Casualty-centred rescue from a mode of transport: Full access

Control Measure Knowledge

Glass management

Glass management should take into account the need to protect the casualty from the environment as much as possible, irrespective of the ambient temperature. The glass should be managed appropriately to minimise the risk to the casualty and emergency responders. However, it should be done in line with the rescue plan, if it is providing some protection to the casualty.

It may be appropriate to deal with glass by using techniques such as winding down a window into the door or taping the glass and leaving it in situ. Many modes of transport are now fitted with laminated glass all around. This in effect provides glass that is already ‘managed’ by virtue of its construction. However, if there is laminated glass in every window, this can limit the ability to obtain immediate access.

Trim removal for road vehicles

The identification of road vehicle safety systems and their components should be an early consideration. This may involve:

  • The use of vehicle information to identify where vehicle safety systems are likely to be
  • Exposure of the area to identify potential hazards
  • Marking of areas that have been inspected and are safe for the use of hydraulic tools, all personnel should be aware of any marking scheme used
  • Removal of trim if possible and safe to do so, such as plastic coverings on A posts and B posts, which may not be possible in some vehicles; this process is sometimes referred to as ‘peel and reveal’

This will identify elements of construction or safety systems that should be avoided. On contemporary road vehicles, this can be a difficult and time-consuming process; the time this will take should be considered in the rescue plan. It may take longer to remove trim that is close to a trapped casualty.

Internal and external space creation

An appropriate hierarchical approach should be used to create space, in line with the rescue plan. This can include using the easiest or quickest methods as a priority, such as the adjustment of internal features including seats, steering controls and the removal of any luggage or goods.

Isolation of power for the mode of transport

Isolation of power for the mode of transport should be carried out only after electronic systems have been used to gain access or create space, for example, powering electrically operated locks and electric seats or steering wheels. Isolation should be carried out following a risk assessment; if it is deemed that the hazards require immediate isolation, this should take priority over the need to use the electronic systems in the mode of transport.

Incident commanders should be aware of the impact of powering down some large goods vehicles (LGV) as this could impact on the maintenance of hydraulic or pneumatic systems.

For further information refer to Transport – Safe system of work: Road vehicle safety systems.

Full access

The actions taken to create full access to the casualty will depend on their medical needs and the direction from medical responders. Additionally, environmental factors such as potential access problems and the position of the mode of transport will dictate the extent of full access, according to the initial rescue plan.

Full access requires the removal of any physical entrapment and objects that may impede the rapid removal of a casualty in a safe and controlled manner.

Sharp edges created by cuts made, as well as resultant movement on the mode of transport from tool operation, should be considered and communicated to medical responders. It may be necessary to cover sharp edges of cut or deformed metal or broken glass to protect emergency responders and casualties.

Medical responders should be provided with progress of the rescue plan, including an estimated rescue time, and updates on the condition of the casualty when necessary.

Strategic Actions

Tactical Actions