To rescue a person is one of the noblest and most heroic acts a firefighter can perform. Life safety is always the most important of the three tactical priorities that govern a firefighting incident: life safety, incident stabilization, and property conservation (LIP).
All firefighters are taught during basic training the fundamental mechanics of how to carry out a search and perform simple carries and drags of victims. Unfortunately, one of the important facets of performing a rescue often is overlooked in most basic-training curriculums. A rescue is not just grabbing, carrying, or dragging a victim and taking off at a full sprint to the front door of the occupancy. Although there may be a time when these tactics are warranted, this should not be the norm. There is more to a properly executed rescue.
A rescue is the physical act of a firefighter’s removing a victim from a dangerous environment to an area of relative safety. During a residential fire scenario, a rescue very often is the heroic end result of a properly executed, diligent, and swift primary search. To achieve this end result, firefighters can use rehearsed, standardized, or practiced techniques, or they may have to substitute improvised methods and procedures based on the specific demands of a given set of circumstances.
If a victim is located during the primary search, the searching firefighters must complete some tasks to facilitate an efficient rescue. These tasks are called the “Rescue Sequence.”
Initiating the Rescue Sequence includes
- Notifying the incident commander (IC) of your status.
- Reassessing the need for additional resources.
- Calculating the remaining air supply.
- Evaluating the avenue out of the residence.
- Effecting the rescue.
KEEP THE IC INFORMED
If firefighters discover a victim while performing a primary search, they should broadcast the appropriate radio advisories to everyone operating on-scene (or still responding to the scene) that they have located a victim and will be attempting a rescue.
This type of radio traffic lets all personnel know what is going on so they can determine what they may have to do to facilitate the rescue operation. Also, this traffic updates the IC regarding the location of his companies and what they are doing, thereby creating an atmosphere in which the IC can make the best tactical decisions for the fireground. The IC can mobilize, redeploy, or request additional companies based on radio traffic informing him that a rescue is underway. This information also lets the IC know that additional companies are needed. Remember, just because one victim has been located doesn’t mean that all the victims have been located or that the primary search is over. Multiple victims are common.
The IC can then assign supplemental resources or additional companies to finish the primary search while the rescue is underway. The chief in charge of the fireground cannot read minds, and if companies are operating remotely, it is almost certain that the chief cannot see what is going on from his location. The firefighters performing the primary search are acting as the IC’s eyes.
Firefighters must take the first step to initiate the Rescue Sequence by broadcasting this type of radio traffic before moving the victim. Otherwise, it is very likely that the necessary radio messages will never be sent and all personnel operating on-scene will be caught unaware and unprepared for the rescue. Firefighters may get too wrapped up in the rescue to stop and generate the appropriate radio traffic once they begin moving the victim.
This initial radio report should include
Company designation. Who are you?
Location. Where are you? Be as specific as possible with the location. This will keep all operating personnel, including rescuers, oriented to their surroundings during the very dynamic atmosphere of performing a rescue.
Situation. What has been found? One victim? Multiple victims? Are the victims conscious or unconscious?
Resources. What is needed to facilitate the rescue operation? Extra hands? A ladder?
Removal route. Have you chosen one?
Status of the primary search. Complete? Not completed? More personnel to take up and complete the primary?
This radio report should sound something like, “Ladder 5 to Battalion 2, we have located an unconscious victim in the third-floor kitchen that we’re bringing down the stairs. Have the medics meet us on the alpha exposure. Status of the primary not complete.”
Although this may sound like it will be time consuming, the reality is that this radio report will be completed in seconds. It is imperative that firefighters understand they must resist the natural tendency of tunnel vision at this point; they must be thinking clearly and not just reacting to the drama of the environment. Be a thinking firefighter, not a reacting one.
Keep radio messages brief. All firefighters should carry a radio as part of their basic personal protective equipment (PPE).
RETHINKING THE NEED FOR MORE ASSISTANCE
Searching firefighters performing a rescue must constantly evaluate the potential need for additional resources. Are there enough personnel at the victim’s location to perform the rescue? Will additional personnel be needed? Is the victim obese or an invalid? Are there multiple victims? Are there going to be any special considerations for moving the victim? How will the victim be moved, carried, or dragged? Will a window/ladder rescue be performed?
Carries vs. drags: Dragging is a fast, efficient method for moving a victim. The old “Fireman’s Carry,” though it may have served our predecessors well, is no longer a practical method for moving a victim. This really should need no explanation. One of the only times a firefighter should carry/cradle a victim is if the victim’s body is small enough for the firefighter to do so easily, such as with a child or small adult. Otherwise, dragging is the quickest and most efficient way of moving an unconscious victim.
The only other time it is appropriate to carry a victim is when firefighters are bringing children and small adults down ladders. Always carry these smaller victims down a ladder, even if they are conscious. Their smaller bodies make it difficult for them to properly and safely descend a ground ladder or an aerial. In fact, many departments have a policy that states children and small adults are always carried down ground ladders and aerials.
Evaluating the need for additional resources must be done within seconds, given the victim’s condition and location. Requested resources may have an extended arrival time because of traffic, distance, multiple floors, or even the location within the residence. Request help early. Be a thinking firefighter, not a reacting one.
CALCULATE YOUR REMAINING AIR SUPPLY
Before moving the victim, assess your remaining air supply. Is there enough air left in the SCBA to complete the rescue? Air equals time. Without enough remaining air, the firefighters with the victim may not be able to complete the rescue without assistance-or they may become victims themselves.
Firefighters must be able to perform this air calculation instantaneously when they look at the gauge on their SCBA. Training and experience are needed to do this.
When assessing the remaining air supply, be disciplined enough to call for help early if it is necessary to do so. Teach new, impressionable firefighters the discipline needed to make decisions that prevent them from taking foolish chances or attempting headline heroics. Things like buddy breathing or removing a face piece inside of an immediately dangerous to life and health (IDLH) environment are not acceptable alternatives to proper tactics.
Although unique circumstances may not leave the operating companies many choices, and firefighters may have to do what is necessary to prevent people from dying, there is a difference between calculated risks and foolish chances. Properly executed rescues don’t just happen. Training and preparation make all the difference between successful, safe outcomes and disaster. Be a thinking firefighter, not a reacting one.
EVALUATE THE WAY OUT OF THE RESIDENCE
Before you can move the victim, you need to know where you will be going. Do not operate on autopilot or allow yourself to get caught up in the tunnel vision of an emotional, dynamic situation. Moving quickly doesn’t mean anything if you’re not sure where you’re going.
Is the path that was taken into the residence still open? Have interior conditions changed or deteriorated? Is another avenue to safety available? Is a window rescue viable? Although leaving the fire building represents ultimate safety, sheltering in place may be an option to consider.
The fastest and easiest way out may not be the path searching firefighters used to locate the victim. The search path or location of the victim may have placed you closer to an alternate exit. For this reason alone, pay strict attention and remain oriented to your surroundings. Interior operating companies must note windows and doors that can be used as landmarks or secondary escape routes. Also, victims are more likely to be located near a window or door. Use anything (a large piece of furniture, a fireplace, or a refrigerator) as a landmark to help you remain oriented to the floor layout and the location of secondary escape routes.
In the ever-changing dynamics of a working residential fire and the added complication of rescuing trapped victims, the entrance route used by searching firefighters may not remain passable. Interior conditions can change rapidly. The fire may have spread; walls or ceilings may have collapsed; the environment may have deteriorated near the door used to gain access; or equipment or operating companies may be blocking the escape path.
Again, the key here is that firefighters should be thinking and not just reacting. Are the stairs still passable, or will a window provide a faster, safer escape route? Is the scene prepared for a window/ladder rescue? Are there enough personnel on hand to perform the selected rescue technique?
Typically speaking, the fastest and safest method of rescuing and removing the victim from the interior environment usually is by going through the residence using the stairs or through the front/main door. Although performing a window/ladder rescue is not the subject of this article, it should be said that moving victims through a window and down a ladder is one of the most difficult and dangerous rescue techniques-for the victim and the rescuer.
With an unconscious victim, a window/ladder rescue is extraordinarily demanding physically and can be very time consuming. Bringing a conscious victim down a ground ladder or an aerial may not be much easier when we factor in fear. Victims are very frightened and may act in an irrational or unpredictable manner. Many firefighters have been seriously injured during a ladder rescue. That being said, the particular circumstances may not leave firefighters with much of a choice regarding performing a window/ladder rescue. Searching firefighters should be thinking ahead and not operating on autopilot. Firefighters performing a rescue should call for help early if they think it will be needed. Be a thinking firefighter, not a reacting one.
EFFECT THE RESCUE
Following the Rescue Sequence to this point, the IC and all operating (responding) companies will know that a victim has been located and that a rescue operation is underway. They also will know who is involved in the rescue, where the rescue is taking place, and what additional resources are needed to complete the rescue. The IC will make any further tactical decisions based on this information, including whether or not additional companies need to be assigned to continue the primary search while the rescue operation is underway.
The Rescue Sequence is finished when the victim has been moved to an area of safety and medical attention, if needed, is being administered. This means that the rescue is not over at the base of the ladder or the threshold of the front door. The victim needs to be moved outside of the action area to a location where the victim is turned over to emergency medical personnel for transport or where on-scene treatment can be safely administered.
Steps 1 through 4 of the Rescue Sequence should take place in seconds. This is not to say that it is easy. On the contrary, correctly executing a rescue is one of the most difficult things a firefighter does. It is extraordinarily demanding physically and mentally. No two rescues are the same, and individual circumstances may complicate the rescue scenario significantly. However, the saving of a life is our core mission.
MICHAEL BRICAULT is a 15-year veteran of the fire service and has been a member of the Albuquerque (NM) Fire Department since 1993; he is assigned to Engine Company Number 5 and is an adjunct instructor at the training academy. He is co-author of the department’s SOP for ladder company operations and author of the training manual, A Street Firefighter’s Guide to Residential Search and Rescue. He is an IFSAC-certified fire service instructor and a certified NFPA firefighter I and II and EMT-B. He recently was awarded full reciprocity on his professional qualifications and training from the states of Maine and Vermont, including firefighter I and II and instructor I.