BY AARON J. HELLER
Staffing levels in fire departments across the nation are continually under attack. We consider ourselves fortunate when the rig is staffed with four or more, as it should be. It is our responsibility to use our personnel to maximum advantage for the sake of our crew and those we are here to protect. If we do this properly, our patients’ outcomes will surely be improved.
Motor vehicle accidents (MVAs) and extrications are on the rise in most communities. As our populations grow and developers eat up the rural areas, we are seeing an increase in traffic, especially on secondary roads. This is a recipe for MVAs. A well-staffed, well-trained, properly equipped, and motivated crew can accomplish a great deal with the first-due unit while waiting for the cavalry to arrive. It all begins with preparation and some foresight.
A properly staffed rescue unit more easily can accomplish all the required tasks and ensures better crew integrity. Having more personnel on a crew also extends the rescuers’ working periods by spreading out the workload and doesn’t tire the personnel as quickly. As a riding captain, I found that when my department went to a four-person crew, I was free to perform as a supervisor. This should equate with a safer, more organized scene.
Whether career or volunteer, it is important to know your job. Standard operating procedures (SOPs) based on your company’s staffing levels and equipment cache are great tools for helping with this. Clearly written and flexible SOPs allow for more informed personnel. Once these procedures are adopted, all personnel can be trained from the same source.
Riding assignments constitute another excellent tool for the extrication crew. Many departments have laminated sheets or engraved signs in the apparatus with the riding assignments listed in detail. This eliminates a lot of confusion since the crew can review them en route to the call. These riding assignments must be ingrained in our personnel. Training according to these assignments is the key to a successful extrication. As each firefighter exits the rig, it is comforting for the officer to know that the personnel know their jobs and have proven their ability to complete the assigned tasks. For instance, a four-person crew must accomplish the basics on arrival, including size-up, tool staging, vehicle stabilization, patient assessment, patient stabilization, and victim extrication.
Following is an example of a four-person crew riding assignment roster:
The officer’s role is crucial on these runs. His scene size-up must include the number of vehicles and patients and the resources needed, such as advanced life support, police, and utilities. The officer must also direct incoming units to the best response route. Many times, traffic is so congested that alternate routes must be used to properly position the next due units.
Photo 1 by Firefighter David Anderson;
If no engine is on scene, the chauffeur should at least set out a fire extinguisher for additional safety. The chauffeur also sets out safety cones or flares. He must use extreme caution to avoid being struck by passing motorists who are more focused on rubber-necking than looking for operating firefighters. Some departments also assign the control vehicle utilities to the chauffeur.
Once the emergency medical services (EMS) unit is on scene and patient care has been transferred, EMS personnel can relieve him, and he can assist with the extrication by backing up the primary tool operator or operating within the vehicle as needed.
|photos 2-7 by author.|
Riding assignments should be flexible, depending on the severity of the incident as well as the number of vehicles and victims involved. When encountering an incident, the officer must quickly recognize the crew’s limits and call for additional resources if necessary. If no engine has been dispatched, it is important to get one assigned quickly for patient and rescuer protection. Preset mutual-aid plans are a great help. They prevent confusion and simplify the incident commander’s job.
APPARATUS AND EQUIPMENT
In trying to simplify extrication operations, look at your apparatus and equipment. Whether you’re carrying your extrication equipment on an engine, a truck, or a dedicated rescue unit, that rig should be designed for quick tool deployment. Again, take into account how you use your personnel when equipment is placed on the vehicle.
Using preconnected hydraulic, electric, and air reels is another option that allows for quick tool deployment, but they are effective only if you can maneuver your apparatus close enough to the scene (photo 3). Many times, this is not an option. In that case, portable carts or hand trucks can be a big help (photo 4). Most apparatus manufacturers offer options like bumper-mounted reels and tools, which put the tools in an easy-to-deploy location that doesn’t aggravate some of those old back injuries so many of us are nursing. One precaution when adding this to your rig specifications: Ensure that the storage area is weather- and road-dirt resistant. I’ve seen many bumper-mounted tools damaged and rusted from exposure to the elements.
How many times have you seen tools you commonly need stored in hard-to-get-to locations? When mounting equipment in your rig, consider the tools that you use most often and the weight of the equipment. The old adage “Work smarter, not harder” makes perfect sense in this case.
Another dilemma in the extrication world is the weight of the equipment. You must determine if your two to three rescuers can safely operate your tools. Physically exhausted rescuers will quickly become ineffective, and the risk of injury to personnel and victims will be much greater. Many of the extrication tool manufacturers are developing lighter-weight products. However, many of these tools lack the cutting and spreading ability needed for today’s new technology vehicle components. They may be lighter, but ask yourself if you are working harder and delaying the extrication.
When analyzing your equipment and evaluating new products, don’t take the sales representative’s word as gospel. Get out on the drill ground and test the tools you are considering purchasing against what you will be facing in the street. Don’t base your decision on how a tool performs on a 1982 Toyota. One fire chief explained that although he couldn’t get a new Volvo or Mercedes to test tools on, he purchased boron pipe from a local supply house and attached it to the B post of the car on which they were training (photo 5). This provided a very good facsimile of the new-technology vehicles his company was facing in the street. Remember, as new vehicle technology presents itself, rescue tool manufacturers are scrambling to keep up. It is our job to ensure they are truly doing just that.
Vehicle stabilization is another issue with which the crew must contend. For some, cribbing and struts can be difficult to carry because of their weight and size. However, a way to overcome this is to use wheeled plastic tubs, totes, or carts. This allows a single firefighter to get much of the needed cribbing to the scene relatively easily. One of our members went so far as to number each tub we use in the order in which it is to be removed from the apparatus. The first tub contains our step chocks, some 4 × 4s, a staging tarp, a windshield saw, and a rescue blanket. The second holds more 4 × 4s, wedges, and 2 × 4s. The third and fourth tubs hold the remainder of our chocking. This numbering system makes life much less complicated on those calls at 3:00 a.m., when it may take a little time for you to fire on all cylinders. It also makes things easier for mutual-aid units and to get back in service after the incident (photo 6).
Another way to quickly move cribbing from the rig to the scene is to bundle it. You can use a carabiner to join the rope handles of six to eight pieces of cribbing, which makes for easier carrying. They can also be numbered according to the order in which they are removed, which may prevent confusion on scene (photo 7).
As we all know, training is the key to a successful operation. The more you practice deploying your equipment and using the tools, the better you’ll function when lives are on the line. Don’t take it for granted that everyone is on the same page as you. Spend the time drilling to ensure that your people are capable of working in these trying situations. They must know what tools and equipment will be needed; where they are located; how to hook them up; and, above all, how to safely operate every piece of equipment they may use. Setting up realistic scenarios and putting your crews to work is an excellent way to gauge your personnel’s extrication preparedness.
When we discuss using personnel, one factor that seems to be an unknown or that is overlooked in many departments is the physical fitness of each crew member. Although this is often pushed to the back burner, it is important to consider. The physical limitations of a crew because of the crew members’ lack of fitness may determine the success of the rescue operation. If your personnel lack endurance, strength, and mobility, their efficiency will be greatly diminished. Personnel are often tasked with working in tight quarters and in awkward positions such as above our heads or, in the case of tunneling operations, on our backs. This requires a great deal of strength and flexibility. This is yet another case for implementing fire department fitness programs. Supervisors should be using training scenarios to help gauge their personnel’s physical fitness and ability.
As we lobby the powers that be for the needed personnel, we continue to answer the call. For so long, we in the fire service have found ways to compensate for what we have lacked. In most cases, we have been fortunate enough to combine relentless desire, skilled personnel, and a bit of luck to mitigate the hazards we face. Like everything we do in the fire service, managing personnel and using them properly can make the difference between success and failure when it counts the most.
● AARON J. HELLER has been a member of the fire service for 25 years and is a career captain with Hamilton Township (NJ) Fire District #9. He previously was chief of New Egypt (NJ) Volunteer Fire Company #1. He is a NJ-level II instructor with the Mercer County Fire Academy. He is the co-director of training for Champion Rescue Tools and the owner of On Scene Training Associates, LLC.