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Rapid extrication of entrapped victims in motor vehicle wreckage using a Norwegian chain method – cross-sectional and feasibility study

Sabina Fattah12*, Anne Siri Johnsen134, Jan Einar Andersen1, Trond Vigerust15, Terje Olsen1 and Marius Rehn136

Author Affiliations

1 Department of Research and Development, Norwegian Air Ambulance Foundation, P.O box 94, 1441 Drøbak, Norway

2 Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway

3 Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway

4 Department of Anaesthesiology, Oslo University Hospital Ullevål, Oslo, Norway

5 Norwegian Air Ambulance, Dombås base, Lørenskog, Norway

6 Department of Anaesthesia and Intensive Care, Akershus University Hospital, Lørenskog, Norway

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BMC Emergency Medicine 2014, 14:14  doi:10.1186/1471-227X-14-14

Published: 3 July 2014



Road traffic injury (RTI) is a global problem causing some 1,2 million deaths annually and another 20–50 million people sustain non-fatal injuries. Pre-hospital entrapment is a risk factor for complications and delays transport to the hospital. The Rapid Extrication (RE) method combines winching and cutting of both front poles and utilising two larger vehicles to pull car wreckage apart to extricate patients. A previous study indicates that RE is an efficient alternative to previously existing methods.


All Fire Departments in Norway were questioned on: background, frequency of training, use and implementation of the method, protocol and equipment. Times used for extrication from motor vehicle wreckage were measured at the National Championship in RE. Questionnaires presented to participants asked about frequency of training, inter-disciplinary cooperation and self-perceived safety for both providers and patients on a 1–7 Likert scale (1 - worst and 7 - best).


Participating Fire Departments use RE in 95% of cases on passenger cars and 77% of cases on larger vehicles. Teams participating in the National Championship scored self-perceived security of crew as median 7 and IQR (6, 7), patient safety 7 (6, 7), communication between personnel 7 (6, 7), teamwork 7 (6, 7), and how well the technique functioned 7 (6, 7).

All teams had extricated and transported the patient into the ambulance within 20 minutes.


Interdisciplinary and regular training of RE can lead to safe extrication of a critically injured patient in less than 20 minutes and may be life saving.

Rapid extrication; Road traffic accident; Road traffic injuries; Rescue services; Emergency medical services; Emergency medicine; Entrapped victims