We've all been there, or at least have heard about it.

You arrive on scene for an entrapped patient. There is a "successful" rescue or extrication, but the patient dies before they make it to the inside of an ambulance. 

You wonder what could have been done differently.

But "everyone knows" that in these types of situation, the person invariably dies.

• Caught between two trucks - dead.
• Buried in a trench - dead.
• Hanging at height in a harness for an extended period - dead.
• Chronic medical condition but caught in a confined space - dead.
• Stuck in machinery - dead.  

Well, everyone is wrong. 

"But what if we get a doctor to the scene?"    We've heard that a bunch of times.

There are a few problems with that.

First, this supposes that a doc is available. Of course, that is the exception, not the norm. It usually is a last minute phone call to the hospital, and any doc will do.  

Second, it is the rare doc that has any training in this type of medical care.  It is even more uncommon to find one who can function safely and effectively in the rescue environment. 

Even supposing that such a doc exists locally, and is available, and can get to the scene, how long will it take? Can your victim wait that long? 

Think about past calls for industrial accidents, farm accidents, vehicle collisions with prolonged entrapment, patient pinned between large objects, and similar calls, where you wish you had been trained specifically for exactly that situation. How long did it take to get specialty equipment or personnel to the scene?

With proper training of rescue personnel in the medical aspects of technical rescue, patient survival is greatly increased.

ARLS is that training.