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by the NFCC

Control measure

Rescue of a casualty with complex requirements

Control measure knowledge

Making an early identification of a bariatric casualty allows for an appropriate response by the fire and rescue service, initiating a response for advanced medical support and appropriate casualty management equipment.

  • Make an early identification of the bariatric casualty
  • Make an early TILE risk assessment:
    • Task
    • Individual capability
    • Load
    • Environment
  • Use the principles of safer moving and handling:
    • Avoid
    • Assess
    • Reduce

There may be complications with access and egress, or in getting to and from the casualty. This could necessitate structural changes being made to the building, and early consideration should be given to requesting specialist resources, such as urban search and rescue (USAR), for structural advice and assistance.

The deterioration of a bariatric casualty’s condition should be anticipated, based on their body position and the forces applied by their weight to organs, blood flow or respiration.

If a casualty requires rescue while remaining dependent on medical equipment, a retrieval team to support their rescue should be requested through the ambulance service. This will help to facilitate the movement and management of the equipment throughout the rescue.

Protocols for a multi-agency response for the rescue of casualties with complex requirements should be established with local care providers and other agencies.

Strategic actions

Fire and rescue services should:
  • Make arrangements with local care providers and other agencies to establish protocols for response to the rescue of casualties with complex requirements

  • Have systems in place to request USAR advice and resources from the National Resilience Fire Control

Tactical actions

Incident commanders should:
  • Consider manual handling when planning to extricate or transport casualties with complex requirements

  • Adopt service protocols for multi-agency working at rescues involving casualties with complex requirements

  • Consider requesting advanced medical support and appropriate casualty management equipment for rescuing casualties with complex requirements

  • Consider the need for structural advice or assistance when rescuing a casualty with complex requirements

  • Request the attendance of a retrieval team for rescues involving casualties with complex requirements