Skip to main content

Developed and maintained
by the NFCC

Control measure

Release of impaled or trapped casualty

Control measure knowledge

The actions of personnel should be centred around the casualty; the selection of tools and equipment should be capable of releasing the casualty while causing the least amount of intrusion or injury to the casualty.

The method of rescue will vary depending on the cause and level of entrapment. Medical assistance should be requested if the casualty has or could have external or internal blood loss, or crush injuries.

Consideration should be given to stabilising the object that is trapping the casualty, to prevent it from moving. There may be resultant movement of the object when it is cut, with stored energy harming the casualty or emergency responders. If possible, this should be mitigated by using items such as hard and soft protection. For further information about personal protective equipment for casualties refer to Personal protective equipment: Rescues

If resuscitation is required, the casualty may have to be moved to carry out life-saving treatment. However, uncontrolled removal of the casualty from the object, or the object from the casualty is likely to result in further injury and deterioration of their condition.

Release from impalement

Stabilisation of a casualty may need to be achieved by immobilising the injured area,with all bleeding stopped or controlled. Release of an impaled casualty will need to be carried out in a way that prevents further deterioration and trauma and will require immediate medical assistance.

Working in hospitals

If personnel need to work in a hospital to assist with the removal of objects from casualties, they should receive a full briefing from the medical staff so that the appropriate equipment can be deployed. Equally, the medical staff should be given an explanation of the potential impact of using the fire and rescue service equipment, for example, potential harm to the casualty, noise levels and level of personal protective equipment (PPE) required.

Where possible, personnel should wear clean PPE when entering a hospital.

There may be restrictions on what items can be taken into a sterile area in a hospital, for example, engine-driven hydraulic cutting equipment. This will require understanding on the part of personnel and medical staff, and may lead to alternative methods having to be investigated.

The use of joint on-site training and exercises may improve interoperability with local hospitals, and ensure personnel understand more about the hospital environments they may be required to work in.

Strategic actions

Fire and rescue services should:
  • Consider providing or having access to rescue equipment suitable for releasing casualties impaled or trapped by objects

  • Use joint on-site training and exercises to improve interoperability with local hospitals

Tactical actions

Incident commanders should:
  • Use an appropriate method to stabilise the object or casualty, to prevent further injury from impalement or entrapment

  • Select the most appropriate and capable tool that is suitable for the working environment

  • Request appropriate medical assistance for a casualty who is impaled or trapped by an object

  • Only consider moving an impaled or trapped casualty if life-saving treatment needs to be carried out

  • Protect the impaled or trapped casualty from the movement of the object when it is being cut

  • Take advice from medical staff when selecting equipment and methods when working in a hospital to release an impaled or trapped casualty

  • Wear clean PPE when entering a hospital