REAL-TIME RESCUE

BY FRED P. LaFEMINA

How many times have you read articles, books, and training manuals on technical rescue by authors who extensively researched the subject but never or infrequently operated at actual rescue incidents? I find it disturbing that many people with limited or no technical rescue background are getting into the rescue business. Ultimately, this will lead to more injuries and possibly fatalities. National standards have been developed and implemented, but a lack of familiarity with or a disregard for them could lead to lawsuits and liability concerns. Although well meaning, these so-called rescuers try to accomplish tasks for which they are neither trained nor equipped to accomplish.

Don’t get me wrong. There are many qualified people with extensive knowledge in these areas who do not get to use their skills as often as they would like because of the size of their locale or department. I have trained with nonfire personnel who are extremely knowledgeable in many facets of technical rescue. I am fortunate to live in a large urban area with the potential for daily technical rescue incidents. In the Fire Department of New York, heavy rescue and squad companies have the benefit of training in these disciplines on every tour and the potential to operate at such an incident daily.

In addition to holding formal certifications in technical rescue in accordance with the national standards, FDNY special units train daily. A semiannual education day has also been implemented. On that day, members are relieved of their shift duties and report to the technical rescue school, where they are taught new techniques and participate in technical rescue-related scenarios. Attendance at this school and engaging in the evolutions ensure that certifications will remain current. In addition, members come off the line for a week each year and attend refresher classes in all rescue disciplines.

Hundreds of crane operations, numerous confined-space entries, and significant scaffold work are commonplace in New York City, increasing the potential for technical rescue work. It is not uncommon for FDNY Rescue Company 1 in Manhattan to have its ropes deployed at least once a week. Not including training, inspection, and repacking of the ropes, it is amazing how many times members get to handle the ropes. They must stay at the top of their game at all times through constant training and documentation of incidents to which they responded. Numerous unforeseen issues always seem to surface while operating at the incident site. These issues should be used as training tools so all members can benefit from the lessons learned.

COMMANDERS’ ATTITUDE

The attitude of some commanders relative to specialized units is disturbing. These veteran commanders still have the mindset that we can get the job done no matter what—an attitude that can sometimes lead to disastrous results. Not having the proper equipment and adequately trained personnel at the scene could mean serious injury or death. This attitude worked well years ago when formal training and equipment were not available. However, training, standards for training, and equipment have made immense progress. There is virtually a piece of equipment for handling almost any situation encountered in the rescue and industrial arenas. It is no longer a matter of improvising to conduct a rescue or remove a victim. Veteran commanders are wary of letting special units operate because these commanders have limited knowledge of the operation or have never seen the equipment or the evolution.

On the other hand, these veteran commanders are invaluable on the fireground; their wealth of experience cannot be underestimated. They usually make the decisions that result in a positive outcome—the fire goes out and nobody gets hurt.

Younger commanders—and they seem to be getting younger—have other issues. Because of their lack of experience on the fireground, a result of the decreased number of fires these days, they do not get to make important decisions on a daily basis. Consequently, when it comes time to command at a technical rescue incident, they usually have limited or no training in these types of operations, which makes them hesitant to let the companies do their job. Remember, training is conducted in a controlled atmosphere, whereas a level of stress is added in an actual incident. Not only do you require the knowledge, skills, and abilities to perform, you must be able to work against the clock in removing the victim.

I continue to defend our special units’ capabilities to commanders who may be wary of the members’ expertise. The companies are highly trained and will evaluate every situation before committing themselves or their members to danger or putting them in harm’s way. I have been to many incidents where no-go conditions existed and more time was taken to evaluate the conditions.

Commanders should be confident in their members’ abilities and training. Members of rescue and squad companies are trained at a very high level and operate within their scope of training. There is nothing worse than constantly training and never getting to apply the acquired knowledge and skills at real-life incidents.

The incident commander (IC) must always take control of the incident. Technical rescue incidents are complex and should be undertaken only by trained personnel. The IC should request resources not at the scene initially that may be able to enhance the operation later. Personnel with the needed expertise will enhance the operation and help to bring about a positive outcome.

The IC should always keep the risk vs. reward factor in mind. A body recovery may still require a lot of expertise, but time is on your side, and proper planning will result in minor or no injuries. Rescue vs. recovery is a very important concern. No members should be exposed to dangers that could severely injure or kill them. Ask yourself, “How much risk should be taken to recover a dead body?” As noted above, time is on your side in a recovery operation. The operation should not begin until the scene is safe and all the needed equipment is available. On the other hand, certain risks might have to be taken when confronted with a viable victim. The IC should make these decisions; he will be held accountable for the actions taken.

EXCHANGE OF INFORMATION AND DOCUMENTATION OF INCIDENTS

There is no doubt that the fire service has gained immensely through the exchange of information countrywide. Some people will not share their information or even discuss it if they are not compensated for it. Others will not write an article because they feel they are not qualified to do so. If you have information that could save firefighters’ lives, it is incumbent on you to share that information with other firefighters. I am a firm believer in getting information to as many people as possible. It could prevent serious injury or death.

Being part of the Department of Homeland Security’s Urban Search and Rescue program, I have access to the most knowledgeable, dedicated individuals in the technical rescue field. For me, this is another tool in my toolbox. The learning process is never-ending. If you are at an incident and something went smoothly or did not go so smoothly, write it down, publish it. Somewhere, sometime, it will save the life of a civilian or possibly a firefighter. There are many avenues for exchanging information; the Internet is great for doing this on an almost instantaneous basis.

SOME REAL-LIFE EXAMPLES

Ferry Incident

Many issues that do not always arise at training sessions seem to rear their ugly heads at an actual incident. Confined spaces become crime scenes, structural building collapses become potential terrorist attacks. Victims and fire department personnel may have to be decontaminated at any type of incident.

While responding to a confirmed passenger ferry accident, which had the potential to involve 4,000 passengers, I could not help but wonder if this could be a potential bombing by a terrorist group. The side of the boat was reported to have a 150-foot hole. While conducting my size-up en route, many different scenarios played out in my mind. Was there a potential for a secondary device? Would force protection be required? Would detection equipment be required? Would mass gross decontamination be required? How many victims or survivors? Would SCUBA rescue be needed, placing an additional burden on the rescue personnel who are trained to do both?

A collapse of an area of the vessel was being reported. Would shoring be required? How much material would be needed if shoring were necessary? On my arrival, I encountered a scenario right out of a motion picture—numerous injured victims, some critically; mangled bodies entwined in steel; hazardous construction materials onboard; the list could go on and on. Initial responders’ first priority was to get viable victims removed from the danger area and transport them to the triage area. Rescue, squad, and ladder companies disentangled and removed victims as quickly as possible while engine company members stretched and charged precautionary handlines. Cutting tools, saws, and small hand tools were needed initially for rescue and removal. Monitoring equipment was set up immediately to detect possible contaminants at the scene. The size-up was ongoing as we tried to determine if any victims were thrown from the ship and were possibly still in the water. Once all the potentially viable victims were removed and triaged, all personnel were removed from the danger area and a rescue vs. recovery reassessment was conducted. Detection equipment was in constant use for the duration of the operation. Shoring was installed so rescuers could safely continue searching for and removing expired victims. The remaining victims were removed, and the police department declared the area a crime scene. The fire department turned scene control over to the police department so it could investigate the circumstances surrounding the incident.

Manhole Incident

Another technical rescue incident I commanded was just as unusual. A man reportedly fell into a hole in downtown Manhattan. The time was 0430 hours on a very quiet Sunday morning. While responding, the radio was clattering with information from the scene. Battalion 4 was reporting one victim trapped below street level in a manhole from which high-pressure steam was escaping.

The next report I received en route was that a member from another city agency was attempting to enter the space without the proper protective equipment. This is a perfect example of having on the scene potential rescuers without the required knowledge or equipment. The high-pressure steam prevented us from getting a clear look at the victim in the hole below. While en route, I immediately radioed the dispatcher to cease all operations until I arrived at the scene. I had done some training with the local utility companies and some research on high-pressure steam. High-pressure steam can reach temperatures of up to 400°F; somebody entering this space could not survive without the proper protective equipment.

While still in transit, I radioed the dispatcher to contact the local utility company and ask that a representative respond and have a work crew at the scene to divert the high-pressure steam to allow us to commence operations. High-pressure steam cannot be shut down; it can only be diverted. High-pressure steam lines in Manhattan run east to west from Battery Park to the East Side, as well as north to 96th street. On my arrival, I asked the squad company on the scene to direct a confined-space fresh air blower into the space to try and get a visual of the victim. When the steam cleared, I could see the victim. He was lying face up on a 24-inch steam pipe. It was obvious the victim had mortal injuries. This changed the whole complexion of the operation: We would move from rescue mode into recovery mode.

Some of the unforeseen issues that arose at this operation were those that concerned law enforcement. The police department had declared the area a crime scene after learning from interviews conducted at the scene that this was a possible homicide. Until the victim was pronounced deceased, however, fire department members can continue to work in the area. It was suspected that the victim fell into the hole as a result of an altercation—the blow-off stack for the steam was knocked loose, and the victim then fell into the hole. A conflict between agencies developed over who had jurisdiction for removing the victim. After much debating—because EMS still was not satisfied that the victim was deceased—the decision was to conduct a joint operation. Using the expertise of both agencies, the victim was removed using a harness attached to a 4:1 mechanical advantage system attached to a tripod. Crime-scene operations, agency conflicts, and utility problems were just some of the unforeseen issues at this operation. Conflicts between fire jurisdictions could arise because of geographical boundaries. Try never to lose focus on the incident and members’ safety. The solution is to get the job done in the safest possible way with the best tools available at the scene, no matter who owns the tools.

Other problems could arise, as they did here, with personnel who are undertrained and ill equipped. Individuals having little or no technical rescue background could potentially become part of the problem. ICs must be assertive and take control. They must remember they are not there to make friends but to do a job for which they have been extensively trained. Also, the IC should not let the operation start until trained personnel and the needed equipment have arrived on the scene.

ICs must establish and control perimeters and the number of personnel in the immediate working area. Many personnel at the scene have good intentions but are not disciplined and become part of the problem. The IC must maintain the integrity and discipline of units at the scene and ensure that they carry out their assignments. Maintaining control reduces injuries and could help to prevent problems at the scene. Untrained members should not act outside of the scope of their training; this could lead to unnecessary injuries or fatalities.

Pass along any lessons learned. The fire service is dynamic; you can never learn enough.

FRED P. LaFEMINA is a battalion chief assigned to the Fire Department of New York Special Operations Command. He is task force leader for FEMA.USAR NY-TF1.

No posts to display