QUESTION: 
What is the role of a spine board in emergency medical response, specifically when dealing with confined space and high-angle rescues?

NOTICE: It is extremely important to follow local protocols in providing emergency medical care.

ANSWER: 

For many years, spine boards have been a staple in emergency medical responses for moving and transporting patients with suspected spinal injuries. In rescue operations, spine boards do an excellent job of immobilizing the patient as well as providing a means of transporting the patient from one location to another.

The mindset of always using a backboard may not be the best for every patient - in fact, there is a risk of harm. 

Studies in emergency medicine have brought a critical perspective to the use of spine boards. While they are indispensable in certain situations, these studies highlight the negative effects of prolonged immobilization on a hard surface. Issues such as pressure sores, discomfort, and breathing problems have been reported, suggesting that the use of spine boards should be carefully considered and not automatically applied to all EMS cases.  

The approach to using spine boards is becoming more selective and nuanced. Medical professionals now advocate for a protocol known as "Spinal Motion Restriction," which tailors the immobilization method to the specifics of the injury and the rescue context. This might involve using devices like C-collars or employing techniques that minimize movement without the complete rigidity of a spine board, especially if the rescue scenario allows for careful handling. 

Team protocols and procedures should stress the importance of not causing additional harm through interventions.

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The decision to use a spine board should be based on a thorough assessment of the injury, the patient's condition, and the rescue environment. Especially due to research that indicates unnecessary use may lead to complications that could potentially outweigh the benefits.

In rescue, spine boards still provide an excellent means of securing a sick or injured patient. It provides a rigid means of transport offering protection of the patient's neck and back. This can be particularly vital in scenarios like high-angle rescues or extractions from confined spaces, where the risk of challenging movements is significant.

While spine boards are a critical tool in certain rescue operations, their use should be judicious and tailored to each unique situation. As emergency response techniques evolve, so will the strategies for spinal protection, ensuring that patient safety and outcome remain at the forefront of rescue operations.  

Additional Q&A Resources

• Rescue Plans...What is Required?
• Q&A: 11mm Rope and NFPA Requirements
• Q&A: Energy Absorber Systems and Safety Lines
• Q&A: What are the Rescue Requirements for Trenches/Excavations?
  
  

READER QUESTION: 
Is an energy absorber system needed on the safety line to help limit the impact forces should the belay system be engaged to arrest the falling load?

ROCO TECH PANEL ANSWER: 

Since we first answered this question here on our site, twin tensioned systems have become more and more popular. However, many rescue teams still employ traditional untensioned belay systems, which can still be effective. Therefore, familiarity with proper use is essential.

Additionally, modern equipment has provided an alternative option somewhat between the twin tensioned and untensioned methods: the “tight” belay system.

When using a “tight” belay system, such as an anchored ASAP, the shock absorber is incorporated into the anchor. This is still categorized as an untensioned safety line rather than twin tensioned system, but the rigging makes it easier for operators to keep the line tighter and minimize the potential free fall distance.

If your team has adopted use of twin tension systems, then the energy absorber may be a moot point for you. These twin tension systems ensure that both lines are under load at all times. This eliminates the free fall potential – if one fails, you have a load transfer (on a tensioned line) rather than a shock load.

Roco trains with all three types: traditional untensioned safety lines, “tight” belay systems and twin tension main/belay. In the untensioned belay systems, we do indeed incorporate an energy absorber (shock) on the end of the line.

Whichever system your team uses will be up to you. If you choose to use an untensioned safety line, OSHA and ANSI each may have a role to play in guiding what equipment you use.

While OSHA does not address specifics when it comes to rescue systems, there is some overlap from the OSHA as well as the ANSI standards that is helpful when considering the belay system during rescue. 

NFPA 1006 Standard for Technical Rescue Personnel Professional Qualifications, sections 5.2.9 through 5.2.11, provides guidance for the construction of a belay (safety line) system. Specifically, the 5.2.11 objective statement calls for the belay system to ensure “the fall is arrested in a manner that minimizes the force transmitted to the load.” The annex information adds: “Belay systems are a component of single-tensioned rope systems that apply a tensioned main system on which the entire load is suspended and a non-tensioned system with minimal slack (belay) designed, constructed, and operated to arrest a falling load in the event of a main system malfunction or failure. 

While these traditional systems used for lowering and raising are in common use, two-tensioned rope systems can also be used to suspend the load while maintaining near equal tension on each rope, theoretically reducing the fall distance and shock force in the event of a singular rope failure. To be effective, two-tensioned rope systems must utilize devices that will compensate appropriately for the immediate transfer of additional force associated with such failures.”

Additionally, the NFPA 1006 definition of belay is “The method by which a potential fall distance is controlled to minimize damage to equipment and/or injury to a live load.” And Annex information “This method can be accomplished by a second line in a raise or lowering system or by managing a single line with a friction device in fixed-rope ascent or descent. Belays also protect personnel exposed to the risk of falling who are not otherwise attached to the rope rescue system."

So, where can OSHA help in all of this? OSHA requires the maximum force of a fall arrest system not to exceed 1,800 pounds. ANSI is more protective and requires arresting forces not to exceed 900 pounds. NFPA does not state what the arresting forces need to be limited to, but the performance measurement is to “minimize damage to equipment and/or injury to a live load.” OSHA and ANSI have already done the homework on this and stated their performance requirements. One proven way to meet NFPA 1006 as well as OSHA and ANSI requirements is to incorporate an energy absorber in the belay (fall arrest) system. Whether 1,800 pounds or the ANSI required 900 pounds is appropriate, or if you use a two tensioned system, this is up to your AHJ. 

UPDATE: Roco Rescue Challenge 2024 has reached full capacity for team participation, but Observers are still welcome. We have created a team waiting list, so please contact us if you are interested in registering your team or plan to come watch the action. Register now!

Roco Rescue Challenge 2024 marks the 31^st Anniversary of North America’s premier Rescue and Training event. Scheduled for October 16-17 at the Roco Training Center in Baton Rouge, Louisiana, Roco Rescue Challenge is much more than a competition. At its core, it is a learning event where camaraderie, teamwork, and networking rule the day.

Rescue Challenge’s biggest success and value as a learning event is the immediate feedback the teams receive. Roco’s experienced training cadre provides debriefing following each scenario. Every team receives a detailed report describing their performance at Rescue Challenge and how they can improve. Teams often find that this report provides an excellent roadmap to focus their post-Rescue Challenge training regimen.

When the weather in South Louisiana turns to nice cool days, join us at the world-class Roco Training Center in Baton Rouge, Louisiana, on October 16-17, 2024, for Rescue Challenge '24.

Space is limited, so enroll early to ensure your team's spot! We welcome all teams, regardless of experience level. Take part in this truly unique event: part learning, competition, and all CHALLENGE.

For more information about Rescue Challenge, click here. To save your spot and register, call (800-647-7626). Observers are welcome; registration is required.

Municipal fire departments looking to challenge their rescue teams should call the Roco office (800-647-7626) for savings on registration.

Additional Resources

• Rescue Challenge Spotlight - Valero Wilmington
• Team Performance Evaluation (TPE™) – How Prepared are You?
• Team Benefits from Rescue Challenge!
• Roco Rescue Challenge 2023 Video
  

On February 5, 2024, OSHA published a proposed update to the 1910.156 Fire Brigades Standard. OSHA is proposing through this notice of proposed rulemaking to issue a new safety and health standard, titled Emergency Response, to replace the existing 40-year-old Fire Brigades Standard. 

The public comment period has closed but was extended twice due to an overwhelming number of comments. OSHA has since scheduled an informal public hearing to be held virtually on November 12, 2024, at 9:30 a.m. ET. Witnesses are welcome to testify about any topics, issues, or concerns they have with the proposed rule.

OSHA is particularly interested in hearing testimony regarding the following topics:

1. Firefighting services that are not primarily all-hazard/structural (wildland, airport, marine, etc.).

2. Emergency Medical Service providers that are not fire department based and those that provide aerial transport.

3. Technical search and rescue providers, particularly those that are not fire department based.

4. Specific recommendations for reducing the burden on volunteer/non-compensated responders.

Those wishing to testify must electronically submit a Notice of Intention to Appear (NOITA) on or before September 27, 2024, at OSHA.gov. In addition, those who request more than 10 minutes for their presentation or intend to submit documentary evidence at the hearing must submit the full text of their testimony and any evidence no later than October 18, 2024.

Chris McGlynn, CSP is a Certified Safety Professional and Nationally Registered Paramedic who serves as the Director of Safety and VPP Coordinator at Roco Rescue. He is also an active OSHA Special Government Employee within the Voluntary Protection Program and current President of the American Society of Safety Professionals Greater Baton Rouge Chapter. Chris also represents ASSP on the ANSI Z117 Confined Space and Z390 Hydrogen Sulfide Training Standard Development Committees.

Follow Chris 

Additional Resources

• Tips for Getting the Most From Your Rescue Training 
• What Does NFPA Have to Say About Confined Spaces? 
• Rescue Plans...What Is Required?
  
  

Manufactured exclusively for Roco Rescue by Skedco.

Sleek, portable and mission-driven – the new Roco Lowrider™ Compact Rescue Tripod is made for low, tight spaces. Originally designed by Roco tactical instructors to meet the mission-critical requirements of elite DoD special operations teams, the Roco Lowrider™ Rescue Tripod brings cutting-edge technology and hard-earned lessons to the civilian rescue industry. 

With a minimum height of 38-inches and a maximum working height of 60.5-inches, the Roco Lowrider™ can be used to extract patients from low overhead spaces using minimal personnel. Designed to be man-packable,
the Lowrider™ weighs only 32 lbs. and features header, anchors and legs connected with stainless steel bolts for maximum strength and weather resistance. The proven Skedco head design allows up to three separate
connection points for multiple rigging options. The anchors are well-balanced to handle rescue loads and each is anodized red for easy identification.

With its light weight, compact size and breaking strength of more than 20,000 lbs., your team’s working efficiency will be dramatically increased – all while staying LOW.

Key Features:

• Weight of 32 lbs., less than half the weight of a traditional tripod.

• Minimum height of 38-inches with a maximum working height of 60.5-inches. 

• Minimum breaking strength of more than 20,000 lbs. at full extension.

• Anchors are anodized red for easy identification.

• No traditional tripod chain – 8mm cordelette provides hobbling capability.

Place Your Order Today!

• Roco Lowrider™ Compact Rescue Tripod Kit

  (Includes: compact tripod, 30-ft. 8mm accessory cord, one William Triact carabiner and carrying bag.)