By Josh (JC) Hill, Roco Technical Equipment Manager & Chief Instructor

As mentioned in our original story, the alarming statistic of confined space fatalities still proves to be accurate – approximately 60% of fatalities in multi-casualty incidents are the “would be rescuers.” In January, it happened once again. Four construction workers had entered a drainage manhole to determine why the newly paved road was settling in that location.

Upon entering the space, which is believed to have been done without initial monitoring or ventilation, the worker collapsed. As is seen much too often, a second worker entered the space to assist the downed worker and was rendered unconscious. A third worker entered the space and again succumbed to the atmosphere.

The 911 system was activated and responders from the Key Largo VFD arrived at the scene and prepared to enter the space to perform rescue. Initial reports state that a volunteer firefighter donned an SCBA for respiratory protection and attempted to enter the manhole. He found the space to be too confining and removed his SCBA to make entry. He was in the space for approximately 20 seconds prior to being overtaken by the atmosphere. Note: It is our understanding that proper monitoring of the confined space had still not occurred at the time of the firefighter’s entry to attempt rescue.

Another firefighter then entered the space and recovered the first firefighter from the deadly space. Medical attention was provided until he was airlifted to Jackson Memorial Hospital’s Ryder Trauma Center. The Miami-Dade County Haz-Mat Team was also called to the scene.

After proper monitoring of the space, it was determined that rescue was no longer a viable option and that the scene would be transitioned to recovery efforts. The testing of atmospheric conditions showed the space contained significant levels of hydrogen sulfide and methane gas with decreased levels of oxygen.

Although original reports did not give indication of toxic gases, the signs surrounding the events make it obvious that the potential was there. To have several workers enter a space like this and rendered unconscious in short periods of time is a classic scenario involving atmospheric hazards. This combined with several statements from neighbors that the area smelled of “rotten eggs” for months provide significant clues to atmosphere being a significant contributing factor to the emergency.

So, why do these confined spaces incidents continue to occur across the nation with emergency responders?

When you break it down, the reasons are fairly simplistic and very alarming. Most citizens have a misconception of fire departments and emergency responders. Most often, it is assumed that if you call the fire department, whether in a large municipality or small township, the personnel responding will be qualified and equipped to perform any task needed.

Fact is the vast majority of fire departments are trained and equipped to perform basic first aid and life support along with standard firefighting operations.

Funding has and will continue to be the major handicapping factor that limits the capabilities of these agencies. Unfortunately, it usually takes a catastrophic event before funding is provided.

Also, unless dedicated specialty teams are established, it is practically impossible for agencies to train each individual to a proficient level for technical rescue and hazardous material response and have them maintain this level without regular, on-going training. It is also unrealistic for departments to outfit each individual responding unit with all of the necessary equipment to respond to every conceivable scenario.

As we all know, emergency responders are built around running towards the danger when human life is at risk. This attitude is what separates them from the average population and makes them successful at protecting life and property.

However, when not properly trained to react and respond to these types of uncommon hazards, the results are often as unfortunate as what we witnessed in Key Largo.

So, how can we change these alarming statistics for emergency responders?

First of all, it is critical that responders understand the unseen hazards they could be exposed to during these types of hazardous confined space operations. It is imperative that all personnel – from the newest rookie to the incident commander – understand what they are facing. Emergency responders must be able to recognize when they are not adequately trained or equipped for an event or hazard. They must understand that their lives are on the line in these hazardous environments.

Firefighters, from the smallest volunteer departments to the largest municipalities, must be trained to recognize the signs of hazardous environments and understand that they would be putting themselves in grave danger if they proceed with rescue attempts. Supervisory personnel should receive additional training that provides the knowledge to understand their full capabilities when facing scenarios they are not properly trained and equipped to safely handle. To stand-down is the wisest decision to protect their personnel from severe injury or death when the chances of successfully performing rescue have little to no chance for success.

It’s a difficult choice – risk vs. reward. But it’s a critical decision that emergency responders must make every day. Their personal safety must come first – it must be a viable rescue before they put themselves in harm’s way.

 By Pat Furr, Roco VPP Coordinator & Chief Instructor

As a Roco instructor, I see all sorts of students coming through our classes. But the one common characteristic in most every student is, “They want to do the very best for their patient or victim when the time comes for them to act!”

Beyond that, our students come with a very wide variety of characteristics. Some are loud and boisterous, while others are a bit shy and quiet. We see folks that are incredibly fast learners and some that need just a bit more time and attention. Some folks are incredibly fit and some could stand to lose a pound or two. And that is the subject of this article... Do we as rescuers have an obligation to our rescue subjects to maintain a reasonable level of physical fitness?

In addition to NFPA 1006 section 4.2 (3) minimum physical fitness as required by the AHJ, I say we do, even if only ethically. And I also say we owe it to ourselves to try to get into or stay in good shape. I don’t mean to throw stones, and I will be the first to admit that I go through periods (some of them extended) where I allow myself to get a tad soft. Well, OK, maybe more than just a tad soft. And when I do, I feel certain limitations that I know are going to hinder my ability to do right by my rescue subject. If I am winded and drenched in sweat after climbing a few flights of stairs, that is going to ultimately count against my rescue victim. If I need to go in “on air” and my mask is fogged from my perspiration, I will need to run a constant purge just to keep my mask clear – and that may spend our air supply prematurely. I remember a few years back during one of my "Jabba the Hutt" periods that I could barely lift up the tripod. Then, after a few months of working out and eating correctly, I remember grabbing that same tripod and slinging it up onto my shoulder as if it was filled with helium. It felt GREAT!!

I don’t think anyone could make the argument that improved fitness will not add to our effectiveness as rescuers. But there are so many more benefits to improving our individual physical fitness. A reduction in soft tissue injuries like pulled muscles and strains, as well as an increased resistance to illnesses. For me I have a much better mood and energy level to go out and enjoy most anything. And exercising regularly can drastically reduce stress levels! But as it applies to my tasks as a rescuer, I have more stamina, strength, ability to handle heat and cold – and because of all those factors, I have an increased situational awareness and ability to formulate and understand the plan. And for those of you that know me that last one is a huge benefit.

So I’ll assume that for the most part you agree with what I have said to this point, at least that’s my hope. What do we do about it then? Well, I suppose the first thing is for all of us to stop for just a few moments and assess where we feel our individual fitness is right now. For those of you that think that you could be a bit, or even a lot fitter, then I have some very basic suggestions to offer you. For those of you that are fit and plan on maintaining that fitness, good on ya! Keep up the good work! For those of you that are not in good shape at all and really aren’t interested or feel there isn’t enough time in the day to do anything about it, well I hope you’ll reconsider and keep reading to see that it really doesn’t take much at all to make a positive change. And as those positive changes happen, it is like a railroad locomotive. It starts out sort of slow, but as the momentum increases, so does the rate of positive change. And you know it when it really starts to happen, and it feels GOOOOOOOOD…..

If you start your day with a morning stretch, that is a good base to build on. If you are like a lot of us, we set the alarm to give us just enough time to get up, dressed, fed and out the door, sometimes finishing that last bite of breakfast as we are driving to work. Here’s a little hint, set the alarm 15 minutes earlier. C’mon…15 little minutes is nothing. This accomplishes several things. It gives us time to do a bit more slow and easy stretching and is plenty of extra time to do a set of pushups and some crunches. It also gives us a few minutes buffer to get to where we need to be on time, and eliminates that feeling of cutting it close which is just another stressor. Wouldn’t it be nice to start the day with less stress and that certain physical feeling of being slightly pumped up? Give it a try for one week; what do you have to lose, other than some stress and maybe a few pounds? 

Do you use the elevator to go up one, two, three floors? My bet is that in the time you wait for the elevator and all the stops you make, it would be nearly as fast to take the stairs. After getting into the stairs-over-elevator habit, you may find yourself going for five, then six, seven, ten stories. Now if we are talking 20 stories or more, then yeah, I’ll give you a pass on this one.

By the way, you don’t need to join a gym to get into really good shape. For those of you with good knees, running is a great calorie burner. For old fogies like me or those of you with knee or other injuries that prevent running, there are plenty of aerobic exercises like brisk walking, rollerblading, swimming, biking, and even dancing that will burn off some of that extra weight. I am fortunate to live very close to several lakes and I have taken up sliding seat rowing for my no impact aerobic workout. Wow! Talk about involving nearly every muscle group along with the heart and lungs. This is one of the best calorie burners I have ever known and the beauty is I am out on the lake at sunrise with the loons, ospreys, and eagles, the odd deer, turkey, fox, or mink on the shoreline, just enjoying the view of the mountains. Okay, I’ll quit waxing poetic now, but it is really nice and boy does it keep me fit.

What about what we eat and drink? Changing what you choose to eat is a simple matter of education and some simple strategies, but don’t make wholesale changes overnight. It is best to gradually change your diet and develop habits that can be built upon. Radical diet changes fail more often than not. There is a lot of truth to the old saying “We are what we eat.” I’ll be the first to admit I love me a big green chili cheeseburger and fries, and chase that with a bowl of ice cream while we’re at it. But I am fortunate to have a pretty good pseudo nutritionist in the house, who mandates adherence to a grocery list. Yup, it’s as simple as that. The key is to do just a bit of research on the sort of foods that should go onto your list, and the good news is there are plenty of resources to help guide you. Make sure to cover all the food groups with a good balance and visit the internet to see the variety of healthy choices within those groups. The next step is to make sure that the vast majority of your list is healthy choices. Next time you visit the grocery store, pay attention to the layout of the store. I’ll bet you will see that the healthy choice items tend to be on the outer perimeter of the store and the less healthy items are in the middle aisles. For example, if you are looking for nuts, see if there are choices near, or in the produce section out on the edge of the store. Then compare the nuts in the bins or light packaging to the choice of nuts on the snack aisle. My bet is the nuts from the produce section have few or no additives, whereas the nuts out of the snack aisle will be loaded with oils and all sorts of hard to pronounce gunk. Now there will be some healthy choices on the inner aisles, like wild or long grain rice- not the instant kind- , oatmeal without additional ingredients, and stay away from foods with artificial coloring. Get into the habit of reading the labels. Avoid or limit processed foods and foods with extensive ingredients on the label. The fewer the ingredients on the label, generally the healthier the item will be. Most of us love pasta in all its forms, but there are alternatives to pasta that taste great using the same Marinara sauce or whatever your favorite topping may be. Consider couscous or quinoa as a pasta alternative. And give it a chance, it isn’t pasta, it’s a substitute.

Don’t worry too much about the few fun and tasty items that still manage to make it onto your list, and even these can be healthy. Consider your favorite fruit or nuts as a snack. Just beware of nuts with additives like oils and salt. Consider your favorite fruit or nuts as a snack. Just beware of nuts with additives like oils and salt. Even some junk food snacks on occasion are not the end of the world, we are human after all, just be sure that they are the special treats and not the norm. And this is where the rubber meets the road and is critical. Stick to your list!! Do not stray at all, and to help with that, go shopping after dinner. Shopping on an empty stomach spells trouble for most of us. The main key to success is to develop a healthy list and then to stick to it.

What about a plan for the frequent traveler? That complicates things a little bit. Traveling disrupts our routine and unless you stay at a suite with a well equipped kitchen, the meal choices are limited to restaurant offerings and complementary hotel breakfasts. As far as your routine being disrupted, remember that the time before work starts is yours. If you get into the habit of doing some stretching and basic “quality” calisthenics first thing in the morning at home, it will be seamless to do the same thing before showering and heading out of your hotel room. If you have a say in your lodging arrangements, try to find a hotel with either a well-equipped fitness center, or one that has an arrangement with a local gym. If you travel to the same locations repeatedly, find the lodging that best fits your needs.

For dining on the road here is a good link to help you make good choices. http://traveltips.usatoday.com/eat-healthy-traveling-business-1476.html

It is tough to resist the fancy menu photos and the aroma of restaurants, but make a promise to yourself that you will follow the guidelines for the vast majority of your meals out. It isn’t the end of the world if you slip now and then, and especially if you are traveling with a group. It is nice to get together socially and have a nice meal, but make that the exception not the norm.

Most hotel rooms are equipped with a drip coffee maker and a microwave oven. For a healthy breakfast, pre-package servings of oatmeal in Ziploc bags before leaving home. Sure, go ahead and mix in some cinnamon or chopped nuts and dehydrated fruit, or grab an apple once you arrive at your destination and chop it up to add in for some added flavor and vitamins. Consider making a quick stop at the grocery store and get some Greek yogurt and fruit like strawberries, blueberries or bananas. Mix them together and have a great high protein breakfast loaded with vitamins. 

I hope you feel the same as I do that we all benefit from being fit. We feel better about ourselves, we are less prone to injury, feel less stress, and ultimately, we are able to perform better in our efforts to save our stricken rescue subjects. I hope that in reading this you can take some, all, or even expand on these tips and start heading in a direction of improved fitness.

KEY LARGO, Fla. - Three workers in the Florida Keys died Monday morning (Jan 16) after they were overcome by fumes, authorities said. Miami-Dade Fire Rescue officials said they responded to reports of three people down. The victims were working at a road project.

A representative said a worker went inside a drainage manhole to see why the newly-paved Long Key Road was settling at that location. She said the worker got trapped inside the manhole and three other workers, a volunteer firefighter with Key Largo Volunteer Fire Department and two Monroe County Sheriff's Office deputies tried to help get him out.

The two workers who collapsed and the firefighter, who also collapsed after going underground, were pulled from the hole, authorities said. The two workers were pronounced dead at the scene. It took authorities several hours to recover the body of the third worker. The firefighter and deputies were taken to Mariners Hospital in Tavernier.

The firefighter, identified by relatives as Leonardo Moreno, was then airlifted to Jackson Memorial Hospital's Ryder Trauma Center, where he is listed in critical condition.

"A firefighter had an air pack on," Monroe County Sheriff Ramsey said. "He found the hole too small, so he elected to take his air pack off and go inside the hole to attempt the rescue."

The deputies are being treated for non-life-threatening ailments. A fourth worker for the contractor was treated at the scene.

Cause of deaths will be determined by the Monroe County medical examiner.

A woman who lives near the manhole told Local 10 News that the area has smelled of rotten eggs for the past couple of months.

The contracted workers were in a 15-foot hole and it's believed that a build-up of hydrogen sulfide and methane is to blame for the deaths.

"There's no sign of any pre-venting going in, and obviously going into a contained environment where there is gases can be deadly, as we unfortunately found out today," Ramsey said.

Records show that the contractor was fined for an incident at a manhole in Collier County in 2002. In that case, OSHA said workers were exposed to hazardous conditions.

UPDATE: We are glad to report that the firefighter involved in this incident has been taken off the ventilator and is breathing on his own with no neurological deficits shown so far. This information is according to the latest update on his gofundme page https://www.gofundme.com/leomoreno

SOURCES: WPLG Local10.com and Firefighter Nation.

Our sincere thanks to Bud and Catherine at Skedco, Inc. for donating new Skeds with Cobra buckles to our Roco Flood Relief Fund. These Skeds will be sold at the very special price of $500 with 100% of the proceeds going to assist Roco team members who have lost their homes in recent flooding.

Normally selling for $759 each – our FIRST 10 callers will receive this special price of only $500 for a new Sked System with Cobra buckles. You can support our Roco Flood Relief Fund and get a great new Sked for only $500 thanks to this generous donation from Skedco. Again, it’s for call-in orders only– first come, first served! So call now 800-647-7626 and ask for Lisha or Teresa!

Guest Eddie Chapa gives an interesting inside look into the world of technical rescue for offshore operations and the complications that are faced under such limited conditions.

On top of all the hazards faced during land-based rescue efforts, Eddie brings to light the other factors such as weather, sea state, medical and extended care support, transportation, and equipment considerations that compound these already difficult tasks.

http://www.rocorescue.com/podcast/04-Off_Shore_Complications.mp3

Roco also has a library of podcasts with discussions on other topics such as confined space, the new OSHA 1926 Construction standard, fall protection and many more. Click our podcast icon below for instructions on how you can subscribe to RescueTalk™ podcasts and listen at your leisure.