Rescue, health and evacuation: What rising bariatric rescue incidents mean for planning

Specialist equipment in greater use as bariatric rescue call-outs rise in Avon

Avon Fire and Rescue Service has reported a marked rise in bariatric rescues in Bristol, Bath, North Somerset and South Gloucestershire, moving from an average of six a month in 2022 to about nine a month in 2025, as reported by the BBC.

That pattern sits inside a wider uptick in special service calls, where crews attend non-fire incidents and often support ambulance colleagues with specialist movement and evacuation.

Taken together, the figures point to a practical question for all services and dutyholders: how does the physical health and mobility of the public shape rescue and what needs to be in place so that people can evacuate safely and crews can work efficiently and with dignity for everyone involved.

What do the numbers tell services about workload?

The BBC report sets out three snapshots for Avon: 50 bariatric rescues between August 2022 and April 2023, 72 between April and December 2024 and 73 between January and August 2025.

For managers, a steady month-on-month demand is usually more instructive than a single headline percentage, because it drives decisions on crewing, equipment availability and training schedules.

It also matters that these incidents sit within special service calls, which overtook false alarms for the first time in 2024/25 in Avon.

That shift has operational consequences, from how often specialist vehicles are mobilised to how crews rotate to manage longer, more resource-intensive jobs.

Peaks coinciding with very hot weather were also noted in the report to the fire authority, which is a reminder that seasonal conditions can compound existing health and mobility challenges.

How does physical health shape evacuation and rescue?

Physical health influences speed, stamina, grip strength, balance and the ability to navigate stairs or tight spaces, all of which are central to self-evacuation and assisted rescue.

In real terms, that can mean longer time to move a person to safety, more personnel needed to handle loads safely and increased reliance on powered or mechanical aids.

For incident commanders, it affects sectorisation, the choice of egress route, where to position crews and how to manage manual handling risks alongside fire and smoke hazards.

For the person being assisted, comfort, dignity and communication need to be maintained, including clear explanation of what will happen and how.

What are PEEPs and GEEPs and when are they needed?

Personal Emergency Evacuation Plans (PEEPs) set out how an individual who may not be able to evacuate unaided will leave a building or reach a place of safety.

They are tailored plans, often used for employees, residents or regular building users who have mobility, sensory or cognitive barriers to unaided evacuation.

General Emergency Evacuation Plans (GEEPs) describe the arrangements a building has in place for visitors or members of the public who may need assistance but do not have a personal plan.

Both approaches cover routes, equipment, assistance roles and communication and they should be tested in drills to check feasibility and timing.

Where a building has changing risk profiles across the day, GEEPs should make clear how help is summoned and who is tasked to assist at any given time.

What planning and kit make bariatric rescues safer?

Bariatric rescues involve moving people who are heavier or who cannot be moved with standard equipment, often in confined residential settings or buildings with limited lift access.

Planning starts with early information sharing between fire control and ambulance control so the right assets are mobilised on the first call.

On scene, crews may require wider access routes, removal of fixtures, temporary edge protection and careful floor load assessment, especially when using powered devices.

Equipment typically includes high-capacity evacuation chairs, bariatric stretchers, friction-reducing slides, inflatable lifting cushions, patient positioning devices and, in some cases, specialist vehicles designed to accommodate larger stretchers and lifting systems.

Crew welfare needs are part of the plan, with rotations, hydration and time for safe manual handling.

A debrief that captures timings, bottlenecks and any equipment limitations helps improve the next response.

How should building owners and managers prepare?

Dutyholders should review whether their current evacuation strategy anticipates assisted movement for people who cannot use stairs quickly or at all.

That means confirming refuge points, checking communications from refuges to the control point, validating evacuation chair types and weight ratings and ensuring routes are free of pinch points that would block wider equipment.

Lift policies should be explicit about non-fire lifts, evacuation lifts where present and contingencies if a lift is unavailable.

Cleaning and maintenance teams should be briefed to keep turning circles, lobbies and stairwells clear, because small obstructions can become major delays when using larger equipment.

Training for staff who may assist should include practical handling on the actual kit in the building, not just classroom instruction.

What can individuals with reduced mobility or poorer health do in advance?

If you are a regular user of a building, ask the manager or employer how a PEEP can be set up for you.

Note your usual arrival and departure routes and identify the closest refuges, alarms and call points on each floor you visit.

Check whether an evacuation chair is present on your floor and who is trained to use it.

Carry essential medication or medical information in a pocket or bag that you can keep with you during an evacuation.

If stairs are difficult, try the route with a colleague during a quiet period to estimate how long you need and whether resting points are available.

If hearing or vision is impaired, ask about visual alarms, tactile indicators or buddy arrangements that fit your routine.

How can services keep language respectful while focusing on safety?

Talking about a person’s weight or health in the context of rescue can feel personal, so services should centre conversations on equipment limits, safe systems of work and the person’s preferences.

Use person-first language, avoid assumptions about ability and explain actions step by step.

When plans are written, keep them factual, specify roles and timings and avoid labels that are not necessary for safety.

In debriefs and training, describe tasks in terms of loads, access and method rather than personal attributes.

Bariatric rescues explained: what they are and why they take time

A bariatric rescue is an incident where crews use specialist equipment and techniques to move a person who cannot be moved safely with standard kit or methods.

The trigger can be body weight, body shape, posture, location, medical condition or a combination of these that makes usual handling unsafe.

Common scenarios include movement from a bedroom to an ambulance when stairs are narrow, extraction from a bathroom with limited turning space or transfer from the floor to a stretcher without causing pain or pressure injuries.

Why they take time is simple: more planning, more equipment setup, more personnel and sometimes building alterations such as removing a window or banister.

The BBC report notes that Avon has seen these incidents rise over the past three years and that they can be resource intensive and costly.

That reality argues for realistic attendance times, clear inter-agency tasking and honest communication with family or carers on scene.

Do evacuation chairs and refuges solve everything?

No single measure addresses every situation.

Evacuation chairs vary in capacity, braking performance and suitability for different stair materials and users need practice on the exact model installed.

Refuges are only as effective as their communication link and the plan to reach the refuge promptly.

Buildings with complex layouts may still require additional staff to guide routes, manage doors and keep stairs clear of bystanders.

For some individuals, a horizontal evacuation to a place of relative safety on the same floor may be safer than immediate stair descent, depending on the incident.

What about costs, training time and availability?

The BBC report quotes Avon’s Community Risk Management Planning Manager describing bariatric rescues as protracted and resource intensive, which has budget and rostering implications.

Services will weigh the availability of specialist vehicles against the frequency of need, aiming to position assets so travel time to likely hotspots is reasonable.

Training time can be reduced by integrating manual handling and bariatric modules into existing programmes and by running joint exercises with ambulance crews who bring complementary skills and equipment.

For building operators, the most cost-effective step is often to verify that current equipment is fit for purpose, maintained and accessible, rather than purchasing more devices that staff are not confident to use.

Where does this leave evacuation strategy and community messaging?

For services, the trend data justifies maintaining a cadre of crews trained and equipped for complex movement and extraction, with call-out protocols that bring the right capability first time.

For dutyholders, PEEPs and GEEPs should be treated as living documents, updated when building layouts change or when regular users’ needs change.

For individuals, simple preparation such as sharing information with a manager, identifying routes and keeping essentials to hand can make assisted evacuation faster and safer.

Across all groups, respectful communication and realistic time estimates help keep incidents orderly and reduce stress for the person being assisted.

Practical steps at a glance

Map where specialist equipment is stored on each floor and who can access it at any time of day.

Audit door widths, stair pitches and landing sizes against the equipment you actually have, including evacuation chair dimensions and turning needs.

Run a timed drill for a representative scenario and record set-up time, transfer time and route time to validate your plan.

Confirm how you will communicate with a refuge if the main panel fails and who monitors and records that traffic.

Agree a handover script between fire and ambulance teams so the person being assisted hears consistent, calm instructions.

A considered approach without blame

Rising bariatric rescues do not assign blame to individuals or communities.

They describe a workload pattern that can be planned for with the right kit, training and building arrangements.

The aim is straightforward: preserve dignity, reduce risk to the person and to crews and make evacuation and transfer as smooth as possible when someone cannot move unaided.

Clear PEEPs and GEEPs, competent staff, suitable equipment and joined-up mobilisation are the parts that make that possible.