Emerg Med J 29:1011-1012 doi:10.1136/emermed-2012-201932
  • Cases for HEMS

Entrapment in an unstable structure

  1. David J Lockey
  1. London's Air Ambulance, The Royal London Hospital, London, UK
  1. Correspondence to Dr David J Lockey, London's Air Ambulance, The Royal London Hospital, London E1 1BB, UK; david.lockey{at}
  • Accepted 31 August 2012


Building collapses may constitute a major incident when there are significant numbers of occupants. Even when there is a single occupant special resources may be required and risks to rescuers can be considerable. This case illustrates the problems of restricted access and the specific additional rescue services available.

Case notes

The prehospital team were called to a building collapse with a person reported trapped. Before landing, aerial survey revealed a large, partially collapsed three-storey house. On arrival, the team was briefed by the on-scene emergency services. There were several workers renovating the house when the collapse occurred, and all but one had managed to escape uninjured and left the scene before emergency service attendance. In addition to the ambulance and fire service an urban search and rescue (USAR) team was present. It was confirmed that a single male patient was trapped on the first floor, lying under two reinforced steel joists (RSJ), a chimney stack and roofing. The house was described as ‘extremely unstable’ but verbal contact with the patient had been established from a ladder resting against the side of the house. The helicopter emergency medical service (HEMS) doctor was asked to carry out a remote assessment in an attempt to determine the state of the patient and urgency …

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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