Rescue Plan Risk Assessment - Method Statement

Document                Revision

Location / Area:

JOB TASK:
Reference No

To:

Operators:
Names of operators who are involved
in the work at height:

Signature of Person Responsible For
Working at Height Rescue (WAH)
Date

What communication systems will be
used between the suspended worker
and supervisor / rescue team?

1. (Tick as appropriate)
2. Direct voice communication 􀀍
3. 2) Whistle 􀀍
4. 2) Mobile Phone 􀀍

Emergency Contact:
In the event of an emergency / fall from
height the WAH
supervisor should immediately alert:
The rescue team and first aid assistance:

Name:

First Aider(s) Name:

If the site rescue team is unable to affect a
rescue within 5 minutes the Fire & Rescue
Service are to be called on ℡ - 999 and the
Ambulance Service should be called immediately.

Local Accident & Emergency Hospital ℡ -

In all instances inform the Control Room of the situation, ℡ -

Note: Once the rescue team is in attendance
and if required, a nominated person is to go
to the site entrance to meet, and direct the
emergency services, and provide the following information:

Operators’ condition after fall:

Safety of Rescuers:
(as appropriate)

Are Operators trained competent & in
date in use of rescue equipment? Yes 􀀍 No 􀀍
Are Rescue training records in date? Yes 􀀍 No 􀀍
Are there a sufficient number of rescuers
available? Yes 􀀍 No 􀀍
Is rescue equipment selected appropriate
for nature of work? Yes 􀀍 No 􀀍

(Detail):

Have assessments been made of anchor points,
& are they in date for test? Yes 􀀍 No 􀀍
Has consideration been made to method
of attaching casualty?
Yes 􀀍 No 􀀍

How will rescuers get to casualty?

• (tick as appropriate) (tick as appropriate)

Rescue ladder                                                       
Keys to building & roof                                                 
Pull casualty in through window / balcony           
Climb / abseil down building / structure                

Remote Rescue Kit

Elevator

Pull casualty up through floor / slab / roof
Suspended access equipment

 Crane man basket

What equipment is needed to ensure
rescue within 5 minutes in order to
minimize suspension trauma?

• (tick as appropriate)

• (tick as appropriate)

Rescue ladder                                                                
Rescue Kit – Winch                                                         
Rescue Kit – Haul                                                            
Low Height Rescue Kit                                                  
Descent Rescue Kit                                                        
MEWP                                                                                 

Aerial ladder truck.
Suspended access equipment
Climbing / rope rescue system
Crane man basket
Stretcher
First Aid Kit

If Operative is injured

• (tick as appropriate)

Can casualty still be rescued within 5 minutes?
Yes 􀀍 No 􀀍
Is a qualified first aider who under stands
suspension trauma present?
Yes 􀀍 No 􀀍
Who and how will the emergency services
and hospital
be alerted?

(Detail):
How will others be protected?

• (tick as appropriate)

Set up barriers

How will Accident scene be protected?

• (tick as appropriate)

Prevent further injury or damage                            
Preserve wreckage                                                        

Other Considerations:

Lone working precautions (Detail):
Unusual features of building / structure
(Detail):
Weather Conditions (Detail):
Proximity to emergency services / hospital
(Detail):
Language barriers (agency / contract staff)
(Detail):

WORK AT HEIGHT RESCUE PLAN PRODUCED BY:

Rescuer In Charge:

APPROVAL OF WORK AT HEIGHT RESCUE PLAN:
Work At Height Supervisor:

Position:

Authorising Manager: