So, you’ve got your rescue team up to date on all the nifty tricks in confined space rescue. Litters, knots, anchoring, mechanical advantage systems, the whole kit, and kaboodle. Now, you’ll need some first aid and CPR training to meet OSHA’s standards. Some folks say a simple layperson first aid course will do it. Others argue that teams need a week-long EMS professional course to prepare. Going further, some folks say that investing in drills and skills retention is the most critical issue. To cut through some confusion, let’s look at some of the things employers might factor in when choosing medical training for Emergency Response and Rescue Teams.

What’s the Standard?

OSHA 1910.146(k) requires that employers “Train affected employees in basic first-aid and cardiopulmonary resuscitation (CPR),” and “ensure that at least one member of the rescue team or service holding a current certification in first aid and CPR is available.” That’s a lot, so let’s take a second to dissect this by defining some terms. According to OSHA, “First aid refers to medical attention that is usually administered immediately after the injury occurs and at the location where it occurred. It often consists of a one-time, short-term treatment and requires little technology or training to administer.” Alright, that’s pretty straightforward.

Now, let’s take a look at CPR or Cardiopulmonary Resuscitation. Simply put, rescuers will perform chest compressions to pump blood around the body and typically breathe for the patient. But wait, don’t I need to shock the patient? What about the AED (Automated External Defibrillator)? Am I required to have an AED in my first aid supplies? A 2004 letter of interpretation says no, AEDs are not specifically required in the rescue team first aid kit. However, AED’s are much easier to use today and an abundance of research says you probably should include one in your kit.

Here's why you may want to consider an AED. According to the American Heart Association, every minute after cardiac arrest without defibrillation, the patient’s chances of survival decrease by 7%-10%, and after 12 minutes, survival rates are as low as 2%-5%. In their 2020 guidelines, the AHA adds, “Defibrillation is most successful when administered as soon as possible after onset of VF/VT (lethal cardiac arrhythmias) and a reasonable immediate treatment when the interval from onset to shock is very brief. Conversely, when VF/VT is more protracted, depletion of the heart’s energy reserves can compromise the efficacy of defibrillation unless replenished by a prescribed period of CPR before the rhythm analysis.” If you have an AED handy, the rescue team is more likely to successfully resuscitate the patient rather than waiting for EMS or for someone to retrieve it from across the site.

Now that we’ve translated the standard let’s differentiate two of the most common training course types for rescue teams: Layperson First Aid and EMS/EMR Professional.

Professional Courses vs Layperson Courses

Although the topics and skills taught in basic first aid courses and EMS professional courses are similar, each route has unique advantages and disadvantages. For instance, and obvious to most folks doing the shopping, the price and time commitments vary. Typically, a simple layperson first aid course takes one day with around 4 to 10 hours of total time with the instructor. The American Heart Association, National Safety Council, American Red Cross, and other nationally recognized organizations offer First Aid CPR and AED credentials. So, although you’re only committing a single day you can trust, in most cases, that the information is solid to give your personnel a knowledge of the basics.

However, if you want your emergency response personnel to be able to take greater lifesaving measures, we highly recommend an Emergency Medical Responder (EMR) course. This is especially true if you are located in an industrial site with numerous hazards and possibly isolated from immediate medical care.

In an EMR course students will get around 50 hours of instruction, practice, and evaluation. According to the National Registry, “EMRs have the knowledge and skills necessary to provide immediate lifesaving interventions while awaiting additional EMS resources to arrive. EMRs also provide assistance to higher-level personnel at the scene of emergencies,” EMR is one of the most common medical certifications amongst both volunteer and professional responders. They are typically regulated by a state EMS education agency and taught by private businesses with licensed instructors.

From my personal experience as a Paramedic, I can say that receiving a patient from a layperson with first aid and a trained EMR can make a big difference. Oftentimes, this increases the viability of the patient – especially when access to professional medical care is not immediately available. The assessment taught to Emergency Medical Responders is almost identical to the scene assessment and patient surveys an EMT or Paramedic performs when responding to an emergency. As a component of your emergency response, medical care for the patient must be assessed and considered a vital part of any successful rescue operation.

Drills and Skills Retention

If you don’t use it, you lose it. Regardless of the course, the most critical component of any program is drilling and skills retention. In a 2020 study, a group of medical students went through a 40-hour BLS course. Immediately after training, 78% of the students were evaluated and categorized as “excellent.” However, 6 short months after the training, that number dropped to 40%.

What does this mean for your team? Should they retrain every 6 months? Maybe we could simplify their training to aid in retention.  Research conducted by the European Resuscitation Council (ERC) in 2019 showed an increase in 3-month skill retention after simplifying their guidelines. The simplest answer I can provide is to do what’s best for your unique situation.

Take a look at the hazards on your site, take note of the possible conditions and injuries, and perform a full-speed drill as often as you feel your team needs to stay proficient. If the one-year minimum for your confined space program shows a severe lack in team performance, try 6 months. If twice a year still reveals major gaps, move to 3 or even 4 exercises a year. The fact is, if you find the issues after someone is hurt or killed, the money, time, and resources you save will be nothing compared to the lives that are changed by the tragedy.

The best day to perform a rescue is the day after class. The rust builds up a bit every day that goes by. So, be proactive, aggressively shop the right course for you, and plan on investing heavily in site hazard-specific drills and rescue exercises that involve first aid and CPR. The families that work for you are betting their lives on it.

Conclusion

There are a lot of medical courses out there to choose from. What level of medical care do you want your team to have? One of a layperson to cover the basics or an EMS professional that sees the bigger picture of patient outcome and the continuum of care. Either way, if you don’t take your training seriously and prepare drills for your specific needs, the chances of catastrophe increase by the day. So, invest in your workforce's safety and peace of mind, give them the tools and perspective they need to be successful, and train hard.

References

1.https://www.osha.gov/laws-regs/standardinterpretations/2004-06-17-0

2.https://www.osha.gov/sites/default/files/publications/OSHA3317first-aid.pdf

3.https://www.osha.gov/medical-first-aid/standards

4.https://www.osha.gov/medical-first-aid/recognition

5.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600120/#ref19

6.https://www.ahajournals.org/doi/full/10.1161/circ.102.suppl_1.I-22

7.https://www.ahajournals.org/doi/10.1161/circ.140.suppl_2.139

Additional Resources

• Emergency Medical Responder Course
• First Aid CPR and AED Training Course

Safety professionals want to make sure all workers get home safely, but what are the best ways to do that?

Ask any safety professional what drives or motivates them to get out of bed in the morning and you’ll probably get 1,000 different answers. Some people may be motivated by their experience working in the industry, some may be motivated by combat experience, some may be motivated by their desire to help people and some may be motivated by money; the point is, we’re all motivated by something. While it’s great to know what motivates you, it’s even more important to ask yourself, “what impact do I want to make today?” 

Click here to read the full article by our own Chris McGlynn that was originally posted on OH&S’s website recently: https://ohsonline.com/articles/2022/12/05/how-to-make-an-impact.aspx?admgarea=news

Chris McGlynn is the Director of Safety/VPP Coordinator for Roco Rescue. He is a Certified Safety Professional (CSP) through the Board of Certified Safety Professionals as well as a Certified Confined Space and Rope Rescue Technician, and a Nationally Registered Paramedic. As Director of Safety, Chris oversees all corporate safety initiatives, ensuring that employees at Roco have the tools and training that they need to do their work safely and effectively. He is also responsible for managing Roco's Safety Services Division, which provides trained safety professionals for turnarounds and other special projects. Finally, Chris serves as the VPP Coordinator for Roco, continuing Roco’s long-standing commitment to excellence in safety and health. Roco has been an OSHA VPP Star Worksite since 2013.

Follow Chris 

Additional Resources

• Roco’s Professional Safety Services
• Want a Safer Workplace? Get Employees Involved!
  
  
  

Inspect all CMC ProSwivel or Rock Exotica Omni-Block swivel pulleys immediately.

CMC and Rock Exotica, who makes CMC's ProSwivel pulleys, have both issued recall notices on their 1.1" swivel pulleys and SwivaBiner pulleys. The concern is surrounding the set screws that hold the button in. The button secures the side plate, so if the button comes out, the side plate could open and let the rope fall out - which could mean severe injury or death.

The recall only applies to the 1.1" versions manufactured from February 2020 through October 2022, however both manufacturers are recommending that all of these swivel pulleys be inspected.

If you have a pulley subject to the recall, return it to the manufacturer at no charge for inspection/repair. If you purchased your pulleys from Roco, we will be happy to assist you with the recall and inspection.

If you have 1.1" pulleys made outside of the recall window, or have other sizes of any date, you may inspect them yourself or return them for professional inspection.

1. 2018 to present
   1. There should be a dab of epoxy sealant that fills the set screw hole. It may be brownish/yellowish or a white/grey color.
   2. If the epoxy is missing, return the pulley for repair.
   3. If the sealant is protruding above the surface, determine the color. If it is white/grey, that's okay. If it is brownish/yellowish, return the pulley for repair.
2. 2016 and 2017
   1. There should be a dab of epoxy sealant like the current models have, but it will only be white/grey. It's okay if it is above the surface of the hole, but if it's missing, return the pulley for repair.
3. Prior to 2016
   1. No visible sealant was used on these models, so don't worry when you see the bare set screw. Just make sure the set screw is even with or below the surface.
   2. If you are not comfortable doing this inspection yourself, you can send your pulleys to the manufacturer or to Roco for inspection.
   3. You may want to add your own epoxy to these models to make your daily gear inspections easier. (see details in the inspection notices linked below)

Instructions for identifying your pulleys and locating the serial numbers are included in the manufacturer recall and safety notices. Be sure that you are using the proper notice for your pulley, as the CMC and Rock Exotica serial number locations are slightly different.

Manufacturers' Detailed Information

Note that CMC's and Roco's offices will be closed 12/23/22 through 1/2/23 and reopen Tuesday, January 3rd. However, if you have an urgent need during the holidays, you may reach CMC at info@cmcpro.com and Roco at 800-647-7626 (follow the prompts for emergency after-hours service).

Always remember to inspect your gear before each use. Stay safe, and Merry Christmas!

There are so many angles to talk about in rope rescue but for now, let’s focus on Low Angle vs. Steep Angle vs. High Angle rescue.

We hear these terms utilized often in the rescue community, but it is not always clear what each term defines. Each one comes with a degree of slope range, something like;

• 0-15 degree slope is flat terrain
• 15-29 degrees is considered low angle
• 30-50 degrees is steep angle
• anything above 50 degrees is high angle

You may have heard some different numbers associated with each and that’s ok because, in reality, they are just guidelines to help us make informed decisions about what kind of systems to use in a given scenario. If I’m being honest, I don’t really care what the angle is because I still haven’t carried around a protractor in my rescue kit to tell me what degree slope I am working on. I have my own internal protractor, my eyes, my experience, and my level of training. All I am really concerned about is the steeper the ground, the more difficult and the more technical the rescue becomes.

It is not just the degree of slope that tells me what I need to do, it is also the terrain and the condition of the terrain that makes a BIG difference. The terrain AND the slope are going to be major factors in deciding what rope systems to use as well as how many personnel are involved in the rescue. Some examples of terrain that may push you to utilize ropes in a rescue situation would include loose rock/scree, mud, snow, or any other debris that could cause bad footing and an unstable rescue for the patient. Ropes may have to be used to gain access to the victim, to support the team members and the patients during the rescue and remove them from the rescue site.

It is not just the degree of slope that tells me what I need to do,
it is also the terrain and the condition of the terrain that makes
a BIG difference.

So, our size-up goes something like this.

• Can rescuers move freely across the terrain without assistance and manage patient movement effectively and safely? Yes = no ropes
• Do rescuers need assistance to safely and/or more efficiently move themselves or the patient, but the ground is predominately supporting the load? Yes = 1 rope system
• Are rescuers and the patient fully supported by the system or a single rope failure would cause catastrophic results? Yes = 2 ropes.

Each one of these scenarios presents its own set of challenges and the systems used can vary greatly. The goal for all of us is to provide for the safety of our teams and the people we are there to help.

Additional Resources

• 11mm Rope and NFPA Requirements
• Rescue Compliance...Is Your Team Ready?
  
  
  

READER QUESTION: 
How often should I replace my rescue harness?

ROCO TECH PANEL ANSWER: 

We get many calls asking about the “life expectancy” of harnesses, rope, and other nylon products. Of course, many factors are involved, but a lot depends on how much you use your harness and how you use it.

First of all, NFPA 1858 10.1.2 states that “Software products shall be retired in accordance with 10.2.1 no more than 10 years from the date of manufacture.” Be sure to check the label of your harness, which should tell you when it was manufactured. If it’s beyond this 10-year service life, we recommend that it be taken out of service.

The frequency of use can have significant impact to the service life of a harness.

ASTM F1740-96 (2018) Guide for Inspection of Nylon/Kernmantle Rope also recommends a 10-year service life for rope, which can be applied to a nylon harness as well. Section 5.5.2 states, “Retire any rope which is greater than ten years old, regardless of history and usage.”

Here are a few examples based on industry use. The fall protection industry generally recommends 2 to 3 years as a service life for a harness or belt in regular use. The Climbing Sports Group of the Outdoor Recreation Coalition of America states that a climbing harness should last about 2 years under normal weekend use. The military uses 7 years as a service life for nylon products. Of course, hard use of any product would call for a shorter service life than would normally be expected. Also, the frequency of use can have significant impact to the service life of a harness. It is not only the continual wear and tear a harness receives during use, but the exposure to other factors that exacerbate the degradation of textile fibers such as UV, sweat, or potentially other airborne chemicals. Frequent and rigorous use of a harness could decrease the service life substantially.

Even how and where you store your gear is an important factor. In an industrial environment, for example, atmospheric exposures may be a key consideration for nylon products even while in storage. Storage conditions, heat, light, temperature, and other variables can all impact nylon. NFPA 1858 Section 9.2 references the storage of life safety rope and other nylon products, “Equipment shall be stored in such a manner as to prevent damage contact with other equipment and to prevent exposure to chemicals and atmospheres that can contribute to rust, corrosion, or oxidation.”

How and where you store your gear is also an important factor.

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As with all of your rescue gear, it’s very important to account for each use and follow the manufacturer’s instructions for care, use and inspection. As with ropes, if your harness has been subjected to shock loads, fall loads, abuse other than normal use, or fails the inspection for any reason, it should be removed from service and destroyed.

Bottom line…Never take chances when there’s any doubt about the serviceability of a life safety product. It’s simply not worth the risk.

Additional Resources

• Service Life Guidelines for Rescue Equipment
• Guidelines for Permanent Marking of Rescue Hardware