Rescue operations place special demands on the Emergency Response Team (ERT). The ERT must balance the complexities of site management with the intricacies of victim management to stabilize an effective and efficient manner while maintaining the safety of responding personnel.
Every situation presents unique challenges that can be overwhelming without a methodical, pre-determined series of response actions designed to guide the officers’ thought processes and decision-making. The environment and victim condition(s) demand different strategies, and the first arriving officer’s responsibilities include staging, size-up, and identifying response options. Officers must survey the scene by assessing the scope of needed rescue operations and safety precautions ch as personnel, equipment, mutual aid, and agreements with private sector entities that include construction and demolition companies and hardware or lumber suppliers. Faced with this array of information, priorities, and options, officers must rely on incident management systems to direct their thought processes and guide their decisions.
Size up at any scene is the first step of evaluation that will determine the response action, and will continue throughout the response as changes in the environment, personnel, equipment, and victims evolve. Life safety is always the first priority to ensure minimal risk to the officer, response team members, and victims at the site. The first series of decisions is to identify the goals for the operation and the tasks required to accomplish those goals. The ultimate goals are rescue and life safety, but to determine the specific goals to accomplish rescue, information must first be collected about the location of victims and hazards in the environment, the nature of the victim’s injuries, and the ever-changing nature of these mitigating factors. Information gathering includes observing the scene, talking to witnesses (and victims when possible), and determining their validity. Witnesses can provide crucial information, and officers will have a better understanding of the challenges they face, such as hazards or victims injuries, if they understand from witnesses how the scene came to its current configuration.
Confined spaces present a variety of hazards to rescuers, many of which are obvious. The space may have limited entry and exit; there may be equipment such as motors, gears or agitators that hinder movement and could cause physical harm; it could contain grain, water, or other material that could shift and engulf the rescuer (the second-leading cause of death in confined space); or it may be poorly lit, have slippery surfaces, or impede communication between rescuers. But it’s the hidden dangers that are the most threatening and the easiest to forget or ignore.
Every confined space should be considered dangerous until proven otherwise and precautions are taken to mitigate the potential hazards. Asphyxiation is the leading cause of death in confined spaces because the atmosphere is easily corrupted and atmospheric hazards are impossible to detect without monitoring equipment.
Rescuers often rely on their senses to evaluate and identify hazards, a practice that is fundamentally flawed. Even when the physical senses may detect atmospheric hazards, the contact necessary for detection alone is often fatal. The only safe and reliable means for testing the atmosphere of a confined space is to use equipment designed for that purpose, and training rescuers to use the device.
Proper atmospheric testing requires deliberation and care. Approximately one-third of all confined-space fatalities occur after the space has been tested and determined safe for entry. Quick tests at the point of ingress are insufficient.
Above all, proper and regular training equips rescuers with the presence of mind to apply calm mental calculation to any rescue incident. Rescue scenes often are cluttered and confusing, and can present responders with a rush of information that can be overwhelming without a clearly established plan. Rescuers often fall prey to the idea that time taken to think through the operation is lost time, but without adequate understanding of the dangers imperiling the victim, the rescuer risks becoming a victim.
Confined space incidents demand a systematic approach from rescuers, who must proceed carefully through the phases of recognition, evaluation, and control. This involves not only rescuers interviewing witnesses about the equipment and conditions that led to the situation at hand, but assessing the perimeter to determine which hazardous conditions can become immediately dangerous, identifying which conditions may be deteriorating or capable of deteriorating, and taking steps to secure the area against all of these threats.
Once the area around the confined space is secured, rescuers can begin to assess the space itself by analyzing the configuration of the confines; identifying products that may be stored in the space, as well as any mechanical or structural hazards the space presents; and locating important documentation such as entry permits and checklists, hot work permits, Material Safety Data Sheets (MSDS), and a diagram of the space. As with the perimeter, the stability of the confined space must be ensured, and the responders must make sure the proper personnel and equipment are on scene for the operation.
After all of these efforts to secure the scene and protect rescuers, responders must finally stop and determine if their precautions and risk mitigation are enough. If not — and this is a decision responders are reluctant to make — operations may need to shift from rescue to recovery.
A successful rescue operation depends first on the degree to which the rescuers have been trained to recognize on-scene hazards, to evaluate them and their impact on ensuing operations, and to control the scene’s variables for the protection of all personnel. All of this precedes the actual efforts to gain access and stabilize, package, and extricate the victim.
Only training can equip the rescuer with the mental tools that enable methodical, careful analysis of the scene to override rash action. Only training can equip the rescuer with the knowledge to take full advantage of the life-saving monitors and equipment available to them. And only training can provide the rescuer the patience necessary to remember that the conditions that overcame the victim can, and will, overcome the rescuer without diligent attention to life safety.
For more information, go to www.teex.org/rescue