Rescue of trapped person

Incident information

Confirm and communicate the involvement, number and severity of any casualties (persons or animals)
Question the casualty, other responders and witnesses to understand incident factors and history
Anticipate casualty condition and potential survivability given the environmental situation
Establish the last known position (LKP) or place last seen (PLS) of casualties, including times
Identify the casualty's level of consciousness and offer reassurance where possible
Further incident information
- ARCHIVE - Ascertain the likely numbers of people affected and the impact on responders accessing the scene
- Access past, present and future weather information from sources such as the Met Office
- Carry out testing and monitoring of the atmosphere and use the results to inform the incident plan
- Identify any hazardous materials signage and other indicators as part of scene survey
- Consider using a range of thermal imaging resources such as aerial appliances, drones and helicopters

Resource information

Request adequate resources to enable effective search and timely extrication of casualties
Consider requesting external specialist resources appropriate to the type, size and complexity of the incident
Request medical support at rescue incidents as soon as a need is identified
Confirm that required agencies have been requested or notified (e.g. Police, Ambulance, environmental agencies)
Request attendance of heavy or specialist rescue equipment (consider other agencies and USAR)
Further resource information
- Consider requesting hazardous area response teams (HART), Special Operations Response Team (SORT) or equivalent for bariatric rescue bariatric rescue
- Consider requesting specialist fire and rescue service technical rescue teams for bariatric rescues
- Request the attendance of specialist bariatric medical support teams and ambulances
- Consider requesting specialist resources for detection, identification and monitoring (DIM)

Risk information

Working environment
- Consider isolating sources of noise
- Identify and isolate personal medical equipment that presents a risk to responders
- Avoid handling sharps if possible and take precautions when it is necessary to handle sharps
- Consider the risk from oxygen enrichment when using tools, equipment or defibrillators
- Provide lighting to illuminate hazards to personnel in poorly lit environments
- Consider establishing an equipment, tool, debris or personnel areas
- Evaluate a range of options that avoid committing personnel to work in a confined space
Restricted access and egress
- Establish safe access and egress routes to machine rooms and shafts
- Establish, identify and communicate safe traffic routes, establish clear zones and equipment points
- Define routes using physical barriers and clearly illuminate where there is reduced visibility
- Consider the effects of geography on equipment logistics, casualties and the welfare of personnel
- Be aware of security systems and devices which could potentially isolate personnel in hazard areas
Unstable structure
- Assess and continuously monitor the structure for signs of collapse
- Consider the risk of structural failure at bariatric rescues and request specialist advice or USAR team
- Request specialist advice prior to creating new or wider openings in existing structural elements
- Consider requesting advice on structural integrity from local authority building control teams or USAR Tac Ad
- Consider requesting specialist tactical advice and resources for shoring
Confined space
- Ensure that no person shall enter a confined space unless it is not reasonably practicable to achieve without such entry
- Identify the location of suitable access and egress routes before committing crews to a confined space
- Consider implementing a tag line system to assist in tracing and locating personnel working in confined spaces
- Establish a recovery system for personnel deployed into confined space environments and ensure it is in place at all times
- Ensure that emergency arrangements are maintained and resourced for the duration of the incident
Electricity
- Isolate any utilities that may affect the incident or crew safety, and secure against reconnection
- Implement high-voltage safe system of work if a yellow 'danger of death' sign present
- Consider isolating the power supplies, considering the impact on any critical systems
- Request and record permission from the designated competent person (authorised person or senior authorised person) before commencing fire and rescue service activities near high-voltage equipment
- Identify, implement and manage safety distances for power sources that cannot be isolated
- Take precautions when carrying metal ladders or other operational equipment; these should be carried horizontally and as low to the ground as possible
- Consider the appropriate use of electrical gloves, in line with service procedures
Machinery
- Liaise with the responsible person or process expert to obtain specialist advice on machinery involved
- Liaise with the owner or occupier, on-site engineers or maintenance engineers regarding power systems
- Consider Isolating power supplies to on-site machinery
- Prevent the uncontrolled movement of machinery through shoring, chocking or similar means
- Only competent persons should be used to operate site machinery
Unguarded edges
- Use any work equipment or safety device provided in accordance with training and instructions
- Select the most appropriate work at height equipment for the activities and hazards identified
- Ensure that work at height operating systems include an appropriate degree of redundancy
- Ensure that competent personnel assess and monitor the suitability of the structure for working in the hazard area
- Monitor personnel for signs of stress, anxiety, vertigo or dizziness while working at height
- Use ladders for short duration tasks and request other equipment (e.g. aerial appliance) for other activities
Rescue tools
- Consider extrication methods which do not require the use of tools or equipment
- Select the appropriate rescue tool considering the condition of the casualty, extrication plan and materials
- Provide hard and soft protection between the tool and the casualties, operators and other responders
- Consider positioning a safety officer to monitor rescue tool operation
- Monitor rescue tool performance for indicators of unidentified materials
- Consider rotating crews involved in the use of rescue tools to reduce fatigue, exposure to noise and vibration
- Ensure all personnel wear PPE according to service risk assessment and procedures for rescue incidents
Heavy and bulky objects
- Consider using machinery or other equipment to assist with manual handling
- Request additional or specialist resources to assist with manual handling tasks
- Consider the task, individual capabilities, load and environment (TILE) when carrying out risk assessments for manual handling
- Ensure personnel adopt the provided safe system of manual handling
- Consider task rotation when personnel are carrying out manual handling tasks
Animals
- Identify and communicate the presence of animals, and any associated hazards, to emergency responders and the public
- Avoid, contain or control animals if necessary
- Request support with managing animals from owners, keepers, police, vets or welfare organisations
Bodily fluids
- Avoid contact with body fluids where possible
- Wear body fluid gloves and cover broken skin with waterproof dressing
- Isolate or cover body fluids following casualty removal
- Instigate decontamination procedures following exposure of personnel and equipment to body fluids
Hazardous materials
- Identify and contact the responsible person to understand incident factors and history
- Identify any hazardous materials signage and other indicators as part of scene survey
- Identify whether the incident should be reclassified as a hazardous materials response
- Consider the risk from oxygen enrichment when using tools, equipment or defibrillators
- Carry out testing and monitoring of the atmosphere and use the results to inform the incident plan
- Comply with hygiene arrangements and do not eat, drink, smoke or vape

Powers, policies and procedures

Restrict the access of persons to premises or a place if they reasonably believe an emergency to have occurred
Further powers, policies and procedures
- Enter premises or a place, by force if necessary, without the consent of the owner or occupier of the premises:
  - If they reasonably believe an emergency to have occurred
  - If they reasonably believe a fire to have broken out or to be about to break out
  - For the purpose of extinguishing or preventing the fire or protecting life or property
  - NB Does not apply to Crown property (including ministry of defence) and diplomatic or consular premises
  - NB The Master of the ship (or delegated officer) of a merchant vessel must give permission to board

Why?

Expectations?

Benefit vs Risk?

Objectives

Maintain the safety of all personnel, other responders and the public
Save life and reduce harm
Provide medical care and release trapped casualties
Further objectives
- Promote community recovery and restore normal operations
- Minimise the impact of the incident and fire service actions on any identified environmental risk

Tactical priorities

Establish a safe working environment for personnel and other emergency responders
Identify the number of casualties requiring medical attention and instigate a triage process
Anticipate casualty condition and potential survivability given the environmental situation
Develop a plan based on Locate, Access, Stabilise, Transport (LAST) principles
Develop and communicate immediate release, emergency and full extrication plans
Further operational tactics
- Check casualty for presence of medical ID, jewellery and other indicators of pre-existing conditions
- Protect casualties from environmental exposure to reduce risk of hypothermia or hyperthermia
- Establish emergency arrangements appropriate to the type, size and complexity of the incident
- Stay 1 metre from live parts of the system when performing a rescue of person in contact with live electricity
- Stabilise an impaled casualty by immobilising injured area and stemming any blood loss

Operational tactics

Make a safe approach to the casualty and maintain a safe environment for all involved
Identify the casualty's level of consciousness and offer reassurance where possible
Protect casualties by physically isolating them from immediate harm where possible
Request specialist medical advice prior to attempting to move casualty unless injuries are immediately life threatening
Consider benefits to casualty of immediate extrication or medical attention in-situ
Stabilise life threatening injuries or conditions and maintain casualty care throughout incident
Select the appropriate rescue tool considering the condition of the casualty, extrication plan and materials
Implement appropriate space creation techniques in line with the casualty extrication plan
Extricate the casualty considering their injuries and overall threat to life
Further operational tactics
- Check casualty for presence of medical ID, jewellery and other indicators of pre-existing conditions
- Protect casualties from environmental exposure to reduce risk of hypothermia or hyperthermia
- Establish emergency arrangements appropriate to the type, size and complexity of the incident
- Stay 1 metre from live parts of the system when performing a rescue of person in contact with live electricity
- Stabilise an impaled casualty by immobilising injured area and stemming any blood loss

Communication

Ensure that everyone on the incident ground is fully briefed on the current hazards, specific risks and control measures including other agencies and organisations
Share situational awareness and establish a joint understanding of risk with other agencies
Provide a structured handover when transferring casualty to medical responders
Further communication
- Establish effective communications with other emergency services and relevant people as soon as possible
- Use intrinsically safe radio equipment in atmospheres where there is a risk of fire or explosion

Control

Co-ordinate the simultaneous activities of extrication teams and tool operators
Appoint competent safety officers to monitor specific hazards or activities
Further control information
- Commit only minimum number of essential personnel to hazard area
- Consider task rotation when personnel are carrying out manual handling tasks
- Carry out and formally record analytical risk assessments at suitable intervals
- Communicate findings of analytical risk assessment to all personnel and other agencies

Incident closure and handover

Ensure that hazards, potential hazards and control measures are identified when handing over responsibility for health and safety to the responsible person
Secure the scene to ensure evidence is preserved for internal and external investigations
Further incident and closure information
- Conduct a debrief at a level appropriate to the size and/or complexity of the incident
- Record and share significant findings from incidents and investigations to inform future practice

Rescue of trapped person

Incident information

Further incident information

Resource information

Further resource information

Risk information

Working environment

Restricted access and egress

Unstable structure

Confined space

Electricity

Machinery

Unguarded edges

Rescue tools

Heavy and bulky objects

Animals

Bodily fluids

Hazardous materials

Powers, policies and procedures

Further powers, policies and procedures

Objectives

Further objectives

Tactical priorities

Further operational tactics

Operational tactics

Further operational tactics

Communication

Further communication

Control

Further control information

Incident closure and handover

Further incident and closure information

Additional information