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Chapter 16

Rescue Procedures

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Introduction

Rescue has many meaningsActions that trained firefighters perform to remove someone from imminent dangerExtricate people if they are already entrappedFirefighters must be aware of existing dangers and minimize the risksConsistent training required to keep up to dateThis chapter only touches the surface

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Hazards Associated
with Rescue Operations

Hazards associated with every type of rescue operationTunnel vision: focusing on a particular problem without considering alternatives/consequencesRisk/benefit analysis performed each time personnel committed to rescue operationsReassess continually throughout operationEstablish exit points and safe havens

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Safe Havens

Safe havens are areas of refuge that can be utilized while waiting to be rescued or until you are able to escape the hazardous condition.Utilized when firefighters can no longer exit in the same manner in which they entered due to a dangerous conditionFirefighter should identify safe havens and employ basic survival techniques that will allow them to escape the situation

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Safe Haven Characteristics

Characteristics are basically the same for all emergency incidentsTemporary safe areaAway from the hazardTenable environmentIdentifiable by rescuersAllows for self rescueSafe havens are identified to provide temporary safety during a dangerous situation

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Safety and Survival

Upon entry of a safe haven, firefighters should employ safety and survival techniquesInitiate MaydayMaintain constant communication with Incident CommanderStay calm and conserve airMaintain constant contact with crew members Position yourself away from hazard but next to wall or window to allow rescuers to find

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Safety and Survival (contd.)

Upon entry of a safe haven, firefighters should employ safety and survival techniques (contd.)Lay horizontal with PASS device positioned effectively and create audible sounds such as tappingFirefighters should be prepared to use all of the skills necessary for self survival and rescue

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Figure 16-3 Well-equipped interior structural firefighting/search and rescue crews need a minimum of full PPE, SCBA, PASS, forcible entry tool, flashlight, portable radio, and thermal imaging camera.

Search of Burning Structures

Two-in/two-out: Work in teams of two or moreTwo firefighters standing by immediately outsidePerform rescue profile before enteringOccupancy type/time of dayFire/smoke conditionsActivity cluesMaintain awareness of position within a buildingTeam members stay togetherLeave a light at the entry point

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Figure 16-4 During an interior search, firefighters should stay in contact with a wall. If visibility is hampered, firefighters can reach into the center of the room using a tool or a human chain technique.

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Figure 16-7 Crawling, holding on to one another in a straight line (A) is not very productive when searching. Extending off one another toward the center of an area being searched (B) will allow more area to be covered in a quick manner.

(A)

(B)

Primary Search

Search for both life and fireConducted prior to fire being controlledOne of the most dangerous activitiesSearch areas most likely to have victimsWhen searching fire floor, go to fire area and search backward toward entry pointAbove the fire floor, work toward fireVisibility often obscured by smoke and darknessPause occasionally to listen for victims

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Secondary Search

Conducted when fire is out or under controlMuch more thorough since no immediate fire dangerSearch through debrisSearch building exterior for victims who have jumped or escaped and are injuredRecommended that different crew perform secondary searchSecondary search must be thoroughMany victims have been missed on search efforts and their bodies discovered after firefighters leave

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Thermal Imaging Cameras
and Search

Thermal imaging cameras (TICs) aid in search efforts and identifying potential hazardsInfrared energy has three types of emitters:Passive emittersActive emittersDirect source emittersDrawbacks and limitations:Expensive; do not replace basic search techniquesDo not see through glass or water

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Figure 16-11 Infrared energy is not visible but is part of the electromagnetic spectrum.

Figure 16-12 Visual representation on a TIC screen.

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Figure 16-13 Visualizing convected heat currents on the TIC can help firefighters determine the location and extent of a fire.

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Large Area or Rope-Assisted
Team Search

Rope anchored to stationary point outside hazardous environmentFirefighters lead out the search lineTeam crawls into the structure following the lineFive to seven firefighters requiredTeam leaderControl/Entry supervisorRemaining firefighters

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Figure 16-15 Large area occupancies generally have not only large open spaces but may also incorporate obstructions (shelf units, machines, displays, etc.) at various and random locations within the open spaces.

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Figure 16-17 Firefighters should work from a search rope bag that can be shouldered while controlling the rope as it is deployed from the bag.

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Figure 16-18 Semicircular main line search pattern.

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Rapid Intervention Teams

Average of 12 firefighters to remove one downed firefightersAs many as 20 percent become victims themselvesFive goals:Locate firefighterAssess condition and environmentProvide emergency air supplyCall for additional teams and resourcesAttempt to remove firefighter

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Victim Removal, Drags,
and Carries

Victims removed carefully and expeditiouslyDo not cause any further injuryRescue situations sometimes prevent rescuer from using all the care a person would likeAll carries and drags place additional stress on rescuers musculoskeletal systemTighten core muscles around hips, back, torsoKeep spine in neutral positionUse legs and buttocks for leverage and lifting power

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Carries

Extremity carry: Conscious and unconscious patientsRequires two rescuersSeat carry:Conscious patientsRequires two rescuers

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Drags

Blanket dragUses blanket or salvage coverRequires one rescuerLift and dragConditions must allow standing upRequires one rescuerPush and pull dragWorks well for removing unconscious firefighterRequires two rescuers

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Figure 16-20 Webbing and pre-manufactured slings can be valuable for dragging a victim.

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Ladder Removals

Bringing a victim down a ground ladder requires four to six team membersRescuers on the inside get victim over windowsillExterior team gets victim down safelyCommunication between teams very important May present the victim head- or feetfirst, facing toward or away from the rescuerIf rescuer feels loss of control, leaning into ladder will stop the victim from moving

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Backboard, Stretcher,
and Litter Uses

Preferable to use a backboard, stretcher, or litterDesigned to provide protection, immobilization, safetyBackboards provide spinal immobilizationRescuer at patients head maintains traction and directs effortPatient placed on stretcher by extremity carry, utilizing backboard, or having patient lie directlyPatient must be secured as soon as possible

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Extrication from Motor Vehicles

Extrication more difficult in larger vehiclesHeavier structural components and crash severityFollow pre-determined sequence of events:Scene assessmentEstablishment of work areasVehicle stabilizationPatient access and stabilizationDisentanglementPatient removalScene stabilization

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Tools and Equipment

Firefighters most valuable tool is knowledgePower hydraulic toolsHydraulic pump supplies pressure to operate spreaders, cutters, and ramsAir bags can lift heavy loads a considerable distanceAir chisels and reciprocating electric saws have evolved

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Figure 16-21 Gasoline engine-powered hydraulic pump for extrication equipment.

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Figure 16-22 Power hydraulic spreaders.

Figure 16-23 Power hydraulic cutters.

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Figure 16-24 Power hydraulic rams.

Figure 16-25 Power hydraulic combination tool.

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Figure 16-26 (A) A typical high-pressure air bag set. (B) A typical low-pressure air bag set. (Courtesy of Rick Michalo)

(A)

(B)

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Figure 16-28 A high-pressure air chisel kit. (Courtesy of Rick Michalo)

Figure 16-29 A battery-powered reciprocating saw.

Scene Assessment (Size-Up)

Predetermined sequence of steps or actionsCarried out by the officerScene safety considerations:TrafficNumber and type of vehicles involvedPotential number and extent of injuriesHazardous conditionsDegree of entrapmentAssessment determines need for additional resources

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Establishment of Work Areas

Ideally, all traffic in and around area of vehicle incident should be shut downCongestion creates secondary hazardsTraffic barrierLarge fire apparatus can form initial barrierPark at a slight angleTraffic calming:Warn approaching traffic of upcoming hazardHazards zoning

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