Situational awareness - Calls from or about people at risk: Severe bleeding and unresponsive casualties

Control Measure Knowledge

Redirect calls to ambulance

Calls from or about unresponsive casualties, or people losing a lot of blood, should always be redirected to ambulance control, once sufficient details have been obtained to determine the fire and rescue service response to the incident.

Redirecting calls to ambulance control will ensure the call is triaged and the casualty can receive appropriate medical care. To redirect calls to another emergency service, fire control personnel should follow the process in PECS Code of Practice. Refer to Share information with other agencies: People at risk for more information about the call redirection process.

To prevent a delay in the sharing of risk-critical information, the fire control commander should ensure that information from an emergency call that is in progress is shared with relevant operational personnel and other agencies. This task may be allocated to another member of the team so emergency call management and provision of guidance is uninterrupted. If delays in calls being answered are experienced, the use of relevant hailing groups should be considered.

Refer to Emergency call supervision and Organisation of the fire control function for more information.

Zero responders

Research shows that many uninjured bystanders involved in, or close to, emergency events, will spontaneously help others. A zero responder is somebody at the scene of an incident who can provide first aid in the critical minutes following a casualty being injured and before professional emergency services arrive on the scene. This action can help to fill or mitigate the ‘care gap’. Fire control personnel may be able to provide zero responders with initial advice to help save lives and reduce harm.

Providing care should not put zero responders in increased danger. They should be advised to remain alert to current hazards and monitor for changes.

People calling about events where people have been severely injured are likely to be distressed, even if they are not injured themselves. The use of appropriate techniques when communicating with distressed people can help them to remain calm. Refer to Control measure – Effective communication: People at risk for more information.

If it is not possible to redirect a call, for example if there is a technical failure, or extensive delays in calls being answered by ambulance control, fire control personnel must gather information from callers.  They use the information gathered to identify those casualties requiring life-saving initial medical attention, such as those losing a lot of blood and unresponsive casualties.

Fire control personnel should try and establish the nature of the injuries and condition of the casualty the caller is describing, including:

  • Their level of consciousness, for example, are they:
    • Walking
    • Talking, including reacting to being spoken or shouted at
    • Breathing or not breathing
  • If there are signs of severe bleeding with, for example, blood:
    • Gushing uncontrollably
    • Coming out in regular spurts
    • Trickling out slowly
    • Pooling on hard surfaces or soaking into absorbent surfaces, such as grass or clothing
  • Where the blood is coming from, such as:
    • Neck
    • Chest
    • Groin
    • Buttocks
    • Limbs
  • How the injuries happened, for example the casualty may have been involved in an explosion; describing how an injury occurred may help ambulance control and emergency responders
  • What the wound looks like, for example whether it is a large open wound or whether there is anything embedded in it, such as a bladed weapon, shrapnel or broken glass
  • The age of the casualty, which may also help ambulance control and emergency responders

Fire control personnel should accurately record and share the information with ambulance control and operational personnel without delay, as it may affect the guidance that should be given and influence the integrated multi-agency response by prioritising those casualties who are bleeding severely.

First aid equipment

Retrieving first aid equipment should only be advised if the caller feels doing so would not put them at greater risk of harm.

Callers may tell fire control personnel they have access to first aid equipment, such as a bleed control kit (also referred to as public access trauma first aid kit) and an automated external defibrillator (AED), which are designed for zero responders to access and use. Fire control personnel should encourage callers to send someone else to retrieve the equipment rather than delay or interrupt initial first aid efforts by retrieving it themselves.

Emergency call supervision

Emergency call supervision can help fire control personnel who are gathering information and providing guidance to callers by ensuring that contact is made promptly with ambulance control, operational personnel and other Category 1 emergency responders by, for example, allocating the task to other fire control personnel.

Fire control personnel will be able to provide the most current information to ambulance control if a mobilising system allows personnel at multiple workstations to view information about injured people that has been recorded by colleagues engaged in emergency call management.

Strategic Actions

Tactical Actions