Road Traffic Collision

Challenge Handbook
and Assessment Methodology

Rescue Organisation Ireland
Eagraíocht Tarrthála Éireann

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Introduction to the Handbook

The Provisional Review of Road Crashes 2013 published by the Road Safety
Authority states that as of 31st December
2013, there have been 180 fatal collisions,
which have resulted in 189 fatalities on
Irish roads.

This represents 28 more fatal collisions,

and 27 more deaths compared to the
same period in 2012. 2013 has seen an
increase in year-on-year fatalities for the
first time since 2005, exceeding the
number of fatalities in 2012 (162), and by
a narrow margin, the number of fatalities in 2011 (186).

Driver and passenger fatalities represent over two thirds (67%) of fatalities in 2013,
while vulnerable road users (pedestrians, motorcyclists and pedal cyclists) represent
the remaining third.

Of the vulnerable road users, there were almost as

many motorcyclists as pedestrians killed in 2013,
a trend not previously observed, as pedestrian
fatalities have typically been significantly higher
than motorcyclist fatalities to date.

There have been some changes in the profile of

road user fatalities in 2013 compared to 2012, as
shown in the graph.

There was a 22% increase in driver fatalities in 2013 (up from 78 in 2012 to 95 in
2013). A review of the Garda collision information shows that the greater majority of
these fatalities were among men (80%). The age profile of the drivers killed is
shown below and indicates that exactly half of driver fatalities (50%) were among
those aged 16-35. Younger drivers are the most vulnerable.

Age Group No. of Fatalities % of all Fatalities

16-25 25 26%
26-34 23 24%
36-45 9 9%
46-55 8 8%
56-65 10 11%
66-75 7 7%
76+ 13 14%

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Of the driver fatalities, the vast majority involved car users, with a minority of fatal
collisions involving other vehicle types, such as tractors, quad bikes, HGV’s or Vans.
Over half of the driver fatalities (54%) were single vehicle collisions, with the
remainder (46%) involving at least one other vehicle. 16 of the 95 drivers (17%)
were not wearing a seatbelt.

The numbers of injured at these incidents is a multiple of this and in 50 – 74% of all
reported road traffic incidents, in Ireland patients require transport to hospital. The
Irish Fire Service responds to approximately 4000 of these incidents every year.

The Global status report on road safety 2013 presents information on road safety
from 182 countries, accounting for almost 99% of the world’s population. The report
indicates that worldwide the total number of road traffic deaths remains unacceptably
high at 1.24 million per year.

Only 28 countries, covering 7% of the world’s population, have comprehensive road

safety laws on five key risk factors: drinking and driving, speeding, and failing to use
motorcycle helmets, seat-belts, and child restraints.

The report serves as a baseline for the Decade of Action for Road Safety 2011-
2020, declared by the UN General Assembly. The United Nations Road Safety
Collaboration has developed a Global Plan for the Decade of Action for Road Safety
2011-2020 as an overall framework for activities which may take place in the context
of the Decade.

The categories or "pillars" of activities are:

- Road safety management;
- Safer roads and mobility;
- Safer vehicles;
- Safer road users;
- Post-crash response.

This final “pillar” is what this Handbook focuses on and how the Fire and Emergency
Services can improve training and response to the Road Traffic Collision.

The range and complexity of tasks required ensuring a safe, casualty centred and
time efficient extrication from a crashed vehicle is broad and will continues to
expand.

The past 20 years and more have seen the response to Road Traffic Collisions,
coupled with various other rescue scenarios from a variety of emergency situations,
becoming the norm in the Fire and Rescue Service area of operations.
With this has come the inevitable increased use of specialist equipment and the
associated procedures and guidelines which the Emergency Services must operate
to. There is now also an expectation for the highest quality in public service
provision.

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This handbook was prepared to assist in meeting the requirements and challenges
of these complexities and will provide guidance on the training system and principles
associated with the “Challenge Concept”.
.
The handbook will be reviewed and update as a matter of course, this version has
been prepared by the Rescue Organisation Ireland / Eagraíocht Tarrthála Éireann
committee members.

Chair of ROI Phil O’Hare, Assistant Chief Fire Officer,

Cork City Fire Brigade

Vice- Chair Walter Johnston,

Retired NI Fire and Rescue Service

Secretary Padraig Ó Longaigh, Acting Chief Fire Officer,

Meath Couth Fire and Rescue Service

Treasurer Declan Cassidy, Sub-Station Officer, Officer,

Meath Couth Fire and Rescue Service

Head Assessor Michael Gahan, Assistant Chief Fire Officer,

Carlow County Fire and Rescue Service

Technical Advisor Michael Rogers, Station Manager B,

Leicestershire Fire and Rescue Service

Medical Advisor [Link] van der Velde, Pre-hospital Emergency

Medicine Physician, Cork University Hospital

Trauma Co-ordinator Brian Ó Ceallaigh, Advanced Paramedic,

Health Service Executive, South

Non-Exec Committee Member Finbar Mc Nulty, Assistant Chief Fire Officer,

Cork County Fire and Rescue Service

Non-Exec Committee Member Liam Carroll, Assistant Chief Fire Officer,

Laois County Fire and Rescue Service

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Foreword from the Committee of Rescue Organisation Ireland

It is with great pleasure that Rescue Organisation Ireland is able to provide this RTC
Challenge Handbook to current and potential participants with the most up-to-date
information available on the Road Traffic Collision Challenge Concept and
Assessment Methodology.

On both a national and worldwide level it has been recognised that the learning and
experiential participation of individuals and teams in the events held by Rescue
Organisation Ireland, and its international partners, has increased the working
knowledge and confidence of emergency personnel in dealing with real operational
road traffic collisions and trauma incidents that they attend in the course of their
work.

Rescue Organisation Ireland (ROI) was formed in March 2008 as an Emergency

Services based national charity focused on providing an additional training outlet for
Road Traffic Collision and Trauma based incidents for Irish Fire and Rescue Service
personnel. ROI is affiliated to the World Rescue Organisation and is a Level 1
member having hosted the World Rescue Challenge in 2010 and running regular
skills days and National Challenges throughout Ireland. Our Committee members
come from all corners of the country and have worked tirelessly to bring the focus of
casualty centred training and rescue to operational emergency personnel across
Ireland through the numerous events that we have held.

The content of this handbook is focused around the ‘Challenge Concept’ where the
emphasis is on developing and promoting ‘Best Safe Practice’. The handbook is a
learning platform by matching talents and skills through assessment and
encouraging participants to make hard and critical examination of their own rescue
practices, techniques and tools. It is envisaged that this Challenge Handbook will
provide a particular insight to all persons who are interested in taking part in the
Challenge Concept and in developing their skills through participation in ROI events.

Teams that participate under ROI have the benefit of gaining new and additional
skills at minimal cost with the added potential of representing Ireland and their
Services on a National and International platform.

Please visit our website for more information [Link] or the

World Rescue Organisation [Link] where you can gain an insight to our
past and future activities.

We look forward to seeing you at the next ROI event.

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CONTENTS
 
1.0 Road Traffic Collision Challenge Concept 1
2.0 Rescue Organisation Ireland 4
3.0 The design of the Handbook 5
4.0 Assessment Methodology 5
5.0 Team Dynamics and Management 7
6.0 Feedback 9
7.0 Challenge Marking Sheets 10
8.0 A vehicle on 4 wheels 18
8.1 Considerations: 0 – 2 Mins 18
8.2 Considerations: 2 – 4 minutes 20
8.3 Considerations: 4 – 8 Minutes 21
8.4 Considerations: 9- 15 minutes 22
8.5 Considerations: 15 – 20 minutes 23
8.6 Completion 20 minutes 24
9.0 A vehicle on its side 25
9.1 Considerations: 0 – 4 minutes 26
9.2 Considerations: 5 – 10 Minutes 28
9.3 Considerations: 10- 15 Minutes 29
9.4 Considerations: 15 – 20 minutes 31
10.0 A Vehicle on its roof 33
10.1 Considerations: 0 – 2 Minutes 34
10.2 Considerations: 2 – 5 minutes 35
10.3 Considerations: 6 – 10 Minutes 36
10.4 Considerations: 10- 16 minutes 37
10.5 Considerations: 16- 20 Minutes 38
11.0 Debrief process 40
12.0 Standard Equipment List 41
13.0 Rescue Organisation Ireland Sponsors 42
14.0 Fundraising for Teams 43
15.0 Training tips 43
16.0 Frequently asked questions 46

Appendices
A1 Details of past skills days 48
A2 Details of past National and World Rescue Challenges 51
A3 RTC and Trauma Team Pack 2013 52

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1.0 Road Traffic Collision Challenge Concept

The loss and injury through road traffic collisions is a modern phenomenon that
knows no boundary. Wherever there is a motor vehicle then, inevitably, people can
become victims to it.

When the Road Traffic Collision (RTC) challenge concept was introduced is was
widely recognised as the birth of the World Rescue Organisation (WRO) where
rescue organisations throughout the world came together with a view to
standardising the approach to rescue operations and to provide a theatre for the
sharing and advancement of vehicle rescue.

The World Rescue Organisation is an international body that

incorporates national rescue organisations with the view of the
enhancement and maintenance of emergency procedures and
techniques for dealing with road traffic collisions.

It is the aim of the WRO to increase the number of national rescue organisation
members. The drive to increase membership will continue year on year, with
emphasis on encouraging members from Asia, Africa and South America. It is their
goal to achieve total world representation.

The WRO exists solely to save lives and reduce injuries by;

• Providing training, resources and systems for rescue services in developing

nations through the International Development Program.
• Sharing technical and theoretical knowledge to establish global best practice
through the annual World Rescue Challenge.
• Providing for the enhancement of individual rescue skills in both member and
developing nations.

The first World Extrication Challenge was ‘Rescue Down Under’ held in Australia in
1999. Over the years the challenge has visited South Africa, New Zealand and
England twice, the Czech Republic, Canada, Spain, Wales, Germany, Ireland, and
the United States of America. During this time the ‘Challenge Concept’ has
developed considerably in meeting the needs of both rescue workers and those they
are called upon to assist. Through the promotion and development of the Challenge
Concept at world, regional and local levels a widely accepted industry standard for
the care of individuals and their rescue from vehicles has developed.

The WRO has ensured that the World Rescue Challenge has also evolved to reflect
the challenges encountered by rescue and medical workers, through the introduction
of other intervention disciplines.

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Every year, teams from around the world compete in a timed event hoping to
extricate casualties from simulated RTC’s in 3 distinct scenario types;

1. A vehicle on 4 wheels.
2. A vehicle on its side.
3. A vehicle on its roof.

In addition to these standard scenario types, teams would face additional restrictions
in time allowed, number of casualties and equipment available for use;

1. Rapid evolution (10 minute duration, 1 casualty, all tools allowed).

2. Limited evolution (20 minute duration, 1 casualty, non-hydraulic tools only).
3. Standard evolution (20 minute duration, 1 casualty, all tools allowed).
4. Complex evolution (30 minute duration, 2 casualties, all tools allowed).

In recent years the WRO has introduced variations of these scenarios to attempt to
reflect the changing needs of Fire and Rescue Services (FRS); however it should be
noted that not all rescue organisations undertake the additional scenarios as part of
their regional and national challenges, but teams should be aware of the differing
challenge scenarios when competing at International level. Several International
challenges now incorporate a mixture of the rapid and standard evolution which is
termed the complex or extended evolution where a team is assessed for correctly
identifying the rapid time critical casualty and extracting them in less than 10
minutes; with a further entrapped casualty requiring release.

Rescue Organisation Ireland holds various skills day and a National Road Traffic
Collision and Trauma Challenge each year. The objective of the National Extrication
and Trauma Challenge is to bring together teams of rescue personnel who are
committed, not only to displaying their ability, but to expanding their practical skills by
learning from and teaching others involved in the same field.

Teams from across Ireland and visiting teams from abroad will gather at a single
venue for one or most likely two days. The Challenge consists of;
• An EXTRICATION challenge - which aims to see all of the participating teams
use their professional skill and ability in the extrication of a trapped casualty or
multiple casualties from a severely damaged vehicle:
• A TRAUMA challenge - which aims to see all of the participating teams use
their professional skill and ability in the treatment of one or more people
suffering from severe trauma.

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What these personnel observe and learn during the challenge goes back with them
to their own brigades and services where someone may directly benefit from this
newfound knowledge. Thus knowledge and practices learnt can cascade across the
country, benefiting all those who become victims of a Road Traffic Collision.

The emphasis in the National Extrication and Trauma Challenge is on developing

and promoting ‘Best Safe Practice’. The challenge is not primarily to win, but to use
what is learnt at these events in protecting and saving those whom we serve, as well
as ourselves, the rescuers.

Although the ‘Challenge’ appears to be a competition, it is far more than that. It is a

learning platform, matching talents and skills through assessment. Encouraging
participants to make hard and critical examination of their own rescue practices,
techniques and knowledge of the tools they have available to them. It is necessary
to study current extrication philosophy, search out new developments and innovate
with new ideas.

The main objectives of the challenge are:

• To provide a forum whereby rescuers of all disciplines meet and share
knowledge; develop skills; stimulate ingenuity; all of which will culminate in a
higher level of efficiency and professionalism.
• To develop an education platform for rescuers, to assist them in dealing with
the extreme demands placed on them by the modern motor vehicle collisions.

The Benchmarks of the challenge are to:

• Develop a Safety First attitude amongst all rescuers.
• Emphasise patient, rescue personnel and scene safety.
• Encourage higher and more proficient levels of pre-hospital care.
• Create the broader spectrum of extrication principles and techniques.
• Develop the systematic approach to incident command.
• Stimulate ingenuity in terms of skill, practices and equipment to advance the
best safety first concept.
• Through co-operation, develop an agreed code of best practice.

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2.0 Rescue Organisation Ireland

Rescue Organisation Ireland (ROI) is a voluntary organisation and a registered

charity. It was founded by members of the Irish Fire and Emergency Services as a
means of improving, updating & standardising the training of Emergency Service
personnel (in particular Fire Service) who regularly respond and deal with Road
Traffic Collisions on Ireland’s roads.

It was a response to the consistently high level of incidents on our roads and how we
as professionals in the Emergency Services can strive to improve and train to be
better at what we do. It is only by the drive and commitment of its members that we
have developed to the point that ROI is a leading authority on crash rescue
techniques and RTC training in Ireland.

The Committee of ROI comprises members from across the island and covers
various roles and organisations within the Irish Emergency Services. Together we
are working hard to bring the focus of casualty centred training and rescue to
operational emergency responding personnel throughout Ireland.

Every year ROI holds a National Challenge event which is focused on RTC
Extrication and Trauma scenarios. Regular Skills Development Days are also held.
These events are hosted in different locations around Ireland, in conjunction with the
particular Fire Authority as a means of promoting casualty centred training and the
'Challenge Concept' in all corners of Ireland.

ROI is a level 1 member of the World Rescue Organisation and as such actively
participates in the administration of the WRO and supports teams to enter WRO and
other International events. ROI has a commitment to support FRS throughout
Ireland and as far as practicable ROI will use these variations in its scenarios in both
the national challenge and the various workshops held throughout the year, which
are intended to accurately reflect the incidents that crews will attend and hopefully
prepare crews for the challenges faced on the roadside and on the international
stage. ROI is fully aware of the substantial time and costs that are incurred by both
individuals and teams to travel to, participate and train for the National and
International Challenges that run throughout the year.

For teams that become placed at the Irish National Challenge that is run every year,
ROI provide financial contributions to them to enter and participate in other
International events. Teams can also raise funds under the ROI Charity banner
through sponsorship, collection etc at events that we support.

Further details on fundraising is available in section 14.0 of this handbook and also
on our website [Link]

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3.0 The design of the Handbook

This handbook is designed to give each role within the team an insight into the
needs of the casualty in a straightforward standard 20 minute evolution using the 3
distinct scenario types described previously. It is ROI’s intention to develop this
handbook further to give similar insights into the Rapid, Limited and Complex
evolutions and to develop a separate handbook on the Trauma Challenge and
Assessment Methodology of same. In-line with the scoring system COMMAND
considerations will be identified by red, TECHNICAL in blue and MEDICAL in green.
Each scenario will explain timelines and other considerations which will give each
team member an insight into the demands placed upon them at different stages
throughout the scenario.

Further in depth explanations of the scoring system is outlined later in the document
and it is a requirement that teams understand that feedback following a scenario is
ONLY relevant to the technicalities of that scenario in its entirety and any techniques
or advice may not be appropriate to other similar scenarios that the team may
complete as vehicle design and construction will vary, as will the needs of the
casualty.

4.0 Assessment Methodology

ROI assessors are selected because of their particular skill base, experience and
training. ROI assessors are experienced in attending a wide selection of rescue
challenges throughout the world and are applying a recognised standard when
assessing teams. Therefore, the feedback given from assessors to teams is
reflective of their standing not only at national level, but at a level commensurate with
other teams throughout the world. This gives teams the best possible advice on how
to improve and crucially what to continue to do in order to improve their performance.

Each discipline; Command, Technical and Medical are assessed over a prescribed
scenario and scores are given for each discipline. The scoring system is not a
negative marking matrix; it uses a system of idiosyncratic behavioural indicators to
award a score from 0-10 per section. The individual areas are categorised as Basic,
Efficient or Thorough which identifies specific areas for improvement and importantly
areas that the individual and team did well; and should continue to do. The
assessment process is constructed by identifying individual areas and processes
from the arrival of the fire appliance through to the whistle blowing on time or the
team captain calling time whichever comes first.

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Team members should always have the following mantra in mind whilst competing at
challenges.

The assessors are looking for a....

1. SAFE!
2. CASUALTY CENTRED &
3. TIME EFFICIENT EXTRICATION

Throughout the document the scoring system will be referenced to, which will allow
teams to understand the assessment process with timelines explained from the
arrival to handover process. The individual scenarios will be explained in detail and
this will be cross referenced to specific demands that are placed on each discipline
within the team with a final overview of the scoring sheets at the end.

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5.0 Team Dynamics and Management

Each team consists of up to six members, one of whom must be designated as

Team Captain/Incident Commander, one as Medic and three or four others. Five
personnel will be allowed to participate in all scenario types, but a sixth member may
be used in the complex scenario. A team may substitute a team member in the case
of illness or injury only at the discretion of the Head Assessor. If, during a scenario,
a team member is injured and has to withdraw, the team, if able, may continue until
they finish or ‘Time’ is called, however the substitute is not permitted to participate if
a team member becomes injured during the scenario evolution.

The formation of the team requires careful consideration, the role of the Team
Captain/Incident Commander should be at minimum a junior officer whose role it
would normally be to attend and command emergency incidents, Fire-fighters who
have developmental needs can also occupy the I.C role as the simulations provide a
good assessment of the incident command requirements at RTC incidents.

Usually the role of medic and tool operators falls to members of the service best
suited to the roles with some teams utilising the skills of trained Paramedics in the
role of team medic. Contrary to popular belief, this gives teams no more of an
advantage than other teams competing as the assessors are looking for a well

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coordinated response to the incident following the mantra given above. However in
the case of medical competency, it is expected that the medic will be competent in
the administration of oxygen and as such approved by their service to do so. It is
recommended that the management of the team should be led by the senior
operational staff of that service, this is an aspect which can often be overlooked but
invariably the team’s failings can be contributed to mismanagement of the team from
a strategic standpoint. It is therefore vital that each team has the commitment,
support and drive from the senior operation staff of their service. The role of the
senior managers will be one of encouragement, training, strategic planning and
development including financial support.

Often teams do not reach their full potential because of a fundamental failure of the
team dynamics. It is wise to understand that the Team Captain/Incident Commander
has overall responsibility for the safety of all their personnel; however, extraction
routes and physical rescue techniques used throughout the scenario should be
advised on by the Medic. In that the medic is responding to the needs of the
casualty and those needs must be formalised and communicated into a safe, time
efficient extrication plan.

Teams should always have in mind that the most important person on the incident
ground is the casualty, not neglecting their own safety, and therefore any action by
the team which is detrimental to the wellbeing of the casualty will be scrutinised by
the assessors. It’s a foolhardy team who ignores the needs of the casualty and
therefore the needs of the medic!
 

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6.0 Feedback

The feedback process is an important part of the challenge scenario, assessors will
clarify areas that teams can improve on and praise areas of good practice. The
challenge concept is one of continual learning and as such, assessors are
sometimes surprised by new techniques that teams have creatively designed. The
assessor will not have any pre-conceived ideas on how a team should achieve the
extrication nor should an assessor ever explain that they wanted to see a particular
technique demonstrated. The scoring system is designed so that teams can
demonstrate a wide array of extrication techniques and assessors will objectively
score teams on what is actually done rather than what could have been done!

Teams should leave the debrief with an honest reflection of their performance; the
score and debrief is not a reflection of ability, rather than a reflection of a
performance hence the well used term, “you are only as good as your last cut”.

Teams that perform well do so in a consistent manner and perform well over a
number of disciplines. Teams that have a mixture of performances across the
disciplines will tend to come towards the middle of the field in challenges. This
document is intended as a guide only and does not replace the actual assessment of
crews at any of ROI’s challenges, as it is widely recognised that formal assessment
of skills, combined with feedback is what benefits crews and the level of service
provided to members of the public.
 

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7.0 Challenge Marking Sheets

Challenge Marking Sheets and the Marking Schemes are available on the ROI and
WRO website for teams to use during their training. There is no magical formula
applied to the scores and the assessors will be following the behavioural indicators
given in the marking schemes to allocate scores. A common question asked by
teams; is what is the difference between a score of 8 and a score of 10 in the
thorough section of the score sheets? The behavioural indicators guide the assessor
to the appropriate section (Basic, Efficient or Thorough) and then the assessor uses
their professional judgement to assess how consistently the team demonstrated the
skills.

If the team performed the task of stabilisation in a methodical and thorough way and
it was checked regularly and consistently throughout the scenario, the team will
score 10. If the stability was done out of sequence or the 5th point was not added
until the I.C requested it, then the team will score lower. The scoring range is from 0
to 10 and teams can score 0 as well as scoring a 10. Assessors are trained to
allocate the correct score against the behavioural indicators, so rumours of
assessors never awarding a 10 are simply not true and conversely the opposite is
also true!

Below is the generic challenge marking sheets, currently in use. ROI will endeavour
to have copies of the latest Marking Sheets available on our website and if any
changes are introduced this will be highlighted on the website and discussed prior to
any challenge or workshop.

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As previously stated and in-line with the scoring system the following COMMAND
considerations will be identified by red, TECHNICAL in blue and MEDICAL in green.
Each scenario below will explain timelines and other considerations which will give
each team member an insight into the demands placed upon them and at what stage
throughout the scenario.

8.0 A vehicle on 4 wheels

Due to the ease of access for the medic and simplified stability requirements,
vehicles that are presented on all 4 wheels are usually part of the rapid scenario or
will have other vehicles as part of the complication factor. (Prop vehicles).

8.1 Considerations: 0 – 2 Mins

360 degree hazard identification and safe systems of work to be implemented. Brief
crew on type of vehicle(s), hazards, location of casualty, entrapment and access
points for medic, tool dump, any issues for stability? Priorities tasks, Thinking time
for I.C.!

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Act on 360 hazard identification, remove or isolate hazards, mark tool dump area,
discuss issues effecting stability, access to vehicle for medic and extraction pathway
options, stabilise vehicle, secure airbags if required for medic give I.C. outer survey
considerations.

Complete outer survey for casualties thrown clear, make contact with casualty in car,
check for catastrophic haemorrhage, secure C-spine, begin A,B,C and conduct basic
casualty assessment based on impact damage to car, likely injuries and extraction
pathway options as a result of injury, prepare a brief for I.C. ensure oxygen is fitted
correctly & secondary entrapment is identified.

8.1.1 General

Basic 4 point stability is sufficient in the early stages, 5th point will be required before
work on rear of car. Stability should be achieved in 1 minute on the primary car with
secondary stability required for prop car if it cannot be moved (manual handling risk).
Kinematics of crash (forces applied) to the casualty vehicle would indicate casualty
will have C-spine injuries, Thoracic injuries and possible pelvic and lower limb
injuries on right side. Medic will most likely recommend the rapid route out of driver’s
side (removing prop car) or rear passenger side if prop car cannot be moved and
front seats are manoeuvrable, full extraction out of rear of vehicle. Other options
partial roof flap, side removal.

8.1.2 Complications

Prop car cannot be moved, extraction pathway limited to rear removal. ‘B’ post will
not let seat recline requiring cross ramming / seat cutting; consider partial / full roof
removal for access and casualty wellbeing.

8.1.3 Assessors

Will be looking for safe approach to the incident, 360 hazard identification completed
and safe systems of work being implemented. Methodical approach to the vehicle,
and a comprehensive outer survey by tech team with systematic stabilisation being
implemented. Once vehicle is stable, further access points to be identified and full
inner survey which should identify B post compromised and its implication on
planning (seat reclining). Medic should have hands on, with basic ABC and C-spine
immobilisation and have completed a catastrophic bleed assessment of the casualty.

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8.2 Considerations: 2 – 4 minutes

I.C should have a full external and internal survey of target vehicle, identify extraction
options based on damage to car and be instructing tech crew to pathway options
with caveat that the plans may change upon a briefing from medic. I.C. needs to be
proactive with safety, ensure airbag protectors are fitted and hazard areas are being
observed for other non deployed airbags and that the scene is safe with the vehicle
fully stabilised. Emergency and Full Plans needs considering, time verses benefit in
space created must be considered! Thinking time while crew stabilise the target
vehicle!! At this stage the I.C. should consider the implementation of the emergency
plan prior to commencement of the full plan; this may be one of the same.

Tech team should be completing the equipment dump, ready for glass removal in
line with I.C.’s provisional plans. Ensure 5th point stability is in place and start
prepping the inside of the vehicle for cutting and ramming of B post. Full access will
be required for medic, so internal strip down of car furnishings is required, advise I.C
on any complications to the provisional plans. Initial cuts to remove soft furnishings
and sacrificial body work needs completing, consider space for casualty by removing
trim, steering wheel, opening emergency route and roof flap/removal.

C-spine immobilised, A,B,C surveys completed and baseline observations for

casualty noted, handover to second medic for full primary survey and breathing
assessment. Check for signs of bleeding and identify extraction pathways based on
casualty’s injuries and baseline observations. Request opening of emergency route
and fit neck collar. Construct a brief to I.C. and advise on extraction options
stressing emergency route first then full extraction options based on casualty
injuries. When returning to casualty, complete a full secondary survey and compare
initial baseline observations, if casualty is unstable, inform I.C. and consider using
emergency route. Provide soft protection for the casualty!

8.2.1 Assessors

Will be looking to see if airbag protector has been fitted and safety zones are being
observed, the vehicle should now be fully stable with 5th point being introduced
demonstrating an understanding of the principles of stability. The medic should have
briefed the I.C on the casualty condition and recommended optional and appropriate
extraction pathways based on the injuries sustained by the casualty. Ongoing scene
safety should be maintained and crews should be moving with purpose but not
rushing, increase in speed can result in an increase in risk. I.C. should fully brief
crews on emergency and full route and ensure emergency route is completed ASAP
with work being done on full pathway plan. I.C should have considered complication
of B post and ensure this is done before ending the cutting stage. All glass
applicable to the plan should be removed/managed and debris being collected in one
point away from operations. Casualty must be protected at all times with hard and
soft protection and communication from team – Medic – Casualty.

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8.3 Considerations: 4 – 8 Minutes

I.C. must be satisfied that the emergency route is now available and cutting is
underway to achieve the full pathway. Constant liaison with the medic on condition
and time lines of casualty with a full brief being expected at 10 minutes. I.C. must
observe all cuts with hydraulic equipment and ensure crew safety, VISORS! I.C.
must stand back and take an overview of the incident to ensure safety of team.

Tech team to ensure the medic is briefed on all cuts and movement of debris from
vehicle, stability check number 1 needs completing 5 -6 minutes in with a recheck
after a significant cut to the car or significant change in weight displaced on the
vehicle, i.e. medic/2nd medic entry or exit from the vehicle. Emergency route should
now be available for medic and provide extra access, internal trim removal and
cutting should now be focused on the full extrication plan, being mindful of potential
plan changes. Team need to prepare for cross ramming of B post and consider if
roof removal is required to aid casualty handling or have access to doors? Team
should look towards completing all cuts on 6 minutes for rapid, 15 minutes for
unlimited scenario.

Casualty statistics should be noted for comparison, if involved in a rapid scenario,

medic should be considering boarding options at this point. For full scenario,
casualty survey needs completing with help of second medic, prepare a brief for I.C.
on 10 minute mark and consider if current pathway options are still a viable option.
Other work can now be done, pulse oxygen levels monitored, breathing survey and
treating injured limbs. Ensure oxygen is still being delivered at correct level and
sufficient O2 is available for remaining time. Reassure casualty constantly and
assess AVPU levels.

8.3.1 Assessors

Looking at ongoing scene and casualty management, I.C. must position themselves
so that they can observe the full incident and be aware of breaches in safety / hazard
zones, and must avoid being drawn in to the inner cordon. Glass management
should have been completed with due regard to I.C.’s plans, and at least one stability
check should have been completed. Medical assessor will be concerned with
ongoing care and injury identification as well as ensuring casualty is adequately
protected from the environment and cutting operations. Assessors will be looking for
a clear emergency route free from equipment and work on cross ramming B post if
required before long board is introduced.

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8.4 Considerations: 9- 15 minutes

I.C. must guard against excessive time wasting on complicated cuts, the team
should now be in a position to clear the B post to allow for the reclining of the seat
should it be required and the final stages of cutting should be nearing completion. A
further brief is required from medic to ascertain the stability of the casualty and
reassure the medic that the full plan will be completed on time. Ongoing
considerations regarding tool operation, scene safety, manual handling and stability
should be an ongoing process. I.C. to remain outside the 2 metre cordon unless a
safety issue requires dealing with, the final plan should have sufficient room for the
casualty and the team who require manual handling space. All sharp edges should
be covered at the earliest opportunity with all debris being removed to the debris
dump and unused equipment being returned to the tool area.

External cutting should be nearing an end with the focus switching to internal space
creation and cross ramming of B post. All exposed sharps should be covered and
debris and tools returned to the appropriate area. Ongoing liaison with medic as to
the condition of casualty and ensure that cross ramming does not adversely affect
the casualties condition. Stability checks need completing prior to hand over to
medic and a casualty handling area need establishing, clean up of tool away from
the vehicle. Tool rotation will now be important as team members will start to tire
with ongoing support needed for all members. Consideration must be given to the
length of time the medic has been supporting the casualty and the medic will require
a relief so that a final brief can be given to I.C.

Complete final treatment of injuries as far as practical, ensure O2 line is free and the
casualty is reassured. Complete further assessment for observations and prepare a
brief on the condition of the casualty for the I.C. Ensure casualty protection is
adequate and help identify a suitable handling area away from the vehicle when
briefing the I.C. Ensure all secondary entrapment is free (feet & hands) and that the
casualty is free to be placed on the board when available ensuring no restrictions in
pathways exist. Prepare for handover and briefing the crew (Clear route to daylight).

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8.4.1 Assessors

Will now be focusing on the viability of the planning process and ongoing
considerations. Is the plan viable, in line with the casualty’s injuries and is it
achievable within the time frame given to the team by the I.C.? Are there any safety
issues with ongoing operations and is the scene safe for ongoing operations? The
assessors will now be looking for a clear and concise handover to the medic for the
release stages of the extrication. Is there sufficient room for the casualty or is the
process incomplete and requires further space creation? Has the I.C. sacrificed
internal space in a bid to achieve the scenario thus compromising the safety of the
team and casualty? Has the team achieved all that has been asked of them and
was the space creation achievable in the time given?

8.5 Considerations: 15 – 20 minutes

I.C. should now be looking to either achieve the scenario, at 15-16 minutes the
control of the extrication phase should be handed to the medic who will need 3 – 4
minutes to board the casualty, with a further 1 -2 minutes to lift them free of the car.
QUESTION! Do I have enough space to safely extricate this casualty? YES-
proceed and handover to the medic whilst retaining command and control of the
scene! NO – continue with rescue operations do not attempt keyhole removal of the
casualty!

The I.C. will look for confirmation that all cutting has been completed and all sharps
are covered. Ensure all tools are away in the tool area prior to handover to medic.
Ensure only medical gloves are used to touch the casualty and debris gloves are
removed. Clear all tripping and snagging risks to ensure smooth extraction.
Understand clearly what the medic is requesting. If you are unsure, then ask! Be
mindful of safe lifting and manual handling restrictions when moving casualty.

The removal of the casualty in a safe manner will be the medic’s responsibility,
prepare for the process to be handed over to you and formulate a casualty brief to
the team. Casualty brief should compromise of:
1. Casualties name.
2. Brief summary of the casualties injuries (Being mindful of casualty hearing the
information)
3. Clear instructions to the team on how the casualty will be boarded.
4. Clear and concise instructions on the stages of boarding.
5. A clear handover from I.C with terminology used being “ I am now in control”.
6. Ensure continued safety of casualty.
7. Whoever controls the head controls the movement of the casualty!

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8.5.1 Assessors

Command and technical assessor will start to collate scores and look at the finer
details of stability and the internal space made by the crew. Medical assessor will be
expecting a smooth and controlled transition from the seat to the long board and out
from the vehicle. Casualty care considerations and vehicle stability will be assessed
while the casualty is being moved. Medical assessor will be expecting a thorough
brief as to the casualty condition as would be expected by Paramedics or Doctors at
the scene. Medic should focus on specific injuries and treatment given at the scene
including administration of oxygen and times of administration. The medical
assessor may ask specific questions as would be required during an incident.

8.6 Completion 20 minutes

The casualty will either be:

1. Within the confines of the vehicle but boarded.
2. Still in the position the crews found them.
3. In the process of being removed from the vehicle or,
4. In the casualty handling area.

It is important that the crew continues with the scenario up to the point being stopped
by the command assessor. The signal to stop will be made with a whistle and if the
casualty is in transit from the vehicle to the casualty handling area, the movement
should continue for the safety of the casualty.

The medical assessor will be expecting a full brief of the casualty’s injuries and
treatment given by the team medic and points are awarded for the handover process
so medics are encouraged to formalise a handover. The assessors will be collating
scores and looking over the space creation achieved and the technicalities of the
planning and extrication process. It is important to understand that assessors will
have assigned scores before the debrief process with the exception that on some
circumstances assessors will need to clarify some areas with the team before
awarding final scores. Teams should be mindful that assessors will ask for clarity
and teams often talk themselves out of points rather than answer the question in a
straightforward way. Therefore, teams are encouraged to answer the questions in
an honest and transparent way so accurate scores and an effective debrief can be
completed.

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9.0 A vehicle on its side

The problems with dealing with a vehicle on its side are predominantly stability in
that there are very few contact points of sufficient structural integrity to ensure a
constant stable platform to work on. Inevitably the vehicle is supported by the side
panels / doors with partial stability being provided by parts of the wheels which may
or may not be in contact with the ground.

It is important that teams must understand that a car on its side on flat stable ground
will never fall back on to its wheels. The car may fall on to its roof if enough
movement is applied by the entry of the medic, so the initial stability applied should
always come from the roof side first, before adding full stability from the underside of
the vehicle with stability rams. There is no hard and fast rule with how many rams
should be used, if the team use one ram, this should be positioned approximately
half way down the underside of the vehicle, to use two rams; one should be
positioned just behind the engine compartment / Firewall and the second should be
positioned just forwards of the fuel tank (under the rear seats). The assessors are
looking for a stable vehicle, how this is achieved is down to the team! There is a
misconception that to use one ram is not sufficient and if teams do use one ram then
this should be placed two thirds the way down the floor of the vehicle to counteract
the weight of the engine. This is a misconception in that the weight is supported by
the ground along the entire length of the vehicle hence the stability ram is providing a
lateral force on the car ensuring good contact with the stability wedges / blocks on

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the A, B and C post which is where the key to the success of stability rests and the
rams are not supporting any notable weight. If the team decide that two rams are
required, it is important that the I.C. positions themselves either at the front or rear of
the car so that they can see down the length of the vehicle. To make sure that the
vehicle does not crab (walk side by side) when the two rams are tensioned
independently of each other and;

1. The car is not raised off the ground.

2. The rams do not over extend and push the car beyond the 90 degree plane

9.1 Considerations: 0 – 4 minutes

360 degree appraisal of the incident, locate casualty and advise medic on location,
identify all external hazards including hot exhaust and exposed engine parts and
inform crews for preventative measures. Focus on stability of target vehicle and
assess if prop car(s) can be moved (after stability) best access for medic is usually
through rear boot hatch or windscreen. Hands on may be achieved through
underside window, be mindful of hazards (glass, fluid, car movements). Thinking
time while crew stabilise vehicles!

Take stability wedges with you when completing 360 or conduct tool dump
operations while I.C. conducts 360. When confirmed safe to touch car by I.C. begin
stabilisation of the target vehicle initially from the roof side on the A, B and C post as
appropriate, conduct internal survey of car and possible extraction pathway options,
survey any Prop car with a view to moving to allow full 360 degree access. If prop
cannot be moved, inform I.C. and conduct initial stability (wheel chocks and blocks
on the front only). Move to full stabilise target car using either one or two rams as
appropriate. Once rams are in place and secure, final adjustment of chocks will be
needed, then move to fully stabilise prop car or move prop car as required.

Priority is to get hands on the casualty as soon as safe to do so, liaise with I.C.
regarding 360 degree risk assessment and safe areas to approach the vehicle.
Make verbal contact with casualty as soon as possible and look for access points to
get hands on and oxygen therapy. Positioning should take into account possible
stability points that may need to be used and the risk of car movements which may
trap medic! Look for access options (rear boot or windscreen) which will be main
extraction pathway. Be mindful that tech team will require more time to stabilise
vehicle so handover to second medic will be on the 5 minute mark. Get comfortable!
You will be there for at least 5 minutes as additional time will be required to stabilise
the car.

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9.1.1 Assessors

At this point in time the assessors are looking for a safe approach to the vehicle and
a systematic stabilisation programme. Safety concerns are that crews position
themselves under unsupported areas of the vehicle which may move trapping the
medic. Technical assessors will look for systematic, controlled stability which should
be coordinated by the I.C. with medical assessors looking for good spinal control and
early O2 for the casualty.

Teams should not rush stability and ensure that the car is fully stable before cutting
operations commence. Failure to obtain full stability will cost the team as ongoing
stability issues will cause problems for all team members and cutting will need to be
halted to try to obtain stability. Therefore, take the time to correctly stabilise the
vehicle, in an unlimited or complex scenario (20 & 30 minutes duration) a team may
take upwards of 5 or 6 minutes to obtain full stability, but this time is well spent and
will pay dividends as the scenario continues. For the rapid scenario, the team must
remember that the objection is to remove the casualty within 10 minutes; hence,
stability and glass management should be basic and speedily done.

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9.2 Considerations: 5 – 10 Minutes

Space is now required for the tech team and the Medic to work. Look at viable
options of moving prop vehicles and potential extraction pathways. Rear hatch /
boot is an obvious access and egress point, but be mindful of sprung weight when
opening which may be hazardous. Avoid all temptation to declare upper facing
doors as an emergency route for the casualty, this is very difficult and will require
large numbers of people to lift a casualty vertically through the car, whilst maintaining
some degree of control! Consider rear boot removal, windscreen removal for
emergency route. Assessors will want to see a viable emergency route opening
before full extrication plan is completed. The emergency route and the full plan may
be one of the same routes, with more internal space being created for the full plan.

Tech team will need to consider complications with space creation, try to clear as
much away from the outside of the vehicle as possible. Look for large openings,
boot/ rear hatch, windscreen removal, sunroof removal for access to casualty. Be
careful when opening rear hatch/ boot as gas struts are pressurised and are not
supporting the full weight of the rear hatch, so the opening may be violent, which
often causes concern for assessors. Ensure your weight is against the rear hatch
when opening. Try to use vehicle keys or hatch release inside the drivers
compartment, if not removal of glass and spreading may need to be done. Avoid
spreading off plastic bumpers, consider use of crowbar to open shut lines before
spreading. The next 5 minutes must be used for glass removal and access points
for medic, with cutting starting as soon as possible, consider dis-assembly by means
of impact driver or reciprocating-saws.

The Tech team will be focussing on access points for the medic, avoid suggesting
upper doors as emergency routes as this usually is not a viable option and shows
that the medic and I.C. have no understanding of the concepts required to move an
injured person. Viable options are the rear hatch/ boot, windscreen or partial/full roof
fold/removal. Be careful of blocking casualty access when inside the vehicle, if you
declare the rear hatch/ boot as the emergency route ensure there is enough access
available for team members to enter the vehicle without you having to move. This
problem is highlighted during medic handovers! Consider all available options and
prepare a brief for the I.C. The I.C. will need suggestions not problems as their
workload is very high in the initial stages of this type of extrication.

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9.2.1 Assessors

At this stage assessors will be hoping for a fully stable vehicle and the achievement
of as much room around the outside of the vehicle as possible. The casualty should
be under the care of the medic with O2 being administered; the full primary and
secondary surveys will be slightly delayed due to the work required on stability. The
command assessor will be looking for the I.C. to declare achievable and appropriate
extrication plans, which meet the needs of the casualty and in line with their injuries.
There should be no movement of the target vehicle when/if the prop car is moved
and when the crews are entering the vehicle. Ongoing stability will now be a
constant theme with command assessors looking for the emergency route to be
available within 10 minutes, preferably sooner and then work progressing towards a
full plan.

9.3 Considerations: 10- 15 Minutes

I.C. should have been fully briefed by the medic and have a comprehensive interior
and exterior survey at their disposal, the emergency route should now be open and
available and the crews should be working on the full extraction plan. Ongoing
considerations are stability and the need to rotate medics due to the limited space
inside the car. Medics should be briefing I.C.’s again before the 15 minute mark to
confirm plans are acceptable and achievable!

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Tech crews should have the emergency route open and available and it must be
kept clear of tool operations that may impede the speed of release for the casualty
(cross ramming). The skill in successfully extricating a casualty with a car on its side
is the amount of internal space that is created by the tech team, the team will need
space to lift and move the casualty, so all internal seats will need to be removed or
reclined in order to achieve the required space. Make good use of the reciprocating
saw in confined spaces and ensure that dual tooling is used (both team members
cutting at the same time with different tool) time is now important as every cutting
technique must be evaluated using the cost vs. benefit method, (how much time will
the cut take vs. how much space will it give me). If the space gained is small and the
cutting time is over a minute, then other options should be explored.

Ensure that the primary and secondary surveys have been completed and you are
starting the second set of surveys for comparison reasons. At this stage the need to
either extricate the casualty for emergency reasons or progress on to the full
extrication plan will be clear and the casualty should be relatively stable. You will
need to prepare a final brief for the I.C. and either approve the current plan or
suggest amendments. The tool team will be working hard to create the space
required inside the vehicle, ensure seat backs have been reclined or removed at this
stage as often is the case the seat may not move and require cutting. This is
essential to the successful conclusion of the scenario, so take time to request its
removal at this stage! If you need to move the casualty, this is acceptable so long
as it is done in a controlled way, sometimes it is better to stop the cutting and take
the time to move the casualty to allow easier access to a cut than it is to leave them
in situ and try to cut around them. Be mindful of vibrations from saws, vehicles on
their sides inevitably lend themselves to heavy use of the reciprocating saw and the
casualty will be in contact with the bodywork of the car!

9.3.1 Assessors

Will be checking for ongoing stability problems and safe cutting techniques,
especially around the casualty so ensure hard and soft protection is used
throughout. Vibration from tools is a common complaint by casualties so consider
moving or packing the casualty to protect from vibration and noise. Assessors will
be keen to see if the welfare of the casualty is being considered at every stage and
that the plans take into account information gained from the casualty and that
sufficient space is achieved to complete the plans. Main areas for teams to lose
points at this stage, is the lack of achievable planning, usually the emergency route
is not available and the interior of the car is compromising planning. Remember the
emergency route need to be available from 10 minutes and the full route from 17
minutes! At this stage it is vitally important that the team listens to the needs of the
medic!!

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9.4 Considerations: 15 – 20 minutes

Ensure there is sufficient space being created for the casualty. A decision now needs
to be made by the I.C. should the team continue to cut and create space or at 17
minutes, does the I.C. handover to the medic? Make the space fit the casualty not
the casualty fit the space!!!

The closing stages are vital, ensure the vehicle is stable as the casualty will need to
be moved; is there sufficient space? Yes: handover to medic at no later than 17
minutes, No: continue space creation techniques, the medic requires 2 – 3 minutes
to board a casualty and remove them from the car, so cutting can continue for a
while longer. Do not rush this stage, the team will be eager to release the casualty,
take the time to calm and focus the team on their objective of space creation.
Ensure any debris is cleared away and a space has been identified for the casualty
handling area away from the vehicle and tools. Focus minds on stopping any
unessential cutting and concentrating team efforts on space creation and casualty
welfare!

Focus on quality cutting, slow down and do not rush cuts. Take the time to do the
cut right and you will only need to cut once! Focus on internal space creation for the
casualty and don’t forget additional space for movements of the casualty along the
length of the car. Stability will now be a concern as the car will have been cut and

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several people will have been inside the car on a number of occasions. Be proactive
and ensure the stability checks are done periodically and one MUST be done prior to
the movement of the casualty on to the board. Liaise with the medic for the internal
space requirements.

Don’t compromise casualty welfare in the latter stages, liaise with the Tech team for
your requirements for internal space and confirm final extraction pathway plans with
the I.C. The team will sense the closing stages and will start to rush to complete the
final cuts, try to focus minds on being methodical and not rushing. Complete final
checks with the casualty and be mindful of manual handling requirements for moving
the casualty. Regardless of time remaining, complete the tasks fully, remember that
more points are lost in the last 3 minutes that at any time throughout the scenario!
Complete handover from I.C., brief team as to the casualty’s name, injuries and
method of lifting. Ensure that whoever controls the head controls the moves.

9.4.1 Assessors

The assessors will now be focusing on the closing stages of the scenario, stability
will be an ongoing concern and internal space for the casualty; being mindful that
additional space will be required to safely lift and manoeuvre the casualty. Medical
assessors will be looking at ongoing spinal care and the coordination of the team
when moving the casualty. At this stage the team should appear to be focused,
controlled and not rushing or stumbling about completing the final cuts. Where
possible, once the cutting phase has finished and the extrication has been handed
over to the medic for the casualty phase, it is poor planning to re-engage cutting
processes because insufficient space has been created. This shows poor planning
and space creation and should be avoided, however; unforeseen circumstances do
present themselves, and assessors may question I.C.’s during debriefs if cutting
operations are instigated after handover to medic has been completed.

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10.0 A Vehicle on its roof

This remains one of the more simple scenarios a team will face so the chances of
having a vehicle on its roof without serous complications from prop cars or street
furniture is very slim. The car on its roof scenario is a favourite for rapid scenarios
which ROI teams will be exposed to in WRO challenges.

The reason for its simplicity is that there is no sprung mass to stabilise and the
weight of the engine often makes the car rest engine down, giving teams’ good
access to the rear hatch/ boot. One complication to this, is when saloon cars are
used which complicates rear removals of casualties without additional cutting /
removal of rear seats and supports. The most obvious pathway option remains the
rear hatch/ boot or side removal. The largest natural space on any vehicle is the
rear hatch/ boot area and this should form at least one of the extraction pathway
options for the casualty. Manual handling of casualties will always be an issue when
dealing with this scenario, therefore the I.C. must consider access to the sides of the
car to assist in the effective and safe manoeuvring of the casualty. In saloon cars,
additional cutting of the rear seat supports will need to be considered and the use of
the reciprocating saw should be considered in these circumstances.

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In the picture above; the team has made a decision to use a stability ram to support
the rear of the car. In this situation the decision was entirely appropriate as the car is
unstable due to the rear quarter resting on the concrete barrier. Due to the ease of
access for the medic and technical team, the pit crews will add an element of
complexity to challenge the team. Although in this situation the use of the stability
ram is correct, ensure due thought is given to the location of any supporting rams as
potentially, the team may be limiting their extraction pathways which unnecessarily
complicates what is essential a simple scenario.

10.1 Considerations: 0 – 2 Minutes

I.C. completes a full 360 degree safety survey of the scene, due to the ease of
access, look for complications to the scenario such as prop vehicles, street furniture
or excessive damage and limited access to the casualty. Relay hazards including
hot exhaust and exposed engine parts and control measures to the team ensuring
they fully understand the briefing. The priority will be stability and access for the
medic, however, resist the urge to block off potential egress routes from the vehicle
with stability rams and opt for stability along the roof line to allow for maximum
space. Consider side removal or door removal to assist with casualty handling and
access.

Version 1.0  34  January 2014 

Receive full safety brief from I.C. and confirm understanding. Prioritise medical
access along with stability. Avoid over complicating stability, the vehicle maybe
relatively stable due to no spring mass and the weight of the engine should hold the
front of the car on the floor, leaving the rear and roof line off the floor and requiring
stability. Decide on simple stability options using wedges and chocks along the side
rails of the roof line where the reinforcement is located near to the window openings
(High strength materials are used here). Once vehicle is stable, allow access for the
medic and complete a full inner and outer survey, remember the seats will have to
be reclined or removed to allow for the removal of the casualty so check seat
reclining mechanisms now and report findings to the I.C.

Once the vehicle is stable, enter the car and apply O2 and manual stability of C-spine
while checking for catastrophic bleeding, airway and breathing. Reassure the
casualty and as soon as possible request a handover from the second medic so a
full primary and secondary survey can be gathered. If the scenario is a rapid or
complex scenario now is the time to look at viable rapid extraction pathways, this will
either be through an open door or rear hatch. Ensure that during the secondary
survey phase, the casualty’s extremities are moved to a more compliant position and
soft furnishings in the car are removed.

10.2 Considerations: 2 – 5 minutes

The I.C. should now have a full brief on the vehicle and what is achievable. Before
declaring plans, ensure that the plan is achievable and in line with the type and
condition of the vehicle, do not declare a rear removal if the rear hatch is
compromised or the seats will not recline or are difficult to remove. Check
understanding with the tech crew on options and give two planning options that can
be prepared, the priority is a secure emergency route from the vehicle which will
usually be the door nearest to or in line with the casualty. Ensure that you speak to
the medic before formally declaring the extraction plans.

Confirm planning information with I.C. and suggest viable options and advise if
planning options are not aligned with the internal and external survey of the vehicle.
Start work on opening the emergency route and prepare the soft furnishings and
internal space required for the primary extraction route, do not start cutting on the full
primary rote until the plans have been confirmed with the medic. Liaise with the
medic before cutting and spreading so the casualty can be prepared, the emergency
route should be open and available within 6 minutes!

Liaise with the I.C. on the condition of the casualty and suggest extraction pathway
options. Ensure primary and secondary survey is completed before speaking to the
I.C. as plans cannot be given until the full condition of the casualty is known to the

Version 1.0  35  January 2014 

team. Make sure the casualty is protected from the elements and falling glass.
Ensure the correct level of protection is given throughout! Monitor the casualty
closely for signs of a rapid scenario (complex scenario) extrication within 10 minutes.

10.3 Considerations: 6 – 10 Minutes

Remember the cost benefit analysis, how much time will a technique cost and is the
space created worth the time spent? The team will need as much internal and
external space as possible so simultaneous activity will be needed both inside and
outside the car. Monitor the crews for progress and be prepared to change or modify
the plans as required. Due to the scenario, a car on its roof can be labour intensive
for cutting and space creation and techniques need slight modification as the car is
inverted so cuts that are done last may have to be done first!

Remember when opening doors that the window aperture will need cutting to avoid
lifting the car. Try to reduce the number of cuts needed to remove doors or the side
of the car. Instead of removing the door completely, try folding the door against the
front wing, the cutting is less and the space created is the same. Side removal can
take any number of cuts; try modifying techniques so that the side is flapped onto the
floor pan of the vehicle rather than fully removing the doors. The emergency route
should now be available for the medic and work will be ongoing on the full extraction
route, the medic will need 3- 4 minutes to board a casualty so the focus on finishing
cutting will be on the 16 -17 minute mark, however, continue to cut if space is
required and avoid the temptation to key hole the casualty, remember, if it’s not in
the best interest of the casualty then you WILL be penalised by the assessors!

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Liaise constantly with the technical crew on what is acceptable and give guidance
when cutting near the casualty. Around the 10 minute mark, a second briefing will
need to be given to the I.C. to ensure that the current plans still fit with the condition
of the casualty. Prepare a second primary and secondary survey to compare initial
observations and brief the I.C. on any changes to the condition of the casualty.
Confirm verbally that the plans are still appropriate or if they need modification in line
with the casualty’s ongoing condition. Monitor O2 usage and ensure the cylinder and
airline is safe and uncompromised while cutting is ongoing. At this point a neck
collar and any secondary treatments should be completed, ensure that the fit of the
collar is done correctly and if the position of the casualty will not permit the
application of the collar then this information is passed to the crew and I.C. as a
more structured moving process for boarding the casualty will need to be completed
and an addition 2 minutes may be needed. Ensure the internal space is sufficient for
the planned extraction and advice technical crew if more space is needed.

10.4 Considerations: 10- 16 minutes

Ensure there is sufficient internal space for the casualty and the medic, the
emergency rote should be open and be available if required for rapid extraction. The
tech team should be well on the way to finalising the external space creation and the
working are should be free from tools and debris from the car. Ensure the
equipment dump is being used and monitor manual handling risks especially when
parts of the car are being removed. The gas struts on the rear hatch can present a
hazard as they are under pressure and are now not lifting the weight of the rear
hatch so the boot may open with excessive force especially when being forced by
the spreaders. At 16 minutes, a decision will need to be made to continue the
cutting or hand over to the medic for casualty removal, avoid the temptation to
keyhole the casualty and it is better to continue to cut and provide the space rather
than pull the casualty out. There are 4 minutes left in the scenario and the medic will
need 3 of them to board the casualty!

Cutting to achieve the main extraction route should be well underway, there should
be sufficient internal space for the casualty and medic and there should be no
complications with the plan. Ensure the working areas are kept clear of tools and
debris and focus on completing the cuts within the time given. Avoid the temptation
to complete half of the techniques leaving debris compromising access and egress
to the vehicle and ensure all cuts are done whilst liaising with the medic and all sharp
edges are covered for health and safety reasons. The assessors will be looking for
good systematic use of the tools and ensure the right tool is selected for the job at
hand.

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Continue to reassure the casualty and monitor the casualty’s condition and o2
usage. Liaise with the tech crew and I.C as the final stages of the extrication are
approaching and the tech team will start to rush in anticipation of releasing the
casualty. Resist the temptation to be caught up with the hype and provide a
steadying influence over the tech team and ensure things are done thoroughly.
In the closing stages the team has the most potential for losing the most marks as
team members try to shortcut the process which may impact negatively on the
casualty. At this stage the medic has the most potential to lose the greatest marks
and also the potential to impact upon everyone else’s marks so ensure the correct
processes are done at the correct time.

10.4.1 Assessors

The assessors will want to see that the vehicle is stable, the hazards such as airbags
have been considered and preventative actions are taken by the crews. Remember
curtain airbags which are easy to avoid while the car is on its wheels now become a
significant hazard and the exclusion zones must be adhered to for the safety of the
crew. The planning process should have taken due consideration to the type of
vehicle, internal and external hazards, condition of the casualty and viability in
respect of time. I.C.’s sometimes ask too much from the technical team and the
plans are not achievable in the time given. Once the cutting stage has been
finalised, it is often looked upon critically if the team need to start cutting because
they failed to consider the full implications or needs of the casualty.

10.5 Considerations: 16- 20 Minutes

In the closing stages, the team will need reassurance and a calming influence as the
tech team will start to rush cuts and try to shortcut the processes. The decision will
now need to be made to either continue to create external or internal space for the
casualty or handover to the medic for the medical phase of the extrication. Liaise
with the medic at 16 / 17 minutes to assess viable options and relay this to the tech
crew.

Continue to complete the cuts fully and ensure the tempo and work ethic is not
compromised and points are lost as a result. The closing stages are the most
important. The casualty handling area should now be identified and should be up
wind of the generator and appliance and be in a clean area free from tools. Ensure
sufficient blocks are made available to site the board on and ensure both the medic
and I.C. is aware of the location. Ensure sharps are covered and tools that are no
longer being used are cleared away from the area. All parts of the vehicle that have
been removed should be located in one area for accident investigation reasons and
the work area should be clear of all debris. Prepare the long-board for the medic
and ensure all straps and head blocks are removed to help the medic.

Version 1.0  38  January 2014 

Assess the condition of the casualty to ascertain an appropriate movement strategy,
check the long-board is ready and a casualty holding area is appropriately placed.
Start to think about the implications of removing the casualty and access points for
lifting and moving the casualty on to the board. Discuss the viable options with the
I.C. is the remaining time to be spent in moving the casualty or is further cutting
required? Focus on the wellbeing of the casualty and ensure the tech team do not
adversely affect the casualty’s condition when moving inside the car or during lifting.

10.5.1 Assessors

Upon completion of the scenario the assessors will be looking for a controlled
extrication phase which has been correctly administered through the I.C. to the
medic. Once the car is clear the assessors will look at the internal space available to
the medic and see if anything else could have been done to improve the space both
internally and externally. At this stage the assessors are finalising the assessment
decision of the team’s performance and may highlight areas of the vehicle that they
will discuss in the debrief.

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11.0 Debrief process

Time will be given to the team to collect personal kit items before the formal debrief
process begins. This is an important time for both assessors and teams as it give
time for both to reflect upon the performance. Teams should try to avoid discussing
the good points and developmental points prior to the debrief process as often the
teams view of their performance differs from the assessors.

The debrief will usually begin with the command assessor introducing the assessor
panel and then each assessor will debrief each discipline individually, with the
command assessor finally summing up the overall performance of the team. No
scores will be given out at the debrief, however the assessors will give verbal
indications on how well the team have performed against the assessment criteria.
As all assessors conform to the WRO assessor criteria, teams should be mindful that
their scores are reflective of an International performance. This is to ensure that
when teams compete outside of ROI challenges, the assessment decisions are
constant regardless of assessors and the challenge location.

The assessors should identify 3 good points which the team have achieved
consistently throughout the scenario and should continue to demonstrate in future
challenges, and also 3 development points that if addressed, will improve the overall
performance of the team exponentially. The objective of the debrief is to objectively
assess the team’s performance and provide development advice in order to improve
the performance for future challenges. In that way, the team should improve year on
year providing the development points have been addressed.

Scores are allocated in sections; Basic, Efficient and Thorough. The team will need
to ‘consistently’ demonstrate compliance in a given area to score. Occasional
periods of a thorough performance which is predominantly demonstrated as being
efficient will attract a final score allocation of being efficient. The team must be able
to ‘demonstrate’ a ‘consistent’ approach to score in the higher bracket.

The debrief is a process where the assessors may clarify certain decisions made on
the incident ground and is also an opportunity to clarify areas that the team may
have in relation to their performance. The debrief is the only opportunity the team
has to question the assessors, once the debrief is over, the assessors are not
allowed to discuss specifics in relation to the scenario after the debrief has ended
and any concerns the teams have must be directed to the head assessor who will
investigate the concerns on the teams behalf.

Assessors may volunteer options for the team’s consideration but this is merely for a
learning perspective and is not reflective of the marking. The information offered to a
crew being debriefed is done post the marking process.

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12.0 Standard Equipment List

Dry Powder Extinguisher [1]

Hooligan Tool [1]
Ratchet Strap [2]
Glass punch [1]
Hand axe [1]
General Purpose Line [1]
Socket set + torque drivers [1]
Duck tape [2]
Seat belt cutter [1]
Bolt Croppers [1]
Airbags with regulator + cylinder [1]
Rubber mallet [1]
Screw driver slotted [3]
Screw driver posidrive (star) [3]
Hacksaw & blades [1]
Set of spanners [1]
Adjustable spanner [1]
Pliers [1]
Locking Knife [1]
Step blocks wood [10]
Step blocks plastic [5]
Crib blocks [8]
Wedges, wood [10 (small & large)]
Wedges, plastic [5 (small & large)]
Short extension ladder (two section) [1]
Tension buttress stabilisation system (e.g. Stabfast or similar)
Windscreen saw [1]
Spare batteries [12]
Hydraulic Rescue Tools for the Rapid and Standard Scenarios
Tear drop - hard protection [2]
Soft protection sheet [1 set]
Salvage sheet [1]
Screen sheet [1]
Sharps covers [1 set]
Long spine board [1]
Medical collars [1]
Resuscitator/ O2 therapy unit + O2 cylinder [1]
Trauma bag [1]
Blanket [1]

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13.0 Rescue Organisation Ireland Sponsors

Chief Fire Officers Association

Vanguard Fire & Rescue Ltd

Amber Fire Protection Limited

Consolidated Enterprises

Sidhean Teoranta

Argos Fire & Safety Ltd

Arqiva Ireland

Finer Filters Limited

Fireguard Fire & Rescue Ltd

Tetra Ireland Ltd

Irish Road Victims Association

TrinitySeven Studio Ltd

Sponsorship options can be obtained by contacting members of the ROI

committee. Further details are on our website [Link]

Rescue Organisation Ireland wish to thank all our past and present
sponsors/suppliers for their support.

Version 1.0  42  January 2014 

14.0 Fundraising for Teams

ROI is fully aware of the substantial time and costs that are incurred by both
individuals and teams to travel to, participate and train for the National and
International Challenges that run throughout the year.

2 main streams are open to teams:

• To help support those that are interested in participating in events, for those
that become placed at the Irish National Challenge run every year, ROI
provide financial contributions to teams to enter and participate in other
International events.

• Since ROI is a registered Charity we are able to raise monies through

sponsorship, collection etc at events that we support and run. In this light we
could therefore “Support/Run” local events in your local area under the ROI
Charity banner without the local repercussions that the Local Authority may
have if it was just a number of their fire-fighters doing this for themselves.

If you are interested in progressing with these yourselves speak to Phil O'Hare,
Declan Cassidy or Padraig O'Longaigh about the options available to do this. Further
details is available on the ROI website

15.0 Training tips

The old adage; “Failure to prepare is preparing for failure” is true. Teams will need
to spend long hours honing their rescue skills and ensuring the team gels as a unit.
An honest discussion will need to be held if individuals within the team have a
disruptive nature and cause imbalances in the team dynamics. As previously stated,
one of the most important people on the incident ground is the casualty; therefore,
the most important member of the team is the medic, so ignore their wishes at your
peril.

There must be a fine balance in what the casualty needs and what is achievable
within the time frames, scenarios are achievable, they may be challenging, but they
are all achievable in the time limits given. With that in mind, medics and I.C.’s must
be mindful to make the planning process realistic in its approach and complex cutting
techniques take time!

Set a training schedule up where the team will meet for an hour each week and walk
through each stage of the scenarios. No cutting of vehicles is needed at this early

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stage in the training; a team member’s car is an ideal focal point. Teams should
focus on each of the stages listed below paying particular attention to their role and
the time constraints; time is aggregated to demonstrate the actual passage of time:

1. Initial approach, 360 risk assessment and casualty contact (30 seconds)
2. Fully brief all members of crew on hazards. (1 min)
3. Initial stability (hands on) to allow rapid entry for the medic if appropriate!
(1:30)
4. Full stability:
a) Car on all 4 wheels (2:00)
b) Car on side (4:00)
c) Car on roof (2:00)

Once the initial stage of the scenario is embedded into the team approach then the
next progressive stages can be built on to the initial approach.

1. Glass management (only glass that needs removing) (4:00)

2. External survey of vehicle:
a) Type of vehicle.
b) Fuel.
c) Duel fuel or single.
d) Laminated and toughened glass locations.
e) Any doors that open.
f) Access to keys.
g) Extraction pathway options. (5:00)

3. Second tool operative to establish tool dump and connect tools to generator
(5:00)
4. First cut or spread to establish emergency route (5:30)

During the second stage, the medic should be preparing a briefing for the I.C. with
viable options for extraction pathways. The external survey of the vehicle and tool
dump activity will give the I.C. time to think of viable options. The first cut or
spreading action should be within 6 minutes at the latest to give the emergency route
option within the 10 minute window.

1. Emergency route open and available (7:00)

2. Medic brief I.C. on pathway options and casualty condition (7:00)
3. Full extraction plans now formed and team briefed (7:30)
4. Cutting processes begin to achieve full extraction plan (7:30)
5. Medic to update I.C. (9:00)
6. Use emergency route or continue with full plan? (9:00)
7. Internal space creation nearing completion (12:00)

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 8. External space creation nearing completion (15:00)
9. Medic update I.C. on viability of plans (16:00)
10. Continue to cut or move to casualty phase (16:30)

Casualty phase:
1. I.C. to hand control to medic (17:00)
2. Crew briefed on casualty condition and movement strategy (17:30)
3. Casualty positioned on board and ready for removal (19:00)
4. Casualty at handling area away from vehicle (20:00).

As the challenge date comes closer, the team should focus on quality training for 2
hours each week. If a team member is rushed or cannot commit to the full training
time then consideration should be given to cancelling the training and rescheduling.

Only in the closing weeks should the team be completing full runs, quality training on
the specific phases of the scenario will be more beneficial than simply cutting car
after car with no thought being given to the incremental steps of the extrication. ROI
operate several skills development days where assessors are available to advise
and demonstrate techniques for teams which will assist in the time management of
the scenario. If you want to be a world class rescue team, you have to put the time
in!

A helpful tip is to have the training videoed, then spend some time debriefing
yourselves and what is often the case, you will see the development points for
yourself and this allows the team to iron out problems before the challenges.

Finally, it is a good idea whenever possible to spend time looking at the interior of
cars. Valuable minutes can be saved if the technical team and medic’s are familiar
with the different designs on vehicle interiors and can strip out seats in a matter of
seconds cleanly without the need for cutting or spreading. Enlist the help of vehicle
mechanics or technicians for help and advice, people in the local garages are only
too happy to help and be associated with the fire and rescue service!

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16.0 Frequently asked questions

Q: Our helmets don’t have visors on them, can we still use them?
A: No! Health and safety stipulate the minimum standard for eye protection is
safety glasses at all times which is upgraded to full face visors for cutting with
hydraulic tools.

Q: On one debrief the assessors told us to use a technique and then we are
criticised for using the technique this time?
A: The debrief is only valid for that period and scenario. Specific advice on
techniques will need modifying for different types and makes of vehicles and
stability scenarios.

Q: Can we use our own specially constructed device / tool?

A: Yes, however, this must be approved by the head assessor prior to starting the
challenge.

Q: The assessor stopped the team during the scenario; does that mean we will
come last?
A: No, the assessors may stop a scenario for a number of reasons; if the issue is
safety then the team will be told why they were stopped and how to remedy
the situation. This may have an impact upon the marking sheet in one area.

Q: Do we have to attend the team briefing at the start of the challenge?

A: Yes. Important health and safety information will be given to the teams at that
time.

Q: Do we have to use traditional fire kit?

A: No, one piece rescue suits are becoming the norm however, any equipment
and uniform that the team use must be approved by their Chief Fire Officer.

Q: Is any additional information available?

A: Yes, the ROI website and WRO website hold all the information teams will need
to access. In addition ROI run a series of team training events throughout the
year which are free to attend and are a good source of up to date information.

Q: Who can I speak to if I need advice?

A: The contact details are located on the ROI website.

Q: Is the equipment located in the pit or is it provided on the fire appliance in the
isolation area prior to the team competing?
A: All equipment required by the team will normally be on the designated fire
appliance in the isolation area.

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 Appendices
 

Version 1.0  47  January 2014 

A1 Details of past skills days

Rescue Organisation Ireland holds a number of skills development days hosted in

different locations around Ireland, in partnership with the Fire Authority as a means
of promoting casualty centred training and the 'Challenge concept' in all corners of
Ireland. To date the following skills development days have been held and ROI
would like to thank the support and commitment given by each of the Fire
Authorities, without which none of this would have been possible.

Carlow County Fire and Rescue Service

Carlow Fire Station, June 2008
Carlow Fire Station, November 2008
Carlow Fire Station, September 2013

Waterford County Fire and Rescue Service

Dungarvan Fire Station, June 2009

Louth Fire Service

Dundalk Fire Station, November 2009

Kerry Fire and Rescue Service

Killarney Fire Station, November 2010

Limerick County Fire and Rescue Service

Kilmallock, June 2011

Monaghan Fire Authority

Carrickmacrosss Fire Station, November 2011

Cork City Fire Brigade

Ballyvolane Fire Station, June 2012

Clare County Fire & Rescue Service

Ennis Fire Station, November 2012

Wicklow Fire Service

Bray Fire Station, March, 2013

The following was the programme and timetable for the most recent skills
development day was held in Carlow Fire Station during September, 2013. The next
skills development day is scheduled to take place in Skibbereen, County Cork in
February 2014. Further details available on the website [Link]

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Version 1.0  49  January 2014 
  

Version 1.0  50  January 2014 

A2 Details of past National and World Rescue Challenges

Rescue Organisation Ireland has successfully held National Challenges since 2009,
each more progressive than the other. Once again each of these events was fully
supported by the host brigade. Dublin Fire Brigade hosted the very first national
challenge which saw 9 teams from around the Country take part, this grew to 11
teams in 2010 hosted by Sligo Fire Service in March and in September that year
Cork City played host to the World Rescue Challenge and since then the challenge
evolved to include the addition of a separate Trauma Challenge for each team to
compete in.

The National RTC and Trauma Challenge now attracts international teams who wish
to attend and compete alongside their Irish colleagues and Irish teams have
attended international events from regionals, nationals to world challenges over the
past number of years.

To date ROI have held the following National and World Rescue Challenges:

Dublin Fire Brigade

O'Brien Institute, February 2009 - National RTC Challenge

Sligo Fire Service

Sligo Fire Station, March 2010 - National RTC Challenge

Louth Fire Service

Dundallk Fire Station, March 2011 - National RTC & Trauma Challenge

Meath County Fire and Rescue Service

Ashbourne Fire Station, March 2012 - National RTC & Trauma Challenge

Monaghan Fire Authority

Monaghan Fire Station, April 2013 - National RTC & Trauma Challenge

Cork City Fire Brigade

Cork City Centre, September 2010 - World Rescue Challenge 2010

Details of all previous challenges are available on the website, including a gallery of
photos taken on the day.

 
Version 1.0  51  January 2014 
A3 RTC and Trauma Team Pack 2013

Rescue Organisation Ireland 
Eagraíocht Tarrthála Éireann 

Registered charity no. CHV19166

ROI National Road Traffic Collision &  
Trauma Challenge 2013 
 
Monaghan Fire Station 
Co Monaghan, Ireland 
April 13th (& 14th), 2013 

Version 1.0  52  January 2014 

    Contents 

1 Introduction

2 Mission Statement

3 The Objectives

4 The Benchmarks

5 The Challenge

6 The Rules

7 Code of Conduct

8 Tools and Equipment List

9 Health and Safety

10 Assessing and Scoring

11 Awards

12 Documentation

“Its not the winning – but the taking apart”

 

Version 1.0  53  January 2014 

1. Introduction

1.1 The loss and injury through road traffic collisions is a modern phenomenon that
knows no boundary. Wherever there is a motor vehicle then, inevitably, people can
become victims to it.

1.2 The objective of the National Extrication & Trauma Challenge is to bring together
teams of rescue personnel who are committed, not only to displaying their ability, but
to expanding their practical skills by learning from and teaching others involved in the
same field.

1.3 Teams from across Ireland & visiting teams from abroad will gather at a single venue
(Monaghan Fire Station) for one or most likely two days (depending on team
numbers – this will be clarified 5 weeks before the event). The Challenge will
consist of,

a) The EXTRICATION challenge - this will aim to see all of the participating
teams use their professional skill and ability in the extrication of a trapped
casualty from a severely damaged vehicle;

b) The TRAUMA challenge - this will aim to see all of the participating teams
use their professional skill and ability in the treatment of a person suffering
from severe trauma.

1.4 What these personnel observe and learn during this challenge will go back with them
to their own Brigades and Services where some person may directly benefit from this
new found knowledge. Thus knowledge and practices learnt can cascade across the
Country, benefiting all those who become victims of a Road Traffic Collision.

1.5 The emphasis in the National Extrication & Trauma Challenge is on developing and
promoting ‘Best Safe Practice’. The challenge is not primarily to win, but to use what
is learnt at these events in protecting and saving those whom we serve, as well as
ourselves, the rescuers.

1.6 Although the ‘Challenge’ appears to be a competition, it is far more than that. It is a
learning platform, matching talents and skills through assessment. Encouraging
participants to make hard and critical examination of their own rescue practices,
techniques and knowledge of the tools they have available to them. It is necessary to
study current extrication philosophy, search out new developments and innovate with
new ideas.

1.7 Although one team will be adjudged the best team overall in each event, in truth the
real winners will be the future victims of motor vehicle collisions and trauma injuries.

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2. Mission Statement
 
2.1 To provide a medium for rescue personnel from across Ireland to come together, in
order to stimulate and develop proficiency levels in all areas of rescue, but
specifically in Incident Control, Safety, Extrication, Pre-Hospital Care and the use of
equipment with control.

3. The Objectives

3.1 To provide a forum whereby rescuers of all disciplines meet and share knowledge;
develop skills; stimulate ingenuity; all of which will culminate in a higher level of
efficiency and professionalism.

3.2 To develop an education platform for rescuers, to assist them in dealing with the
extreme demands placed on them by the modern motor vehicle collision.

4. The Benchmarks

¾ Develop a Safety First attitude amongst all rescuers.

¾ Emphasise patient, rescue personnel and scene safety.

¾ Encourage higher and more proficient levels of pre-hospital care.

¾ Create the broader spectrum of extrication principles and techniques.

¾ Develop the systematic approach to incident command.

¾ Stimulate ingenuity in terms of skill, practices and equipment to advance the best
safety first concept.

¾ Through co-operation, develop an agreed code of best practice.

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5. The Challenge

5.1 The National RTC & Trauma Challenge will be open to all local authority Fire
Brigades in Ireland. It will also be open to a limited number of International
teams who wish to take part.

5.2 The Extrication Challenge will consist (on alternate days if event 2-day) of
1) a ‘Standard’ evolution
2) a ‘Rapid’ evolution

Each evolution will incorporate one of the following scenarios

A single vehicle on its wheels
A single vehicle on its side
A single vehicle on its roof

There may be other vehicles or staging props in the vicinity to act as

obstacles.
Teams may use any of the tools shown in section 8 of this document.
A live casualty will be used in each scenario.

5.2.1 For the ‘Standard’ evolution teams will be allowed a maximum of 20 minutes.
For the ‘Rapid’ evolution teams will be allowed a maximum of 10 minutes.

5.2.2 Each team will be assessed by a panel of three assessors using a common
criteria & marking scheme.
The following areas will be assessed:
Incident Command and Control
Physical Rescue and tool operation
Pre-Hospital care

5.3 The Trauma Challenge will consist of 2 simulations (on alternate days if event
2-day).

It will consist of a team of two personnel dealing with a simulation of a trauma

incident using live casualties.

5.3.1 For each trauma simulation teams will be allowed a maximum of 10 minutes.

5.3.2 Each team will be assessed by a panel of two assessors using a common
criteria & marking scheme.

5.4 Rescue Organisation Ireland is one of the few organisations to use live
casualties in extrication & trauma challenges. These are all medically trained
personnel who will have an input into the medical rescue assessment.

5.7 Each team will be afforded a ‘hot’ debrief immediately following their scenario
run off, with a written critique (post Challenge) on request. It must be noted
that the assessors’ decision is final and all participants are asked to respect
that decision.

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6. The Rules

6.1 No team will participate without the written authorisation of the Chief Fire
Officer or Chief Executive of their organisation.

6.2.1 Each extrication team will consist of 5 members including the team leader and
may include a paramedic.

6.2.2 Each trauma team will consist of 2 members including the team leader and
may include a paramedic.

6.3 Only approved Fire Service issue PPE shall be worn by all team members
including the medic if a Fire Service member. In the event of a Paramedic
acting as medic, he/she must also wear full protective clothing with no
exposed skin on arms or neck and a suitable helmet with face shield.

6.4 Each team will be assessed in 3 primary areas - Incident command & control;
Physical rescue & tool operation; Pre-hospital care of patient. The urgency in
which the whole evolution was undertaken will also be considered as part of
the assessment.

6.5 There will be a time limit on the Standard evolution of twenty (20) minutes.

6.6 There will be a time limit on the Rapid evolution of ten (10) minutes

6.7 There will be a time limit on the Trauma evolution of ten (10) minutes

6.8 Live casualties will be used in the Challenge, within the vehicle, and marks
will be awarded on ‘Casualty Handling’. There will also be a listening device/
radio fitted to the inside of the vehicle or attached to the casualty.

6.9 Basic packaging of the patient will be evaluated using the ABC and S
protocols, with care and safety being of prime importance.
A=Airway Management, B=Breathing & Resuscitation, C=Circulation,
S=Spinal Care.

6.10 Each pit area will have allocated to it three assessors, who will be under the
direction of the Head Assessor. All scoring information will remain the
property of the Organisation and shall remain confidential.

6.11 The decision of the Head Assessor concerning any assessment or conduct
will be deemed to be final.

6.12 A Safety Officer will supervise each evolution with authority to halt any action
deemed to be in breach of safe working practice. Such a breach shall not on
the first occasion incur time penalties; however subsequent breaches can
incur penalties.

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6.13 All participants must keep safety in mind at all times and only approved head,
eye, hand, and foot protection shall be worn. Respiratory protection in the
form of dust masks shall also be worn at the appropriate times. i.e. cutting
windshields or glass.

6.14 Teams may use radio communications in the form of either, hand-held or
helmet attachment, as long as they do not interfere with the host brigade’s
radio frequencies. It will be the team leader's responsibility to supply an
assessor with a radio, on the same frequency, in order that instructions to the
team can be monitored.

6.15 The organisers will ensure the supply of a comprehensive selection of

equipment, (see tool section). Teams may only bring a very limited selection
of their own personal equipment with them, for example hand tools and
oxygen therapy equipment. This may include any home-made equipment, but
such equipment must first be approved safe by the organisers prior to any use
in this event.
Note all competitors are responsible for providing their own full PPE, to
include dust-masks, medical gloves and eye protection.

6.16 Any home-made equipment to be used in conjunction with power rescue tools
must carry a ‘Notice of Certification’ by an approved body or person.

6.17 Teams may lend equipment to other teams ensuring any safety features are
fully understood by the recipient.

6.18 Teams must present themselves to the ‘Registration’ area 60 minutes prior to
their designated run off time.
N.B. Failure to do so may result in elimination of the Team.

6.19 The organisers may substitute another team, in the event of a team ‘No
Show’.

6.20 There will be a briefing of all participants and this will take place at the same
venue prior to the start of the challenge.
N.B. while preferable that all team members should attend this briefing,
it is mandatory that all the team leaders attend

6.21 The Organisers and the host brigade will not be responsible for any damage
or loss of any equipment as a result of participating in this event.

6.22 Workers’ Compensation, Insurance etc. for the protection of the team
members shall be the sole responsibility of the participants in the event. The
host organisation shall supply 3rd party liability insurance.

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7. Code of Conduct

7.1 All participants are reminded that they are not only representatives of their
own Brigade or Service but also that they represent the Emergency Services
as a whole, and are to conduct themselves accordingly.

7.2 Participants are expected to be smartly dressed whilst in the Challenge venue, it is
preferred that working rig be worn to tour the site, however this can be relaxed to
casual wear, so long as it is approved by the team manager.

7.3 Full protective clothing shall be worn in the pit and service area, this may be relaxed
during ’preparation and make up’ at the discretion of the head assessor, when
weather conditions demand.

8. Tools & Equipment List

The following equipment will be made standard stowage on each appliance for the
Challenge. All teams must use this equipment - Teams may not provide their own
equipment, other than personal small gear, i.e. hand tools, medical collar etc.

Type of Equipment Quantity Remarks

DP Extinguisher 2
Small Gear 
 

Halagan Tool 1
Ratchet Strap 2
Glass punch 1
Hand axe 1
GP Line 2
Tool Set 
 

Rubber mallet 1
Screw driver slotted 3
Screw driver posidrive 3
Hacksaw & blades 1
Set of spanners 1
Adjustable spanner 1
Pliers 1
Locking Knife

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Dewalt 24volt saw  1 2 further batteries
Windscreen saw 1
Socket set + torque drivers 1
Duct tape 2
Seat belt cutter 1
Bolt Croppers 1
Airbags with regulator + cylinder 2
Stability Equipment 
 

Step blocks 10 5 wood & 5 Plastic

Crib blocks 8
Wedges 15 10 wood (s&l) & 5 Plastic
Short extension ladder (two section) 1
Stability system 1 set ‘Stabfast’ system or similar
Hydraulic Rescue tools  
1 complete set Chosen by teams
Protection Equipment 
 

Tear drop - hard protection 2

Soft protection sheet set 1 set
Salvage sheet 1
Screen sheet 1
Sharps covers 1 set
Medical Equipment 
 

Long spine board 1

Medical collars 1
Resuscitator/ O2 therapy unit + O2 cylinder 1
Trauma bag 1
Blanket 1

Please note:

All the above equipment will be stowed either in the pit or on the appliance in several
lockers, leaving a further 1 locker available for each team’s personal small gear.

Teams shall provide their own dust mask, latex gloves, goggles and ear defenders as
appropriate.

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9. Health and Safety
9.1 A risk assessment will be conducted prior to each evolution to ensure the safety of
both participants and spectators. Dynamic risk assessment will occur throughout the
evolution, not only by the team involved but also by the assessors and safety officer.
Any unsafe or potentially unsafe practice will be stopped immediately and put right.

9.2 All activity within the Challenge site, i.e. Pit area, Service area, Vehicle storage and
disposal area, Team and Tool preparation area falls under the control of the Pit
Controller who is empowered by the Organisers.

9.3 No Team will be allowed to commence their evolution without direct approval of the
Pit Controller, subject in all cases, to the following:

(i) All Team members are properly attired in their approved personal
protective equipment.
(ii) All non-proprietary equipment is accompanied by the relevant
documentation.
(iii) The Pit Controller has ‘cleared ‘ the scenario.

9.4 Should, in the opinion of any Official, a potential or existing danger, or an unsafe
condition be seen to exist or caused to exist, then that Official must immediately halt
the assessment by a long whistle blast. Any activity carried out after the blowing of
the whistle, other than to ensure safety, will be penalised at the discretion of the
Senior Pit Assessor.

9.5 Should any member of a team participating notice an existing or potential danger, or
an unsafe condition, to exist or be caused to exist, they must call a halt to any activity
by shouting ‘Still’. Any activity carried out after the calling of ‘Still’, except to make
safe, will be penalised at the discretion of the Senior Pit Assessor.

9.6 No team member will be permitted to commence moving, cutting or breaking any
vehicle component without the casualty being protected and other team members in
direct proximity having their face visors in the down position.

9.7 Should any item of the casualty’s personal protective equipment, be removed by a
team member, for any reason, it must be replaced before work can recommence.
Failure to do so may result in loss of points or possible disqualification.

9.8 Testing of pneumatic tools will only be permitted on wooden blocks and with the
‘head’ facing away from any live target. No Hydraulic power units are to be started
without the feed and return lines connected to a tool and the control valve shut.

9.9 Vehicle tyres can only be deflated by valve or valve stem removal. The slashing or
puncturing of tyres is prohibited.

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10. Assessing and Scoring

10.1 Each extrication team will be evaluated in the following areas by a panel of three
assessors.
(a) Incident Command and Control.

(b) Physical Rescue and Tool Control.

(c) Pre- Hospital Care.

10.2 Copies of all the assessment sheets in use will be provided to each accepted team
prior to the event (Copies can also be sourced by visiting the website:
[Link]

10.3 Points awarded per sub-section will be totalled and each sub-section added together
to give an overall score for that particular criteria.

10.4 The total points awarded in each category will be calculated as a placing (i.e. highest
points = 1) and all three total placings will be added together towards an overall
award for that evolution. (lowest placing total = 1st)
10.5 In addition, each score sheet will be compared, in order to recognise the ‘Best
Individual’ team member in each criteria. i.e. Command and Control, Physical
Rescue, Pre-Hospital Care.

10.6 Every Team will be afforded a ‘Hot Debrief’ immediately following their performance,
with a follow-up written critique ‘post Challenge’ on request.

10.7 It must be noted that the Assessors’ decision is final and all participants are asked to
respect that decision. Award sheets will be available to each Team Manager after
the Awards Presentations.

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 11. Awards

Each year Rescue Organisation Ireland recognises the performances of the Team
AND the individuals of every Team. The effort and dedication that has been put in by
team members and supporters towards this Challenge over many weeks & months
shows the value of just such an event as this.

Official awards will be made to the top placing teams at Monaghan Fire Station
immediately following the event, in the following categories,

EXTRICATION

Best Overall Team

2nd Place Team
3rd Place Team
Best Individual IC

Best Tech Team

Best Individual Medic

Best International Team

TRAUMA

Best Overall Team

2nd Place Team
3rd Place Team
Best International Team

Note: The awards for Best Overall Team can only be won by Rescue Organisation
Ireland teams as there will be a separate award for the Best International Team.

There will also be an award to the Team that were most representative as
Ambassadors for the Rescue Challenge concept & ethos at this event – to be
decided by the Assessors on the day.

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12. Documentation

12.1 Enclosed you will find the following forms:

1) TEAM REGISTRATION DOCUMENT

2) AUTHORISATION TO COMPETE
3) INSURANCE INDEMNITY

These must be completed and returned, together with the full entrance fee, to the
Following address:

Pádraig Ó Longaigh,
Rescue Organisation Ireland,
c/o Navan Fire Station,
Abbey Road,
Navan,
Co Meath,
Ireland

Or by email to polongaigh@[Link]

12.2 The entrance fee must be received before your team can be accepted as a
participant in the ROI National Road Traffic Collision & Trauma Challenge 2013.

The fee may be paid by cheque, sent to the address above, or by bank transfer to

Acc. Name: Rescue Organisation Ireland

Bank Details: Allied Irish Bank,
72/74 The Quay, Waterford, Ireland
Acc. Number: 10602041
Sort Code: 93-42-75
IBAN: IE17AIBK934275 10602041
Swift Code: AIBKIE2D

NOTE: Payment is due before 28th Feb, 2013

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 EXTRICATION TEAM REGISTRATION
Full Team Entry fee of €350 must accompany the Team Registration before 28th
Feb 2013.

Specify payment method: ........................................ Date:…………………………….

ORGANISATION REPRESENTED

LIAISON OFFICER

CONTACT TELEPHONE/FAX

E-MAIL ADDRESS

TEAM ADDRESS

TEAM MEMBERS –

RESERVE

PREFERRED HYDRAULIC EQUIPMENT

PLEASE SPECIFY
(eg HOLMATRO / WEBER/ LUKAS etc)

To be completed by the Team Manager.

On behalf of the ……………………………………........................................ Rescue Team
I confirm that we have read and understand the rules governing this Challenge and
undertake to abide by the requirements set.

Signed:
Name: Position:
Date:

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 TRAUMA TEAM REGISTRATION
Full Team Entry fee of €150 must accompany the Team Registration before 28th
Feb 2013

Specify payment method: ........................................ Date:…………………………….

ORGANISATION REPRESENTED

LIAISON OFFICER

CONTACT TELEPHONE/FAX

E-MAIL ADDRESS

TEAM ADDRESS

TEAM MEMBERS –

RESERVE

To be completed by the Team Manager.

On behalf of the ……………………………………........................................ Trauma Team

I confirm that we have read and understand the rules governing this Challenge and
undertake to abide by the requirements set.

Signed:

Name: Position:

Date:

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 AUTHORISATION TO COMPETE
 

I hereby confirm that the team from ……………………………………………………….........

is duly authorised by their Chief Fire Officer/Chief Executive, to participate in the ROI
National Road Traffic Collision & Trauma Challenge 2013, as representatives of their parent
organisation and that for the purposes of insurance they are deemed as being on official
duties whilst attending this Challenge.

Signed: …………………………………........... Position: ……………………………..

Organisation: …………………………………. Date: ………….............

INSURANCE INDEMNITY

I hereby confirm, that for the purposes of insurance, the team from:
 

……………………………………………………………………………………………………..
 

are deemed as being on official duties whilst training/practising and attending the ROI Road
Traffic Collision & Trauma Challenge 2013. This has been duly authorised by their Chief Fire
Officer/Chief Executive.

Signed: ………………………………… …..... Position: ……………………………..

Organisation: ………………………………… Date: ……………………

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Feedback and Comments on this Handbook
 

This handbook and like others in the series produced by Rescue Organisation, is
subject to regular review and, for that reason, it is requested that any comments
and/or insights that arise during its implementation are fed back to the organisation.

All comments should be forwarded to:

Padraig O'Longaigh,
Secretary of Rescue Organisation Ireland
polongaigh@[Link]

Michael Gahan
Head Assessor, Rescue Organisation Ireland
mgahan@[Link]

Rescue Organisation Ireland
Eagraíocht Tarrthála Éireann

 
 
Registered charity no. CHV19166 

 
 

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