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. 

NFPA has started a process of grouping related standards into one volume. For example, it has now grouped NFPA 1983, 1858, and 1670 into one volume, NFPA 2500, “Operations and Training for Technical Search and Rescue Incidents and Life Safety Rope and Equipment for Emergency Services.”

So, NFPA 2500 will include all three of these standards. However, NPFA 1006 “Professional Qualifications for Technical Rescuers” still remains a separate document.

According to a blog post by CEO Loui McCurley of PMI, one of the most noticeable changes will probably be on equipment that will now be marked with NFPA 2500 instead of NFPA 1983. NFPA has decided to include the old standard numbers as a reference. For example, equipment previously would have been marked:

                                    NFPA 1983 (2017 ED)

It will now look more like this…

                                    NFPA 2500 (1983) 2022 ED

There will be a “G”, “T” or “E” to indicate General Use, Technical Use or Escape.

The big change is that as of Spring 2023, manufacturers must stop selling equipment marked to the 2017 edition of 1983. Retailers will still be able to sell the equipment until their stocks are depleted.

Your next question might be, “Will users be required to switch to the new NFPA 2500 marked equipment?” Or, “When must I stop using NFPA 1983 marked equipment?”

There is no NFPA requirement that says you have to use or buy equipment meeting the most current version of any standard. Ms. McCurley indicates that the good news is that there were not significant technical changes to the standard, so most all equipment properly certified to NFPA 1983 (2017) will also meet the NFPA 2500 (2022) standard.

Thank you to Loui McCurley, CEO of PMI, for providing the reference material here. Several videos about this topic are available at www.pmirope.com.

Additional Resources

• Q&A: 11mm Rope and NFPA Requirements

• Confined Space Rescue Types Chart & Compliance Guide
  
  
  
  
  

We are often asked, “How should I clean my rescue rope?”

First and foremost, always follow the manufacturer’s recommendations for cleaning and caring for your rescue rope. Your rope is a critical link in your rescue system, and it should be treated accordingly.

Excessive dirt and grit on your rope can lead to wear that reduces a rope’s strength and lifespan – so it’s important to clean your rope when needed. 

Here’s what NFPA 2500 says about cleaning and decontaminating rope:

Ref: NFPA 2500: Standard for Operations and Training for Technical Search and Rescue Incidents and Life Safety Rope and Equipment for Emergency Services, 2022 Edition - Chapter 32 Cleaning and Decontamination (NFPA 1858)

32.2.3 Routine Cleaning Process for Life Safety Rope and Webbing

32.2.3.1 The organization shall determine its requirements for when rope or webbing shall be cleaned.

32.2.3.2 In the absence of manufacturer's instructions, the cleaning procedure shall be as follows:

1. Remove as much debris, dirt, and mud as possible at the scene.
2. Rinse off any excess dirt with a hose.
3. Soak the rope or webbing for a minimum of 30 minutes in a plastic tub of water with mild detergent added.
4. Rinse the rope or webbing by pulling it through a rope washing device twice.
5. Hang the rope or webbing in a cool, shady place to dry.

32.2.4 * Decontamination of Rope and Webbing (* references additional information in the Appendix)
(A.32.2.4 Biohazard cleaning agents can have an adverse effect on the strength of software products. The organization should determine the risk versus benefit of excessive decontamination of rope. At some point, it is best to take the rope out of service.)

32.2.4.1 The organization shall determine requirements pertaining to rope or webbing being taken out of service due to contamination.

32.2.4.2 Rope or webbing that has come into contact with blood or other body fluids shall be decontaminated using detergents or cleaning agents approved for removing biohazards according to the organization’s protocols for decontaminating PPE.

Here’s what PMI says about cleaning and decontaminating rope:

WASH IT – You can wash dirty ropes by hand or in a front-loading commercial washing machine using cold to warm water with a mild soap. Non-detergent soaps are best. Soap should not contain any bleaching agents. And PMI has a product called “Rope Soap” that is recommended.

PMI recommends that top loading washing machines with agitators not be used – they tend to tangle the rope and might even cause damage from friction produced by rubbing of the synthetic rope against the synthetic agitator.

It’s also important to note that ropes may shrink up to 6% after washing – you may want to verify rope length periodically.

LUBRICATE IT – Ropes may dry out and lose some flexibility after washing. Occasionally, you can add a small amount of fabric softener (about a cup) to the rinse cycle. Do not use more than this as it may damage your rope.

DRY IT – Dry your rope in a clean, dry area out of direct sunlight. For best results, it should be laid in a loose coil or coiled around two objects in a low-humidity environment.

AVOID:

1. Using a commercial dryer.
2. Placing wet ropes on a concrete surface.
   (Moisture in the concrete can create a mild acid vapor.)
3. Exposure to exhaust fumes.

And, write it down. Remember to record the cleaning on your rope log.

STORE IT SAFELY – Store your rope in a clean, dark, dry environment, away from exposure to acids, other harmful chemicals, noxious fumes or other abuse. Make sure it is completely dry before storing.

Note: Even properly stored rope can lose strength over time, so it’s critical to store it properly!

DECONTAMINATION – Disinfection of a rope may occasionally become necessary, such as when exposed to bloodborne pathogens. PMI recommends following the NFPA standard for cleaning rescue gear of bloodborne pathogens.

Prepare a solution of 60ml (approximately ¼ cup) of household bleach for every 4 liters of tap water (approximately 1 gallon). Soak the rope for 10 minutes in the solution and then rinse or wash the rope. The rinsing cycle is critical to prevent any damage to the rope from the bleach.

Note: It is vital that the bleach be thoroughly rinsed from the rope. And, repeated uses of bleach can cause damage to nylon fibers – use of bleach to disinfect should be used sparingly and only when needed.

Again, your rope is a critical part of your rescue system. It deserves your close attention in care, storage, cleaning, use and inspection. And, as always, if there’s any doubt – throw it out!!

Additional Resources

• Service Life of Rescue Equipment
• How often should I replace my rescue harness?
• Marking Rescue Hardware
  
  
  

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