Follow the principles of casualty care

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
• If the hazard cannot be removed, the casualty should be moved to a place of relative safety
• Manual spinal immobilisation of all casualties who have the possibility of spinal injury and a reduced level of consciousness, assessed using the Glasgow Coma Scale or AVPU (alert, voice, pain, unresponsive), should be established as soon as it is 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
• 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 casualty care
• Try to identify the mechanics of their injury and obtain a brief history of the casualty; this may require questioning the casualty, other emergency responders or witnesses
• 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