational requirements P Work in co-operation and communicate with other responders in accordance with organisational requirements
Respond to emergencies at the operational (bronze) level
P Work in co-operation and communicate effectively with other responders in accordance with organisational requirements P Confirm availability and location of relevant services and facilities in accordance with organisational requirements P Identify resources required and deploy them to meet the demands of responses in accordance with organisational requirements P Monitor and protect the health, safety and welfare of individuals during responses in line with organisational and legislative requirements P Deal with individuals in a manner which is supportive and sensitive to their needs in accordance with organisational requirements P Liaise with relevant organisations as required for effective responses in accordance with organisational requirements

Control measure
Mass casualty and fatality plans

Major incidents

Control measure

Use casualty transport equipment

Control measure

Use casualty transport equipment

Control measure knowledge

Strategic actions

Tactical actions

TRAINING SPECIFICATION

Knowledge and understanding

NOS knowledge and understanding

Practical application

NOS performance criteria