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.