Disaster Medicine and Public Health Preparedness

Original Research

Confined Space Medicine and the Medical Management of Complex Rescues: A Case Series

Bruno Petinauxa1 c1  id1, Anthony G. Macintyrea1 and Joseph A. Barberaa2

a1 Department of Emergency Medicine in the School of Medicine and Health Sciences The George Washington University, Washington, DC.

a2 School of Engineering and Applied Sciences The George Washington University, Washington, DC.

id1     http://orcid.org/0000-0003-4707-3306


Objective A variety of hazards can precipitate the full or partial collapse of occupied structures. The rescue of entrapped survivors in these situations can be complex, require a multidisciplinary approach, and last for many hours.

Methods The modern discipline of Urban Search and Rescue, which includes an active medical component, has evolved to address such situations. This case series spans several decades of experience and highlights the medical principles in the response to collapsed structure incidents.

Results Recurring concepts of confined space medicine include rescuer safety, inter-disciplinary coordination, patient protection, medical resuscitation in austere environments, and technical extrications.

Conclusion Strategies have been developed to address the varied challenges in the medical response to collapsed structure incidents. (Disaster Med Public Health Preparedness. 2014;0:1–10)

(Online publication February 14 2014)

Key Words

  • urban search and rescue;
  • confined space medicine;
  • collapsed structure;
  • earthquake;
  • prehospital care


c1 Correspondence and reprint requests to Bruno Petinaux, MD, Department of Emergency Medicine, The George Washington University Medical Faculty Associates, Ste 450, 2120 L St, NW, Washington, DC 20037 (e-mail bpetinaux@mfa.gwu.edu).