Small Spaces, Big Tips

911 dispatches echoed the terracotta walls of the Replacement Naval Hospital Project as rescuers were dispatched Dec. 14 for a confined space training exercise executed by various fire departments assigned to Marine Corps Base Camp Pendleton.

Photo found on Wikimedia Commons courtesy of Ser Amantio di Nicolao.

By Jacob McAfee

Paid and volunteer fire departments around the country provide a wide range of technical rescue services. Technical rescues typically include confined space rescue, high- and low-angle rescue, swift water rescue, urban search and rescue operations, and trench rescues. These types of rescues are high-risk, low-frequency incidents; it’s what makes technical rescues so challenging. Although they are high risk, the low frequency occurrence can mistakenly lull you into a sense of complacency with your training and limit the amount of experience you have working real-world incidents.

This article will discuss one position within the confined space incident command structure that often gets overlooked but may be the difference between success and failure during confined space operations: the attendant. Based on my past training and experience, I will also provide some basic tips to assist the attendant in making your next entry run smoother and, ultimately, improve the safety of personnel. Confined space rescue can be one of the most demanding types of rescue the fire service provides. A confined space is defined as an area that exhibits the following traits:

  • Is large enough for an employee to physically enter and perform work.
  • Has limited or restricted means of entry or egress.
  • Is not designated for continuous human occupancy.

Confined spaces are separated into permit- and nonpermit-required confined spaces. According to the Occupational Safety and Health Administration (OSHA) 29 code of federal regulation (CFR) 1910.146, confined space requires one or more of the following characteristics to be classified as a permit required:

  1. Contains or has the potential to contain a hazardous atmosphere.
  2. Contain a material that has the potential to be engulfed.
  3. Has an internal configuration that can entrap or asphyxiate an entrant with inward converging walls or by a floor which slopes down and tappers to smaller cross sections.
  4. Contains any other recognized serious safety or health hazard.

Nonpermit required confined spaces do not contain or have the potential to contain atmospheric hazards capable of causing death or serious injury. During confined space operations, firefighters are put to the test physically and mentally. It takes a certain type of individual to mentally and physically cope with the conditions of conducting an entry rescue. To be successful, rescuers need a good support team that will assist them through the rescue. Typical incident command assignments at a confined space rescue include the following:

  • Incident commander.
  • Safety officer.
  • Rigging.
  • Rescue group/rescue team manager.
  • Medical group.
  • Air supply manager.
  • Attendant.
  • Entry/backup teams.
  • Lock out/tag out.

Although every position plays a part in the outcome of the incident, the attendant may be the most crucial position to the success of the rescue and safety of your personnel. At the tactical level, the attendant has possibly more individual tasks than any other position on scene. The attendant needs to be someone trained at the confined space technician level and have a good command presence and communications skills. He needs to know how to avoid task saturation and maintain good situational awareness. The attendant also needs to be aware of the rescuers’ attitude and tone while in the space. It will be the attendant’s job to talk down rescuers who get feelings of claustrophobia or exhibit other signs of emotional distress.

The attendant serves as the communication line between the patient and rescuers in an unforgiving environment; it is that communication that can have a dramatic effect on the rescuers’ mindset during the rescue. All personnel involved in a confined space entry will, at some point, experience some uneasiness or some signs and symptoms of claustrophobia. The most important factor to controlling those involuntary reactions is recognition. It can be hard as a rescuer in the space to recognize these signs and control them. The attendant should recognize that change in emotion and speech to provide that voice from the outside to help control those emotions.

Although his main responsibility is to the people in the space, the attendant also gives haul commands to the rigging team, communicates with the air supply team, and maintains atmospheric monitoring. He will keep accountability for the entrants in the space, document current and past travel routes, and more. This position is too often filled by anyone on scene that has had confined space training. Ensure that this person has the experience, training, and the knowledge to perform the required tasks just as you would any other position. Primary duties of the attendant include the following:

  • Knowing the hazards of the space and rescue plan before entry.
  • Being aware of possible behavioral effects of exposures. Remain outside the space during the rescue operations until it is completed or when relieved by another qualified attendant.
  • Monitoring the atmosphere.
  • Maintaining primary communications with the entrants.
  • Alerting entrants in any case where evacuation is needed.
  • Maintaining a clear working zone around the entry point.
  • Performing nonentry rescue.
  • Not allowing unauthorized personnel to enter the space.
  • Not performing a duty that will interrupt your primary duties of monitoring, ensuring communication and safety of the rescuers and victims.
  • Making initial patient contact with the victim.
  • Operating hardwire communications.
  • Wearing appropriate personal protective equipment (PPE) and position vest.
  • Reporting to the entry team manager or rescue group supervisor.

The attendant is generally the first one to the entry point so I recommend that he has the following main components:

  • Atmospheric monitor (typically a four-gas) that reads carbon monoxide, oxygen, toxicity, and flammability.
  • Appropriate PPE to include self-contained breathing apparatus (initially).
  • Hardwire communications and talk box (if used) and search cam probe.
  • Equipment for a travel restraint/fall protection (if a vertical entry) and attendant position checklist.

Once the attendant has established patient contact and monitored the atmosphere they will log their initial readings and send them to the rescue group supervisor. Remember that OSHA requires the atmosphere to be monitored before entry. For vertical entries OSHA requires testing of the atmosphere every 4 feet in depth at a duration of 90 seconds to allow the sample to travel up the collection tube. Monitoring must continue throughout the incident and result be given to the entry group supervisor every 15 min. depending on conditions. The attendant will at all times be positioned at the entry point and monitor the rescuers progress and maintain constant communications.

The attendant is the only member who should talk to the rescuers. It is vital that the attendant maintain accountability of each rescuer in the hole. The attendant should document when the rescuers made entry and went on air. The attendant will manage the entry teams work/air duration, their mental stability, their route, their air lines, and their requests for equipment or other support. Note: for extended entry operations that have complex internal arrangements such as tunnel systems, it may be necessary to send more personnel in the space as line tenders. Position these personnel in bends or turns within the space to ensure that supplied air lines move freely and not restrict the rescuers’ movements.

Some tips to make operations run smoothly and reduce task saturation of the attendant include the following:

  • Combining your hardwire communications lines with your supplied air lines can lessen the amount of lines to manage.
  • Color code your supplied air lines. It is easier to track colored lines than remember the names of rescuer #2, entrant #4, and so on. Once someone enters the space and needs slack on a line or has an issue, he can be identified by color. For example, rescuer #1 is red. While in the space, rescuer #1 has an air emergency, he transfers over to his escape pack and needs to get out of the hole immediately. The rescuer relays back take up slack on red, and the attendant relays information to the line tenders outside to take up slack on red.
  • Make sure to map the rescuers travel routes. The rescuers should relay back information about their travel routes as well as marking them inside. This can be critical to cut down time inside the space with complex arrangements. As the operation goes on and multiple rescuers go in and out of the space, failure to keep track of the route can cause duplication of efforts and frustration.
  • Don’t overlook good line management for your rescuers. If you do not take up and let out slack as needed for the rescuer, you may end up creating an entanglement hazard inside the space for your rescuers. It doesn’t take long to create a mess.
  • Maintain radio discipline and composure. Numerous people will be trying to talk to the attendant. Ensure you always put the entrants first. Never miss a message from the entrants; their life could depend on it.

Each year there are more rescuers killed attempting to remove victims from confined spaces than the victims themselves. Train, Train, Train! Confined space rescue operations already put firefighters in high-risk environments. Finding every way to increase our proficiency and awareness of the environment is the top priority of every officer. With all the focus on the entrants and the complicated rope systems, don’t forget about the details.

 

Jacob McAfee is a 14-year veteran in the fire & emergency services profession, serving in a variety of positions across the military and Department of Defense. He is the Assistant Chief of Operations at the United States Military Academy, West Point, New York. McAfee began his career with the United States Marine Corps as an Aircraft Rescue Firefighter and after eight years of service and multiple deployments he left active service honorably in 2007. He’s had the privilege to lead and mentor personnel in Iraq as a captain and division chief with outstanding results. Since then he has served as an assistant chief of operations, fire marshal, fire prevention chief, and health and fitness coordinator as a civilian with the Department of Defense. 

McAfee is a chief fire officer (CFO) designee and has earned a master’s degree in occupational safety and health and emergency management. McAfee is working on his PhD in emergency management with Capella University and is attending the National Fire Academy’s Executive Fire Officer Program. He is an instructor for the California Office of Emergency services—hazardous materials section, the California State Fire Marshal, the National Safety Council, and the American Heart Association. McAfee also instructs hazardous materials, urban search and rescue, and incident command courses throughout California. He is IFSAC/Pro Board certified Fire Officer IV, Inspector III, Instructor III, hazmat technician, hazmat officer, confined space technician, swift water rescue technician, trench rescue technician, advanced rope, and collapse structure technician.

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