RESCUE SITE MANAGEMENT

RESCUE SITE MANAGEMENT

THE RESCUE COMPANY

If you charted the times of the last dozen fires or emergencies you responded to, would they be grouped together or would they be spread out? Would they show some type of regular pattern? How about the unusual—the building collapse, the multivchicle extrication job, industrial accidents, or the “cat up the tree”? The phrase “the unexpected is common in the fire service” is well-used, and with good reason.

Many people like to spend hot August Sunday afternoons at the beach. If I had to envision what types of responses are common for rescue units at that particular time, I would venture to guess: food left cooking on the stove, car fires, rubbish fires, or basic household emergencies such as gas leaks and electrical emergencies. But what about the “surprise” of responding at noon to a report of a fire in a basement “social club” with numerous people trapped? That would be unexpected, to say the least.

Social clubs are usually after-hours operations that open for business when legitimate establishments close by law. Unlicensed, they are generally hidden from the public, and especially from the authorities. Their one means of entry and egress is usually protected by tight security. A new addition to this special protection is the use of dogs. usually the infamous “pit bull” type. These arc just a few of the problems facing the firefighting forces at such places.

What does this have to do with rescue site management?

The incident commander at a recent basement social club fire received high praise for his management of a most difficult operation. Put yourself in his position and figure out w hat to do when the following greets you on your arrival: heavy fire in two stores of a corner taxpayer; lots of people —many with serious injuries—screaming in a foreign language; and a number of cars blocking the hydrants in front of the building. The gestures. the screaming, the serious injuries, the bits of broken English coming from the highly excited people , you don’t need a translator to tell you that your problems have just begun. What actions do you take first?

The incident commander immediately requested additional help. As the first-arriving units moved into action, he started his information gathering, putting together the bits and pieces supplied by civilians and firefighters. He had received reports that from 80 to 100 people had been in the basement club at the time of the fire.

How many escaped? How many were still trapped? How could he account for unknown numbers? (There wasn’t any guest list!) With the fire spreading rapidly and the nearest water supply blocked by vehicles, could he get to the victims in time?

As the problems mounted, he called for more help. He assigned chief officers not only to the firefighting strategy and exposure problems, but to serve as coordinators for victim control, communications, rescue, and w’ater supply as w^ell. This was imperative at such an extensive and difficult operation. Furthermore, two communication channels were established—one a command channel so that chief officers could report to the IC and relay progress reports without interference from over 100 portable radios being used on the scene; the other channel designated for firefighters to report to the chief officers and communicate with each other.

By delegating authority over specific areas of operations to chief officers, the incident commander was able to control the actions of more than 150 firefighters manning 35 pieces of equipment and to manage a most unusual operation. The combination of a well-planned, coordinated firefighting strategy and heroic actions of the firefighting force kept the eventual death toll to seven and injuries to approximately thirty. The potential for a catastrophe was much more evident after the “on-scene” critique conducted immediately after the incident was under control.

Would you have used a similar game plan given those circumstances?

All rescue operations require a game plan. How does one go about developing his plan, or strategy? The development of strategystarts long before any operation. Training, preparedness, operational assignments, and equipment maintenance are just a few of the ingredients of a strong strategic plan.

Training is a vital part of every fire department unit, and in rescue companies it also must be given a top priority. The amount of tools and equipment alone necessitates a strong training program. Some training might seem repetitious, but it provides the necessary foundation for actual operational procedures.

Policies must be established for equipment maintenance. How good is a highly trained rescue firefighter with a piece of equipment that fails to work? This point bears reemphasizing: The site of an operation is not the place for trial or error. Equipment must be maintained and be capable of operating without fault at all times.

Preparedness involves not only the equipment and the physical condition of the rescue firefighter; the mental readiness to deal with rescue operations is also vitally important. The way you handle traumatic injury or multideath rescue situations has an important effect on the operation.

Operational assignments established by the individual rescue companies are another step in the game plan, prepared as part of preincident planning and designed to fit the unit’s primary types of responses: the “tool man”—the tool operator, regardless of the equipment or tool used; the “recon man”— the scene surveyor for additional information (for example, an alternative means of reaching or removing victims); the aide-decamp—the “eyes and ears” of the rescue officer. A haz-mat unit may use such identifiers as “entry team” and “backup entry”; a dive team may use a “lead” or “primary” diver and a “backup” or “second” dive team. Whether at a fire operation or rescue situation. the players make up a very important part of the game plan and must be ready.

An important part of any fire department’s resources are the preincident plans that are established not only for the unusual, but for daily operations as well. Rescue preplanning has its limitations. It would be impossible to have a preplan for every imaginable type of rescue scenario. However, your prior experience should be combined with a game plan and adaptations made at the operation if necessary.

Each time I respond to a rescue operation, 1 try to visualize what I might expect based on my previous experiences in that type of operation. It won’t work every time for everyone, but it will put the “computer” (the one under your helmet) into operation. The “printout” that the “computer” gives you and the information received from the incident itself can oftentimes be enough to help with your preplanning. In more than 25 years of gathering information for my “computer” I can honestly say that

  1. no two fires, emergencies, or rescue operations are exactly the same; each one has its own pecularities;
  2. I have yet to meet an officer or firefighter who was born in a rescue company (although I met a few who thought they were); and
  3. most important, I’ve learned something at every incident that I responded to. An additional innovation, a new procedure, a reinforcement of an “old” lesson are to be remembered, critiqued, and adopted as procedures.

Listening to the radio for more information and trying to formulate your plan while responding requires that extra effort. (But all rescue situations require that extra effort.) While responding to a report of people trapped in vehicles, I always visualize the most difficult operation that I’ve encountered in previous extrication experiences. It may have been the one that required the use of a number of tools, or one that seemed to last a lifetime before the victim was freed, or one in which the ingenuity of one of the firefighters was the turning point.

But you can’t forget the easy ones, either. How many times have you heard the words “try it before you pry it?” That applies to special rescue tools as well as forcible entry. Don’t start using a power spreader on a car door before you try the door handle.

Some things remain clear in your computer for a long time. For me, it was a Thanksgiving night that had been fairly quiet until the receipt of an alarm for a vehicle accident with people trapped. Upon arrival we found a brand new vehicle wrapped around a giant tree that had refused to move. Located off the highway, it was lucky that anyone had seen the vehicle. Being the first unit on the scene, we began extrication and, before help arrived, we had all but one of the victims freed. Only one obstacle stopped us from removing the final victim from the vehicle: her foot was trapped under the brake pedal and she was unconscious. Because of the mangled vehicle parts in our w^ay, putting a tool into this area was out of the question. One unit member realized that he could reach in and, with his all-purpose pocket knife, slice her boots in such a way that her foot could slip out. As he voiced his intentions to the rescue officer in command, the victim suddenly came to and pleaded with him not to ruin her new boots. With her cooperation and some maneuvering, she was freed. That was just another simple solution to what might have been a most difficult operation.

Okay, your “computer” has given you all the vital information you need and now you arrive on the scene. As you approach the scene your eyes should act like a TV camera that pans down from the upper bleachers of a stadium onto the quarterback. You want to get the big picture and then focus into the main rescue area. Report to the incident commander (if on the scene) or to the units which may have been operating at the scene prior to your arrival. Based on the information available and the actions that have already been taken, you must assess and evaluate the situation as you see it. Your initial size-up will include your preplan, the incident scene in focus, and a checklist which looks like a weekly supermarket receipt. Some of the checklist items are:

Is the victim trapped? (Try before you pry)

How’s the victim trapped?

What’s causing the entrapment?

What are the obstacles to overcome?

What’s the victim’s physical condition?

Is he being treated?

Are there EMS personnel at the scene?

What’s their estimated arrival time?

Can the victim be treated while attempts are being made to free him?

Do you need any additional agencies (for example, police for traffic and crowd control)?

Do you need the utility companies to shut down power or gas lines?

Are there other hazards present? A fuel spill? A chemical spill? Are there hazardous materials involved?

W here should you start working from?

How many rescuers can work in the area?

What tools are needed?

Do you have all the tools needed?

Do you need additional rescue personnel?

Will it be a long operation?

W hat about relief and rotation?

How is the victim going to be removed?

What’s the safest means of removing the victim?

Can the victim fit through the selected area of removal?

What information does the recon-man have?

Are there any other victims?

Which ones need immediate attention?

What about the tool man?

Does he need help?

Is he having any problems?

Does he need backup equipment?

Has the incident commander been kept abreast of all actions?

Does he have any additional info?

What if something goes wrong? Do you have a contingency plan?

While the officer in direct command of the rescue operation is held with the responsibility of the rescue, many of the checklist items will be handled by the incident commander. The key to any operation is communication. The right hand has to know what the left is doing. Maintaining communications will allow for progress reports on both sides —the rescue officer informing the IC of progress, and the IC keeping the rescue officer abreast of any developments regarding help, other agencies, arrival of additional personnel to the scene, etc.

What if the IC is not at the scene of an operation? The rescue officer should be capable of performing these duties. He must utilize the resources at hand and make use of the personnel available. Nonrescue personnel can help secure the area, assist in transporting tools to the scene, provide lighting, and help in victim transportation. At these types of situations there is usually more than enough help available. Be sure to give clear and concise orders and directions when dealing with personnel that may be unfamiliar with rescue work and the terminologythat is used. Orders should come from only one boss. Workers are not tennis balls; they should receive their instructions from one direction.

Remember, size up, assess, evaluate and, most importantly, communicate. Management of the rescue site can be simplified if a game plan includes as many of the checklist items as are appropriate for the particular operation. It’s always better to overshop than to have to make another trip to market.

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