THE IMPLEMENTATION OF PLAN B

THE IMPLEMENTATION OF PLAN B

BY ROBERT GALIONE

I arrived at the site at the same time as Lakeland (NY) Fire Department Chief John Napolitano. We were directed to the accident scene by civilians. I proceeded to the tank to evaluate its stability, assess the extent of the workers` injuries, and determine the best method for effecting their rescue. Based on my size-up, I felt it was imperative that access be gained immediately. I observed three victims sprawled about the floor of the tank. Three people were standing over the victims. One was a victim himself, who somehow was able to remain ambulatory. The others were members of the MacArthur Airport Crash Fire Rescue team–Firefighters Tomassone and Carney–who were attempting to stabilize and treat the victims.

Through consultation with Tomassone and Carney, I confirmed that atmospheric conditions were not a factor in this confined space incident. I entered the tank by climbing down scaffolding in the mouth of the hatch opening. Once at the bottom of the tank, the magnitude of the situation became quite clear. What had happened was that the four men rode down a collapse of an approximately 90-foot-diameter piece of the round slab dome about 32 feet high. The top of the tank was now open to the air. Parts of the slab were still hanging by rebar; cracks were evident in what was left of the dome. I quickly evaluated the site and began to formulate a rescue plan that would get everyone out as quickly as possible.

The first priority was to get medical attention for the victims. Personnel and equipment were beginning to arrive. LFD Firefighters Mahoney–also a confined space entrant–and Felitti were at the mouth of the hole. I instructed Mahoney and Felitti to place a ladder through the hatch to the floor of the tank and to secure it at the top with rope. Once the ladder was in place, things started to move.

Mahoney then entered the hole to assist me. Chief Napolitano then sent LFD Firefighters Smith, a confined-space entrant, and D`Agostino, a trained entrant and EMT-D, into the hole. D`Agostino and Smith assessed the victims` conditions while Mahoney and I secured stokes baskets, backboards, cervical collars, oxygen, blankets, and other medical equipment needed to expedite the operation. All the needed equipment was lowered in by rope.

From the medical evaluations, we determined that two victims had sustained serious but apparently not life-threatening injuries. The other victim, however, had bilateral femur fractures, a possible fracture of the pelvis and left ankle, head and facial injuries, fractured ribs, a possible spine injury, pneumothorax with dyspnea, and high pain on inspiration.

THE PLAN

Chief Ryan joined us in the hole to help formulate the removal operation. The following plan was established. Ryan would return to the top to run the rigging operation that would be needed. I would coordinate the removal operation inside the tank. D`Agostino would continue to treat the victims, and Smith and Mahoney would package them.

Paramedic Anthony Seagors from the University Hospital at Stony Brook, who arrived by way of the Suffolk County Police Department medevac helicopter, was sent into the tank to assist with the most seriously injured victim. While Smith and D`Agostino immobilized him, Seagors started an IV with normal saline via large-bore catheter and then applied a hare traction splint to his right femur. Because of the left ankle fracture, a similar splint was not applied to the left femur, which instead was splinted to the backboard. Mahoney and Smith then placed the victim in a stokes basket. He was secured to the backboard with a diaper harness using tubular webbing. A diamond weave was used to secure the victim and backboard to the stokes. The victim`s size and injuries necessitated that the diamond weave be modified and two pieces of webbing be used to accommodate the oxygen, hare traction splint, and leg splint.

Ryan secured a tower ladder to be used as a high point anchor for a 3:1 retrieval system. He instructed Suffolk Police Department emergency services unit officers to construct a 3:1 mechanical advantage. A safety line and haul lines were also needed. From that point on, all communications from the hole went through Ryan.

The large quantity of equipment needed (carabiners, tubular webbing, ropes, stokes baskets, additional oxygen, and more medical supplies and backboards) was acquired from the Lakeland Fire Department, the Bohemia Fire Department, and the Suffolk County Police Department.

D`Agostino and Smith treated and stabilized the other two victims using collars, backboards, head beds, trauma dressings, and splints. (The second victim was stable with an extremity fracture to the left lower leg, which had to be splinted. The third victim, although stable, was in great pain from possible vertebral fractures. There were no signs of neurogenic shock or paralysis. Great care, however, was taken to completely immobilize this victim so that no further injury would occur and he would be as comfortable as possible for the vertical lift to the top of the hole.) Mahoney and Smith started the packaging process. Each victim had to be diamond-lashed into the stokes; the backup harness had to be weaved and made secure with safety lines. Diaper harnesses were also used to secure all of the victims to the backboards and then to the stokes baskets.

We used a vertical lift and the ladder as a support for the stokes basket. This enabled just one entrant to guide the basket up the ladder with a minimum of physical effort, since the members on top did the hauling. A haul line and safety line were attached to the head of each stokes basket. The safety line was also attached to the harness that was weaved to the backboard and onto the victims. At this point, Ryan checked the rigging (the 3:1, the safety lines, and the haul lines), making sure that different color ropes were used for each. Carabiners were offset and locked. I double-checked the attachment of the ropes to the baskets and all other attachment points and then finally guided them to the top.

We could have used a horizontal lift through the open hole left by the collapse, off a tower ladder with an unsupported stokes, tag lines and all. It would have looked great, but it wasn`t called for. It`s safer to keep the operation as simple as possible.

At one point, three news helicopters were hovering over the damaged dome. Their backwash could have caused a secondary collapse. We conveyed our concern from the hole with screams loud enough for the helicopter crews to hear. The IC ordered them to leave. Work had to be stopped until they left. From the time the first rescuer arrived at the scene until the last victim was lifted out of the tank, one hour and 13 minutes had elapsed. The training and commitment to excellence of all involved in the operation made this kind of timing possible.

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Chief Napolitano and Assistant Chief Ryan discuss the operation as tower ladder (not shown) is being positioned. Firefighters are holding rope used to lower medical supplies and equipment to rescuers below. Firefighters in red helmets are the backup confined space entry team. Note the SCBA on the ground. They were discarded when the atmosphere was determined not to be oxygen-deficient. (Photos by Jerry Rudolph.)

Click here to enlarge image

Click here to enlarge image

(Left) The tower ladder platform is raised to allow a clear path for victim removal. Firefighters pull on the haul line attached to the stokes basket carrying the first victim. (Right) The first victim clears the hatchway and is supported by firefighters. Tension is maintained on haul lines until the victim is lowered down to more stable ground. The victim is then hand-carried across the uneven terrain to a waiting ambulance.

ROBERT GALIONE has been a member of the City of New York (NY) Fire Department for 18 years, where he was a member of engine and ladder companies. For the past seven years, he has been assigned to Rescue 2. He is also a 10-year veteran of the Lakeland (NY) Fire Department.

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