The principles of casualty care apply to all casualties:
- Stabilise the casualty by physically isolating them from any immediate hazard that has the potential to cause harm; ideally, all hazards should be removed from the vicinity of the casualty
- Manual spinal immobilisation of all patients with the possibility of spinal injury and a reduced level of consciousness (assessed using the Glasgow Coma Scale or AVPU) should be established as soon as safe to do so, while initial assessment is undertaken
- The Pre-hospital Spinal Immobilisation: An Initial Consensus Statement should be followed; however, it should be understood that other injuries may present more significant concerns and that the recommendations of medical practitioners should be followed
- If the hazard cannot be removed, the casualty should be moved to a place of relative safety
- Maintain communication and contact with the casualty, offering reassurance and identifying levels of consciousness
- Carry out a structured assessment of the casualty and provide appropriate treatment
- Try to identify the mechanics of their injury and obtain a brief history of the casualty
- Prioritise and treat life-threatening injuries, as determined by service policies, procedures or tailored guidance
- Minimise on-scene time
- Provide full access to the casualty for assessment, treatment and packaging
- Prepare the casualty for rescue and transport
- Minimise transit time to definitive care, such as to a major or specialist trauma centre
- Reduce the casualty’s exposure to the environment
At all incidents where casualty care is provided, it should be assumed that there is a hazard of infectious diseases for emergency responders. For further information refer to Operations – Infectious diseases.
Casualty care point
Personnel can assist the medical response in planning for the care of the casualty, by establishing a casualty care point if required. This designated area can be used by medical responders for resuscitating, assessing or treating a casualty.
Consent should be obtained before administering medical treatment, if possible and appropriate. However, it may not be necessary to obtain consent if the casualty needs emergency treatment to save their life.
The British Medical Association defines obtaining consent as:
In an emergency situation, if the patient has the capacity, consent must be obtained before treatment is provided. Where it is not possible to obtain consent, responders should provide treatment that is in the patient’s best interests and is immediately necessary to save life or avoid significant deterioration to the patient’s health.