Rescue and First Aid Service Continues Steady Advance
improvement Noted in Personnel, Equipment and Training Particularly in Volunteer Field
A SPECIAL REPORT
Editor’s Note: Two years ago FIRE: ENGINEERING conducted a survey among fire departments representing various geographical and population classifications of the nation. The findings of this study, published in the August, 1950. Issue of this Journal, constituted the first comprehensive analysis of the rescue and emergency service, as related to the fire forces.
Notwithstanding its scope, that study as published, of necessity omitted a number of factors about which many readers of this Journal have since made inquiry. A number of correspondents pointed out that this earlier information, concerning the equipping and operating of rescue and first aid squads as units of municipal fire departments, lacked certain requisite data that might assist other fire departments, in particular volunteer organizations in the smaller towns and villages and rural areas, to organize, finance and maintain such services, with credit to the departments, and to the communities served. Also, since that first study, considerable progress has been made in the rescue and first aid emergency fields, notably in the apparatus and equipment, and in the training of rescue and first aid personnel. County and State rescue and first aid organizations are on the increase, which augurs well for the future of this service as an essential component of the modern fire department.
In view of these developments, and to meet the requests of those interested readers, we have made a further and supplemental study of this subject, which forms the basis for the accompanying Special Report.
In presenting this Report we desire to acknowledge the assistance given the editors by the many fire departments throughout the nation, and in particular, the heads of many individual rescue and first aid units, large and small. Unfortunately, the list of contributors is too lengthy to be included in full herein. However, because of the nature of their assistance, grateful acknowledgement is made to Dr. Herbert J. Stack, New York University, Vice-president of the International Rescue and First Aid Association; to certain members of the New Jersey State First Aid Council; to Captain Robert W. Boggs of Rockville Centre Emergency and Rescue Floodlight Co. No. 1, and to a prominent officer heading one of the rescue units of one of the nation’s largest fire departments, who of necessity must remain nameless—but who will recognize certain of his contributions in the following. Appreciation is also extended to the manufacturers of apparatus and equipment who generously provided pictures and data, much of which cannot be included herein because of publishing limitations.
AN interesting complement to the fire, police and health services of American communities has been developing progressively during the past few decades, throughout most of the nation. It is known by different names in different areas, but generally referred to as the Rescue and First Aid Service.
Actually, its development has been along two branches, the first being in the field of rescue companies operated by municipal fire departments, and the second, which is today making the more spectacular progress and is the subject of this study, is the volunteer rescue and first aid service. A third branch, not within the scope of this text, might be found in the city-wide emergency ambulance service operated by a few of the large fire departments.
Origin of Rescue Company
However, the municipal type rescue squad is believed to have had its origin in 1915, when the then Chief of the New York Fire Department, John Kenlon. organized Rescue Company 1 and equipped it with picked men and equipment. This unit was formed to meet the special emergencies which the department was being called upon to face in ever-increasing degree with the advances in chemical technology and its attendant hazards, the advent of large refrigeration plants, the increase in the number and severity of railroad, tunnel, aircraft and highway accidents, and the increase in the area and bulk of modern buildings. The specialized and limited nature of the work of this unit is reflected even today in the 575 runs of Rescue Co. No. 1 compared with the 2,000 runs of engine and ladder companies in some congested tenement areas of the city.
Photo courtesy Approved Fire Equipment Corp.
The success of this squad was apparent from the start, being partly due to the urgent need for such facilities, hut in greater measure, due to the care in the selection and training of the personnel assigned to the unit (the first Captain of this company was the late John j. McElligott who subsequently became Chief of Department).
As other cities such as Chicago, Philadelphia, Boston and Washington added rescue companies to their fire departments, the functions and the operation of the units were increased in scope. In some cities the functions were combined with other specialized duties, the squads becoming combination salvage and rescue companies. In other places they served as a manpower pool for operation at large fires and emergencies. In still other towns, the rescue unit was called upon to perform the functions of an ambulance squad as well, a custom widely found in volunteer squads today. A few cities and towns combined certain fire fighting duties with rescue and first aid operations.
A notable example of this is Chicago, where its 13 rescue squads frequently are employed to fight fire with deck pipes with which they are equipped.
The extent of the rescue squad movement is indicated also by New York’s five fire department rescue companies, and the 20 additional emergency squads of the New York Police Department. Los Angeles now has six rescue companies in service, strategically located to serve the 453 square miles comprising that city. In addition, two line companies have been equipped with resuscitators for emergency use until arrival of the regular rescue units. Philadelphia maintains three fullyequipped rescue companies, and most other large cities have more than one of such units.
One of the most unusual rescue developments is the Cincinnati Fire Department Airmatic Task Unit. This was created by former Captain Edward Lamb of the San Francisco Fire Department at the prompting of former Chief Charles Brennan of that city after the fatal Chicago tunnel fire of 1933. Captain Lamb began experimenting with smoke ejectors and eventually designed one known as the Lamb air mover which inspired the creativeminded captain to develop further his idea of a self-contained, mobile piece of equipment, carrying a compressor and various types of pneumatic tools and air-using devices.
The Airmatic Task Unit originally cost $20,000 and had an I-R 350 cfm compressor and eventually a complete assortment of air-operated tools, including jackhammer rock drill, pavement breakers, clay digger, circular saws, etc. In addition, the unit provides air for several hose-equipped face masks permitting operations in smoky, toxic areas, and where there is oxygen deficiency.
In addition to the airmatic tools and equipment, the unit also carries a wide assortment of tools, equipment and supplies essential for rescue and first aid operations.
Since its installation in 1943, the Cincinnati Fire Department reports the Air Compressor Squad Wagon (another name for the Task Unit) has made 263 runs and on 130 of them has used the air mover or pneumatic tools, including use of air helmets for recovery of drowned persons. The unit responds to large multiple alarm fires and on special call.
Generally, the rescue units found in the larger cities are what civilian defense authorities designate as “Special and Heavy Duty Rescue Squads,” the vehicles being large and heavy, and the equipment carried being suitable for large scale operations such as train and bus wrecks, building and elevator collapses, cave-ins, and similar rescue problems. An indication of the type of these units now in service may be had from the accompanying illustrations, and from the lists of fundamental equipment carried and operational tasks published in the August, 1950, issue of FIRE ENGINEERING.
Of late years, with the development of organized mutual aid between fire forces, some county and area rescue or disaster units have been introduced. Perhaps the near-ultimate in this respect is the “Jay W. Stevens Disaster Service Unit,” maintained and operated by the Portland, Ore., Fire Department. This remarkable unit, named after one of the nation’s most progressive and respected fire protection authorities, was designed and equipped to carry every tool and device which experience has shown to be useful for operating efficientlyat disasters and major emergencies.
At the other end of the rescue scale are found small vehicles that could be carried aboard the Portland unit, ranging all the way from automobile sedans and station wagons, to small panel, Make and dump trucks. Not to be ovetlooked also, are the elaborately equipped ambulances. In between are found the great average, the type of unit which is large enough to carry most of the required mechanical and other facilities, with sufficient room to accommodate a number of litter and walking casualties; powered to negotiate the toughest roads and grades, and to operate the mechanized tools, first aid and rescue equipment.
Photo courtesy American LaFrance-Foamite Corp.
First Aid and Light Rescue Squads
The second branch of rescue service development might be termed the “First Aid and Light Rescue Squad.” Most of the volunteer rescue and first aid squads arc in this category.
In the 1920’s, along the New Jersey shore at Ocean Grove, Belmar and Neptune City, there came into being the forerunners of the volunteer rescue and first aid movement as we know it today. Prior to 1920, at most seashore resorts in this country and abroad, notably in the Scandinavian countries, there had long been some form of life saving crews. While their activities were mainly confined to aquatic emergencies and beach accidents, they became the natural forerunners of our present rescue, ambulance and first aid services. Further impetus to the movement was given by a number of large public utilities, which had organized safety and first aid groups for the protection of their employes.
Belmar, N. J., organized its rescue squad on January 15, 1928. It was presumably patterned after a private set-up of the Jersey Central Power & Light Company, which had always courteouslyresponded to outside calls for help. An employe of the company, Charles Measure, was one of the founders of the Belmar squad, and when the New Jersey State First Aid Council was formed at Belmar, August 19, 1928, he became its first president.
The movement spread along the coasts and inland, spark-plugged by enthusiasts both within and outside the volunteer fire departments. As with the beginning of the paid rescue forces, the volunteer arrangements followed no particular pattern, depending upon a number of factors, such as legal and financial limitations, public support, and so on. In some districts it was found expedient to organize and operate the service independently, and apart from, the local fire department. In others, although nominally a part of, and under the jurisdiction of, the fire department, the rescue and first aid units served areas not covered by the department’s firefighting forces. But whatever the organization and operating arrangement, the movement continued to grow.
The New Jersey State First Aid Council became the backbone of the rescue squad movement in that state, and it since has attained a national reputation in its field of rescue, first aid and disaster planning. Other states which have adopted state-wide cooperation among their squads, are Virginia, Pennsylvania, Maryland and Rhode Island. On the West Coast, California has had a long history of intensive squad activity and cooperation.
International Rescue and First Aid Association Formed
Another tar-reaching step was taken in the rescue squad movement in September, 1948, at Atlantic City. This was the formation of the International Rescue and First Aid Association, a move to unite all squads and first aid associations everywhere into one comprehensive organization. Although in existence only four years, this organization has received recognition by government bureaus and private agencies in the field of safety. The N.J. S.F.A.C., in cooperation with the International, publishes the “Gold Cross Magazine” a small monthly journal devoted to the activities of these associations. It is edited by Ivan Hill, a member of the Fanwood, N. J., squad.
Photo courtesy Rockville Centre Emergency & Rescue
Photo courtesy Rockville Centre Emergency & Rescue
New Jersey Alone in Providing State-Wide Service?
Most authorities regard New Jersey as probably alone today among the states in providing free state-wide ambulance and first aid service, to all its residents, with over 375 squads. The N.J.S.F.A.C. has an enrollment of 164 volunteer squads with over 5,000 trained members, divided into 9 districts. There is a mobilization chairman for each district, and a state mobilization chairman, to coordinate the assignments and activities of squads at disasters and emergencies.
Another function of the mobilization chairman is to conduct mobilization drills to keep the squads alert, and to develop a smooth, well disciplined rescue organization, to be of maximum value to the community in time of disaster. An inventory of all the equipment possessed by the 164 squads of the N.J.S.F”.A.C. is under way to facilitate locating and delivering any specialized equipment needed, day or night, to a desired objective.
The average squad in New Jersey responds to about 300 calls a year, involving 1,500 man-hours of work, and 6,000 miles of travel. Some individual squads naturally far exceed this average.
Rescue and first aid services are performing yeoman’s duty in other states. The Bucks County, Pennsylvania, Squad, with three ambulances, one rescue truck and one mobile unit, answered 1,400 calls in 1951 and travelled over 50,000 miles. It is interesting to note that this squad completed 15,000 calls in 20 years for a total mileage of 535,000 miles, and in so doing wore out 12 ambulances. It has its own 60 watt radio transmitter in its squad headquarters, with two-way mobile sets on its vehicles, and walkie-talkie sets for use at accidents and disasters.
Among the numerous other Pennsylvania cities well equipped with rescue and first aid services is Lewiston, site of the Pennsylvania Fire College, where the Fame Company’s ambulance, and Brooklyn Company’s Rescue Unit, the latter having one of the most active, competent women’s auxiliary, provide an outstanding service to both the local fire department, under Chief Nelson Yearick. and to the citizens of the city.
Virginia, too, has its outstanding squads and crews, as has Maryland. The widely known Roanoke. Va., Life Saving and First Aid Crew answers over 500 calls yearly with its squad car and emergency truck. Its equipment includes two boat trailers, six iron lungs, nine oxygen tents and 236 separate items of emergency equipment. It has three full-time telephone operators, paid by the City of Roanoke, Va. The captain of the squad, Julian S. Wise, is an internationally known authority on first aid and resuscitation methods, and as early as 1927 had correspondence with Lt. Col. Holger Nielsen of Copenhagen, Denmark, concerning the latter’s resuscitation method which was recently adopted throughout this country. Mr. Wise is also president of the International Rescue and First Aid Association.
Within a radius of seven miles of Roanoke are seven volunteer rescue squads, including the William Hunton Rescue Squad, which is probably the first squad with all-colored membership.
To residents of suburban Washington, D. C., no introduction is needed to the Bethesda-Chevy Chase Rescue Squad and its indefatigable director, Don. Huntington. Formed by returning servicemen in 1945, it has achieved national prominence for the breadth and calibre of its rescue activities. It is one of the best equipped squads in the country and answers over 1,850 calls yearly.
Rescue Apparatus and Equipment Shows Improvement
Rescue and first aid vehicles are of two general types, not including ambulances, which are not customarily classified as rescue apparatus. The tendency indicated in FIRE ENGINEERING’S 1950 Report, to the effect that a number of municipalities are installing smaller, lighter, more maneuverable and less costly emergency units, without relinquishing the larger, more costly vehicles, is again confirmed. Although no radical departures are noted, the thinking on the part of some chief officers is to increase the number of rescue units by the addition of lighter, faster and less costly squad cars, some of them little removed from standard pleasure cars. In fact, some departments are equipping the cars of battalion and other chiefs with basic rescue and first aid equipment, including two-way radio, on the theory that such units can get to the scene of the average emergency more quickly, operate at less cost, and with fewer men, and thereby justify the cost of the larger number of rigs. Also, they reason, this type unit assembles an additional reserve of first aid and minor rescue equipment at the fire, or other incident, ready for use if it is required making it unnecessary to special call the larger units.
Although there have been no fundamental changes in the basic rescue and first aid equipment carried by presentday apparatus, there have been continual refinements and improvements in the facilities themselves. This is particularly true in the field of respiratory protective devices. Furthermore, the list of these facilities added to rescue and first aid rigs, continues to grow.
It is natural that some squads should specialize in certain equipment particularly suited to the emergencies they must cope with. Many squads serving communities on waterways or lakes, in addition to boats of all types, have developed special apparatus tor body recovery, for diving and underwater operations. Along the Atlantic Coast, where boats are requisite for squads, a number have glass bottom type craft, outboard motors, water scopes, as well as diving and grappling gear. A number of them, like the Lakewood. N. J., Rescue and First Aid crew, have elaborately equipped speed boats to enable them to travel over a large body of water.
The Omaha, Neb., Fire Department Rescue Squad, with approval of the County medical society and after extensive training, carries among its equipment laryngoscopes, for locating and removing foreign matter that maylodge in the throats of patients.
Marking the addition of materiel heretofore not included as regular rescue and first aid equipment, are oxygen tents, iron lungs, large portable power plants. The Johnson City, Tenn., Emergency and hirst Aid Squad, for example, considers all the regular equipment.
Photo by Sharpsville Steel Fabricators, Inc.
Photo courtesy Milwaukee Fire Department
Some authorities may reason that addition of such materiel is purely a matter of local preference. This may be true, but so too not long ago was the decision to add oxygen and air respiratory protective devices. It is entirely conceivable that tomorrow’s rescue and emergency forces will catalog not only such essential appurtenances, but other devices, not yet in the blueprint stage.
Increasing Scope of Squads Calls for Infensive Training
The late Fire Chief John Kenlon of New York established the first municipal rescue unit to cope with rescue and first aid problems introduced by the nation’s introduction of refrigeration, industrial mechanization, etc. As the pace of progress accelerated, all municipal rescue units have had to add more and more component equipment. This naturally has affected the design and construction of rescue and emergency apparatus, and collaterally, the cost. It has also necessitated far more intensive and specialized training of rescue and first aid personnel. A Red Cross first aid certificate is an excellent asset, but the modern rescueman must be trained in far more than first aid. If we are seriously to consider the atomic age into which we are entering, with its radioactive hazards, it begins to look as if tomorrow’s rescue personnel will have to be in the superman class.
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The catalog of emergencies which the average municipal fire rescue squad encounters in the course of a year, like the list of emergency facilities, is continually being increased.
For the benefit of our readers who may be contemplating installation of a rescue or other emergency unit, we submit in two lists of what the authors term basic or fundamental equipment which should provide the foundation, at least, of the modern rescue squad. One list is submitted by an officer of a large municipal rescue company ; the other by the head of a village rescue and emergency company. These are in no way inventories of all the equipment carried but are intended as a check list for basic supplies only.
To return to training: in order to keep abreast of modern developments in first aid treatment, and to raise the standard of training, most first aid squads have medical advisers, and maintain close cooperation with local medical authorities, doctors and hospitals. A few squads, such as North Plainfield, N. J., and Metuchen. N. J., have Cadet Corps for training boys for future enrollment as regular members. Many squads find that a women’s auxiliary corps tends to raise the moral tone of the organization and are most effective in raising funds for the purchase and maintenance of equipment.
The Financial Side
The expense of operating a rescue and first aid squad is no small matter. A modern custom built ambulance, let alone a full-scale rescue truck, runs upward of $10,000. Oxygen tents cost about $700, and iron lungs and resuscitators run into the hundreds of dollars. The cost of replenishing oxygen in initiators and repiratory devices, and the purchase of oil, gasoline and tires, all call for constant outlays. As an example, the Raritan, N. J., Safety Council spends about $13,000 yearly on its three rescue squads, and the Roanoke, Va., squad has an $8,000 yearly expense budget.
The most effective and most common method used by squads for raising funds in the house-to-house canvass. Members of well disciplined and efficient squads are respected in their communities and are cordially received by residents of the area served. Many squads have women’s auxiliaries that sponsor dances, raffles, and cake sales, in addition to aiding in house – to – house canvasses. Various devices, such as coin cards, cardboard coin banks, and bubble banks have been found useful when properly employed. “Tag Days” are popular in some areas. The Devil’s Lake, North Dakota, Squad has a novel membership plan, assessing family groups $2.00 yearly and individuals $1.00 yearly. The plan has 1,100 paid-up members, and is going strong. A number of Pennsylvania squads are maintained on much the same basis, the membership permitting transportation of a sick or injured person by ambulance without other charge. One town in that state largely supports the entire fire department, including the emergency unit, by a single annual letter appeal to all citizens of its area.
Many such squads have been fortunate in receiving donations of money and equipment from service and fraternal organizations, veteran’s groups, union locals and private citizens. It is reported such donations have been ruled exempt from tax. Recently the PeapackGladstone First Aid and Rescue Squad of New Jersey, was the recipient of a $30,000 donation from a private citizen to pay for a new squad headquarters, and other citizens donated the land and architectural services.
In 1951 the State of New Jersey amended its Municipality Contribution Act, raising to $3,000 the amount that a municipality or county may contribute to each rescue and first aid squad serving their areas. However, in past years only a few municipalities contributed substantial sums to the squads. The same state has also extended its Workmen’s Compensation Law to cover volunteer rescue and first aid men injured in line of duty, similar to the existing coverage for volunteer firemen. New York and other States have done likewise. In adtion, the New Jersey State Motor Vehicle Commissioner permits members of these services to display a purple or blue light on their private cars for identification when on duty calls.
Any group or individual planning to organize a rescue, emergency or first aid squad, should first painstakingly review the legal limitations under which his organization will have to operate. Particular attention should be given liability compensation and protection of the squad drivers and first aiders, operating not alone in their own areas but outside areas as well. They must be protected individually and collectively against suits for damage resulting from collision and injury to other vehicles and/or persons.
The volunteer rescue and first aid organization in the smaller communities or rural areas plays an important role.
It is fulfilling a purpose for which it is especially suited; it is doing a job that no other agency is in a position to assume; it is operating with an enthusiasm and efficiency that endears itself to those whom it has brought aid and hope when all was despair.
Operating, as it does, in a field open to criticism from many sides, it is naturally imperative that such units develop a high degree of conduct, efficiency and scientific knowledge. That does not mean that their members should attempt any medical or surgical work, or in any way usurp professional duties. At the same time, there is no excuse for such personnel not taking their job seriously, and learning and knowing all that they possibly can assimilate about their work. Their success depends upon the respect they engender, and the caliber of service rendered to the community or area they serve.
EMERGENCY RESCUE REQUISITES As viewed by a big city rescue squad officer
Two-hour breathing apparatus. Onehalf-hour demand type breathingap150 ft. air hose and fresh air pumps. Telephone equipment for masks. paratus. Fresh air masks, leng-ths of Inhalators and resuscitators.
Oxy-acetylene cutting equipment.
Portable electric generator—at least 1,850 watts. Floodlight equipment, 500 w. and 250 w. lights. Electric power tools, saws, drills, power hammer chisels.
Heavy-duty winch—at least 5-tons capacity. Steel cable.
One-ton differential hoist—portable tripod.
Heavy-duty jacks—hydraulic and screw capacities up to 35 tons).
Towing cables and chains.
Refrigeration emergency equipment, including rubber wading pants, hood, shut-off keys and wrenches.
High tension electrical equipment; longhandled insulated tongs and lineman’s equipment.
Asbestos suit; rubber exposure suit.
Portable boat or rubber raft; life preservers.
Two-way radio and walkie-talkie sets. Trench jacks; various lengths of pipe for cave-in work.
Smoke ejector equipment.
Shallow water diving equipment; underwater light.
Body bags: Stokes stretchers; army type stretchers; safety harness; electric heating pads; chemical heat blocks.
Combustible gas indicator equipment.
Block and tackle.
Forcible entry equipment.
Extinguishers., Asbestos, rubber and wool blankets. Burn-kit.
Note: This officer suggests the following future desirable developments:
- Smaller units for greater mobility in heavy traffic, and a few giant units built around a heavy-duty wrecking truck chassis and body. Since street widths remain unchanged, and trailer trucks and buses become larger, and parked cars increasing, the only solution for greater mobility for rescue companies, and indeed all fire department units, is in smaller, compact units and a better distribution in congested areas.
- Another development to be pushed is special units to generate electricity, or to compress air, to operate a complete line of power tools.
- Better tools and equipment for rescue work at building collapses and caveins.
- Breathing apparatus that can be recharged safely in contaminated atmospheres.
- Better communication facilities between men working in deep in contaminated atmospheres of ships’ holds, sub-cellers and large refrigerated buildings and with men outside.
- Better fire protective clothing, similar to that being developed by the U. S. Navy.
- An annual rescue squad symposium on a nationwide basis.
- Development of a rescue squad manual or handbook.
EMERGENCY RESCUE REQUISITES
As viewed by the small town or village rescue officer.
Adequate working area (in the rescue vehicle).
Adequate storage area—now and future (ditto).
Workability, for first aid and property protection.
Personnel Protection—First Aid
Provisions should include facilities for under-cover first aid and emergency medical attention separated from property protection or fire fighting equipment.
Equipment should include: First aid supplies&working and reserve stocks; medical equipment and supplies, basic surgical kit; operating or inspection light; eye magnet, otoscope and opthalmoscope. Hot water supply. Sterilizer. Burn sprays. Oxygen— Linde “Q” cylinders. therapy masks. Resuscitators and inhalators. Blankets—rubber sheets. Heat blocks and stretchers.
Eights—flood and spot. Smoke ejectors. Jacks—hydraulic. Wedges. Forcible entry tools. Gas shut-offs. Gas detector. Oxy-acetylene cutting outfit— Purox “E” with Linde “Q” size oxygen and “WA” acetylene cyl. Small tools. Shovels. Tarpaulins. Block and tackle. Chain. Bag of sand. Electric drill— heavy duty. Portable generator and lights. Ladder.
(Unit should be two or three-way radio equipped with working space for nperator.