“Advanced” Confined Space Rescue

By Chris Carlsen, Albuquerque Fire Department

Having worked and been an instructor in the rescue field, I am often asked, “what are some advanced rescue techniques in confined spaces?” My response is always, “It depends where you think you are as a team, because advanced can mean many different things.”

Obviously there are confined space rescue scenarios that require a higher level of proficiency and teamwork than others. However, I like to begin by asking a team to do a self-assessment, as outlined below, and to think of “advanced” confined space rescue as anything that advances the ability of a team to perform as rescuers.

Is your team in the CRAWLING stage, meaning you have a trained team but the only time you touch a piece of equipment or do some rigging is during an annual refresher? Then “advanced” for your team means relearning the fundamentals every year. Practicing anchor rigging, building basic mechanical advantage systems, packaging patients in litters and drag devices, setting up SCBA or SAR systems and understanding the importance of atmospheric monitoring and ventilation strategies. All the basic tools you need to get the job done!

Is your team WALKING, having dedicated team members with solid fundamentals that attend regular training evolutions? Then “advanced” can mean organizing team equipment for a more efficient response, pre-rigging standard set-ups for rapid deployment, practicing compound and/or complex systems, identifying and preplanning confined spaces, defining team roles in an ICS type structure, and conducting full scenarios from response to termination.

Is your team RUNNING, with experienced team members who are looking to be challenged? Advanced for you is getting creative and locating spaces that are difficult to reach, difficult to access, and/or challenging to work in. Teams like this will benefit from having time restraints on training exercises to build pressure and increase the speed with which people work. Other ideas would be to limit the availability of equipment so the team has to problem-solve and prioritize actions, or add new pieces of equipment that provide more efficiency or increase safety.

Every one of the teams I just described is capable of making a successful confined space rescue today. But first, what do we consider a successful confined space rescue? For me, it is performing the rescue while providing for the safety of our team and the persons we are responding to. If we can do that, then we have been successful.

Over and above the basics of a successful rescue, what separates good teams from better ones is their efficiency and ability to solve complex problems. The more complex the rescue scenario is, the less efficient the team is going to be… unless they have experienced the scenario before or can relate it to something they have done. And where can they get experiences needed to build confidence and the mental files they can draw from? Training, training, and oh yeah training! The best teams build a sort of muscle memory that derives from all the exposure to various situations they have experienced. I have a quote scribbled on my wall that says:

“A rescue isn’t successful because of what you did today, it was the years of training that led up to the rescue that made the difference.”

I’m not sure who said that, but when I read it, it stuck, and I have spent my professional career trying to make sure I was ready for a rescue today. So I ask, are you ready? Do you know how complex the next rescue problem is going to be?

In order to be ready, we must have a solid grasp of the basics for confined space rescue. I’m not talking about building mechanical advantage systems or selecting the best anchor point. Yes, those skills are necessary, but I’m talking about managing your TIME. Because in confined space rescue, time is one of the greatest factors between a rescue or a recovery. One of Roco Rescue’s great Chief Instructors, Mike Adams, really helped me understand this concept in a simple way. He broke the entire rescue down into four parts.

1. Put your hands on the patient: Everything you do initially must drive towards this goal. The faster you can do that, the faster you will have a complete understanding of the complexity of the rescue. Keep it simple and get in there once you have provided for the safety of your rescuer.
2. Care and Package: Do good patient care, and treat the things that are life threatening first. Once you know the life threat, then you’ll know how much time you have to work with. Then package for the environment and the injury.
3. Extricate: Build a world class rescue system or just put your hands on the patient and move! Either way your team should be ready to perform once the patient is ready to move. The type of space and the orientation of the patient will usually dictate the how and what.
4. Lift and/or Lower and turn them over: Once the patient is out of the space, lift / lower them to ground level and turn them over to EMS. This is typically less hazardous but still just as important if you have a critical patient.

Focus on these concepts in your next confined space training; see how well your team performs, and ask plenty of questions.

Did you stumble a little bit? Was there some confusion about the plan or about who was doing what job? If so, that’s ok! Talk about it, sort it out and do it again - that is what training is for! On the other hand, maybe you cruised right through the scenario and everyone was pretty quiet. If so, perhaps that’s because your jobs are well defined and your team knows what is always coming next. Or was it just because you have done the same drill from the same space for the last 10 years? Either way it’s time to turn up the heat and start challenging your team to get them to the next level.

If you’ve trained with us at Roco Rescue, then you’re familiar with our version of the K.I.S.S. principle: “Keep It SAFE and SIMPLE.” I’ve used it many times, and it works, but as our depth of knowledge grows and the complexity of the incident grows, the “devil” is really in the details. The masters of any craft only became masters through practice. So you want to know some Advanced Confined Space Rescue Techniques? You want to be a Confined Space Rescue Technician?

Train, Learn, Practice.

And as always, be safe.

Chris Carlsen resides in Albuquerque, NM and has been a firefighter with Albuquerque Fire Rescue since 1998.  He currently works as the Heavy Technical Rescue Program Manager within Special Operations.  Chris took his first Roco course in 2000 and became part of Roco’s instructional cadre in 2006.  As a Roco Rescue Chief Instructor he leads courses in rope, confined space, trench and structural collapse rescue.