By PAUL HASENMEIER
How do we prepare a community and ourselves for a school bus emergency? As emergency responders, we bring calm to chaos and always mitigate the challenges in front of us. Just like any preplanned structure or technical rescue that needs an action plan, a school bus emergency needs its own plan that must involve the cooperative efforts of fire, emergency medical services (EMS), police, school personnel, and public officials. You may think that getting all those people together in one room will be the challenge. It certainly will be, but we are a powerful force for public welfare, and resistance will be minimal once all recognize the importance of training and planning.
Imagine arriving on-scene to find an overturned school bus with students trapped, injured, and screaming for help (photo 1). Whether you arrive on-scene in an ambulance or a fire engine, your first priorities will be numerous. Initiating the incident command system (ICS); dealing with the walking wounded; and determining the hazards, the number of patients, and entrapments around the scene are all immediate tasks. Once you determine the incident’s scale to be overwhelming for your organization, you must activate a mass-casualty incident (MCI) plan. Obtaining enough supplies, tools, personnel, and transport vehicles can pose a complicated logistical operation.
(1) Photo by Jennifer Kilbury.
As the incident unfolds, more and more people will be responding. Rescuers will be en route from every direction. News media will attempt to record videos and write stories for the five o’clock news. Then every worried and frantic parent who hasn’t been able to contact their child will be inbound on an already chaotic scene. Dealing with all these people and this technical rescue is not impossible, but getting responders prepared is critical.
The following groups can bring invaluable capabilities to the scene of a school bus crash. They should be active participants at any preplanning meetings.
- Law enforcementtraffic control and scene security.
- EMStriage, medical treatment, and transport of the injured.
- Bus drivers and school representativesimmediate first aid, student identification, parent notification, and cold zone parent updates.
- Tow truck operatorsstabilization and assistance with advanced extrication techniques.
- Public officialsfunding for training and resources at the incidents, critical incident stress debriefings (CISD) postincident.
The classroom session is literally the nuts and bolts of school bus extrication for your responders. Teach everyone in the class to know what kind of noises, challenges, and hazards are around these types of wrecks. They need to understand school bus characteristics and how to gain access and systematically remove injured patients from the bus. Explain the types of buses, their construction, and their weaknesses. Show bus stabilization techniques in an upright, side, and roof presentation. Discuss battery location, fuel systems, and air bag awareness.
Initial access can be problematic, depending on the damage to the bus; front and rear door entry may be impossible. You can get inside by using window, door, sidewall, floor, and roof breaching techniques. Once inside, you must organize and establish patient removal flow. Dealing with entrapment, seat removal, and patient immobilization will be time consuming. By now, students will be itching to practice on a bus using these technical rescue techniques.
Most of us are hands-on learners, and the skills involved in school bus extrication are no different. Have the nonrescue participants, such as the school bus drivers and administrators, watch responders from the cold zone. We recently conducted training that included more than 150 bus drivers, who asked an hour’s worth of questions: What if there is fuel leaking? Which passengers should they move immediately? and What do they tell the dispatchers? are just a few examples.
Have the firefighters start with basic techniques such as window and door removal. Then have them advance through more difficult breaches involving going through the side walls, floors, and roofs. Practice rolling the dash and lifting the roofboth technical procedures they may need to perform if the school bus crashes into another big vehicle (photo 2).
(2) Photo by Tom Johnson.
Have training culminate with a realistic training evolution. Roll a bus down a hill onto a couple of cars with mannequins inside, and you will have an action-packed, challenging scenario. Make the response, initial staffing, and equipment realistic for the first-in crews. Add additional resources to the scenario; involve law enforcement, EMS, school officials, and public officials. Expand the ICS as necessary.
This is the time to determine problems with equipment, staffing, and communications. Do you have the right number of properly staffed rescue companies, EMS units, and air medical units available? Reciprocating saw blades are important for school bus extrication. How many were used during the training? Each rescue truck should have at least 25 nine-inch metal-cutting blades for every saw. Are surrounding departments’ radios interoperable? Is a mobile command unit available?
SCHOOL BUS EMERGENCY RESCUE PLAN
- Establish command.
- Use law enforcement to initiate scene and traffic control.
- Conduct scene assessment, such as identifying potential and immediate hazards and the resources needed; determine the location, number, and condition of victims; ensure proper numbers of personnel and equipment are en route.
- Make the general and rescue area safe through stabilization and by containing and stopping fuel spills.
- Develop an incident action and backup plans.
- Assign groups, teams, and tasks.
- Ensure proper personal protective equipment.
- Brief rescuers regarding incident-specific hazards and accountability.
- Mark entry and exit points.
- Assist the walking wounded out of the bus.
- Protect victims during rescue.
- Use fire department training-compliant rescue techniques.
- Extricate and disentangle victims (package, treat, and remove).
- Transfer victims to EMS.
- Continuously reassess the action plan and make changes if needed.
- Remove equipment.
- Write a personal accountability report.
- Perform decontamination.
- Gather information for reports.
- Return units to service.
- Secure the scene.
- Terminate command.
- Check equipment and service if necessary.
- Hold a critique and offer CISD.
CISD is important to responder health. Even after our best professional efforts, incidents involving young children create emotional reactions that could impair the well-being of everyone involved. From the veteran members to the probationary firefighters, debrief everyone within 24 to 72 hours of a critical incident. This is not an operational critique or a performance investigation but a way to reduce stress, provide support to each other, and improve skills to cope with future critical incidents.
Prepare for school bus emergencies today. School buses are still the safest way to transport children to school, but the next crash may happen in your town.
PAUL HASENMEIER is a 10-year fire service veteran and a firefighter for the Huron (OH) Fire Division. He is a paramedic, a fire inspector, a SCUBA diver, and an instructor. He has an associate degree in fire science, has worked in numerous technical rescue disciplines, and is a member of Ohio’s Region 1 Urban Search and Rescue team. He is a contributing author to Fire Engineering and School Bus Fleet magazines. He was a classroom presenter at FDIC 2008, the New York Fire Chiefs Conference, and the Ohio Fire Chiefs Conference.