Many rescue scenes (and teams) are plagued by confusion because of too much communication. And, if you have three people assigned to do a task, each one will have his or her own idea of how it should be done, where the system should be anchored, etc. Many times the discussion that follows eats up valuable time and slows the team’s ability to get rescuers into a location and get hands on the patient.

This drill is designed to instill confidence among team members, to ensure that rescuers understand their responsibilities at the scene and to help rescuers understand that there are different ways to accomplish the same goals safely. It also helps in getting rescuers to look at the entire scene and understand where their assignment fits in the big picture. It encourages team members to anticipate and solve their own problems.

1) Assign a safety officer/drill manager.

2) Locate a simple vertical simulated space to enter or a balcony or roof edge. The goal is to lower the rescuer into an area.

3) Safety officer/drill manager describes the event to the team and assigns task(s) to each team member.

4) Instructs the team that they are not allowed to speak unless a dangerous condition is observed.

5) Instructs team members to gather the equipment necessary to accomplish their job or task. (Remember No Talking!)

6) Once team members have the needed equipment, move them to location and let them start rigging to get rescuer into the space or over the edge.

7) Once rescuer is lowered into area, leave systems rigged and debrief entire team on the rigging, the order that it was done and what could be done differently.

The difficulty of this drill can be increased by doing an entire simulated rescue or adding SCBA/SAR to the station requirements. You will find that a lot of unnecessary chatter that occurs at rescues will be reduced. It will allow you to see who truly understands “where and how” each component of a rescue system fits in the overall operation. It also encourages rescuers to look at the big picture and anticipate what, where and when they will need to have their assignments completed without waiting for direct supervision.

 

Next in this series: Quick Drill #14 - Knots Challenge (Advanced)

 

By Pat Furr, Safety Officer & VPP Coordinator for Roco Rescue, Inc.

Oxygen-Depleted Atmospheric Hazards in Confined Spaces

It will take your breath away! This is a phrase often used to describe tremendous beauty, or exhilaration. However, in an oxygen-depleted environment, this phrase has a much more ominous meaning. The emotion it elicits is hardly pleasant and joyful. Confusion, panic, impending doom, and okay... maybe even euphoria, which has been reported in near drowning cases, but the euphoria is a late onset emotion once the brain is deprived of oxygen. Suffice to say, having your breath taken away in an oxygen-depleted environment is never a good thing!

In my prior career with USAF Pararescue, I underwent regularly scheduled physiological training in an altitude chamber; otherwise, known as a hypobaric chamber. This was used to train me to recognize the onset of hypoxia (low physiologic oxygen content) and the symptoms that are particular to me. The symptoms of hypoxia differ from person to person and mine were pretty subtle. A loss of peripheral vision and color acuity, a slight warming of the sides of my neck and face, but other than those symptoms, I didn’t have any dramatic, obvious clues that I was in trouble. On at least two occasions, I had to be told by the chamber operator to don my oxygen mask. Once I did, the return to normalcy was profound! I was then able to jot down my symptoms as I remembered them. As I was undergoing my slide into hypoxia, I was given basic written tests to perform such as simple addition problems, connecting the dots, finishing incomplete squares and circles. In every case, I thought that I was doing really well on my assignment; that is until my oxygen mask was returned and I reviewed my work. FAIL!!! This exercise was intended to demonstrate to me the insidious nature of hypoxia and the unrecognized affects it has on coordination and judgment.

My experiences in the altitude chamber were educational and potentially lifesaving if I were ever exposed to a low oxygen environment. By having experienced my subtle symptoms multiple times, perhaps I would recognize them in a lower than normal oxygen environment and be able to take action to rescue myself. However, the environment that I was exposed to was probably in the range of 12% oxygen by volume give or take. In lower concentrations, say below 10%, the onset of impaired judgment would be so rapid that I would have little chance to recognize and react on my own behalf. In extremely low concentrations of 0-8%, there is little chance for anyone to take self-rescue actions. More than likely, the individual will pass out after only one or two gasping breaths. And, most importantly, my experiences were in a controlled environment with highly trained observers and emergency personnel standing by. This is not always the case during confined space entry operations.

How do we end up with depleted oxygen concentrations in confined spaces? 

There are several ways, but I am going to address two broad categories of occurrence: (a) planned, and (b) unplanned. Planned low oxygen concentrations may be unavoidable when doing entries that require an inert gas environment, such as certain types of welding or when doing work in a flammable or explosive atmosphere. By removing the oxygen, one of the three elements of flame is eliminated. There will remain fuel and possibly a source of ignition, but by removing the oxygen, there is no potential for fire in nearly every instance. Even during planned oxygen depleted operations, things have a potential to go wrong. Equipment failure is one possible cause. Faulty supplied air breathing systems can be the culprit. It may be as simple as a failed “O” ring, a faulty diverter valve, a lost connection on an airline respirator system, and many other links of equipment. Or, it could be human error – such as not tending airlines and causing the mask to be dislodged or pulled completely off; failure to change out bottles on the SAR cart; exceeding the safe time and egress requirements if using backpack SCBA; or again, any number of human failures. So you can see that even during planned low O2 entries, the potential for an incident is quite high. That is why OSHA 1910.134 has such stringent requirements for entry into an atmospheric IDLH environment.

It is the unplanned depleted oxygen environments that seem to cause the most incidents, however. Within unplanned low O2 entries, I would like to further categorize them into two separate areas.

1. Unplanned...in that the atmospheric hazard was thought to be controlled, but the potential for the hazard to appear was realized, and indeed created the low oxygen hazard. This could be due to improper isolation techniques or equipment failure.
2. Unplanned and unanticipated...this is the one that really seems to be causing problems. It may happen in permit-required confined spaces and also in non-permit required confined spaces. Upon evaluation, the entry team may have identified the space as non-permit required and assumed there was no need to perform pre-entry atmospheric monitoring. In several incidents, unbeknownst to the entry team, a prior entry team introduced an inert gas into the space for their particular work activities and failed in two ways. The team did not ventilate the space to remove the inert gas and test it afterwards; and, more importantly, the prior entry team failed to communicate the presence of the inert gas to any potential follow-on entrants. Or it may be that the information regarding the inert gas was communicated, but that information was lost in the shuffle. It may have never made it to the follow-on entry team – or that team may have failed to properly process the information. As you can imagine, this type situation has not only led to the demise of the unaware follow-on entrant, but also to several would-be rescuers that attempted rescue without any clue that the oxygen concentration was at a lethal level.

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So what is the solution? 

Although this simple step will not “guarantee” a safe entry operation, I know for a fact that by simply employing an atmospheric monitor to test for oxygen will save many lives. And, don’t limit the use of atmospheric monitors for entries into known or potentially low O2 atmospheres! That is an OSHA minimum, so why not exceed that minimum requirement and get into the habit of testing the oxygen concentration for ALL entries? And, not just for permit-required spaces, include non-permit spaces as well. You just never know. Also when monitoring, don’t forget to test the various levels of the space and all breathing zones. Various gases tend to stratify, some being heavier than air, and some lighter, while others are nearly equal and will diffuse universally. Maintain your monitors, calibrate them and bump test them as required by the manufacturer and use them regularly. They are easy to use and relatively inexpensive. They have saved many lives and will continue to do so, if used properly.

Be safe out there and monitor, monitor, monitor!

Although this article has focused on low oxygen atmospheres, we do not mean to minimize the potential for other hazardous atmospheres, such as toxic or flammable. It is just our experience that of all the hazardous atmospheres, it seems that low oxygen is the one that crops up more often and continues to claim a disproportionate number of entrants AND would-be rescuers.

By Pat Furr, VPP Coordinator & Corporate Safety Officer for Roco Rescue, Inc.

At the start of nearly every rescue class, I'll ask, “Okay, who here is afraid of heights?” Usually a few folks will raise their hands, but the vast majority don’t. I then qualify the same question by saying, “By afraid, I don’t mean that you are so overcome with fear that you cannot function – only that when you are at height you get a little case of the butterflies…” Then a few more hands will go up, but typically still fewer than half the class. I continue by adding that I’m always am a bit concerned for the folks that didn’t raise their hand as it means one of two things. First, it may be they are not being totally honest, but more concerning to me is they truly are not afraid of heights...and this is scary.

Human beings are born with an innate fear of heights. This is natural, and quite protective. I’m certainly afraid of heights, and I still get butterflies. It’s just that I’ve learned how to get those butterflies to fly in formation, so I can then function just fine at height. The day I climb atop a wind turbine tower or get that first peek over the edge of some serious exposure, and I don’t get that familiar feeling, that’s my sign to hang up my harness and ride the keyboard full time. This feeling is our not-too-subtle reminder that we do not have wings…and it is a healthy reminder!

There is a point to this, and I’m about to get there. Over the years, I've had some students with a serious case of YMIC (young male immortality complex). They will insist that they are not afraid of heights – or anything else, for that matter. I've found, when it comes time to go over the edge while hanging from that skinny little ½” kernmantle rope, backed up with a ½” safety line, our superheroes tend to freeze like the statue of Michelangelo. They won’t budge, can’t speak, or look any direction but down! Most often, these individuals gradually gain trust in their equipment; in the techniques they’ve learned; and perhaps, most importantly, in themselves. While they may never be "comfortable" going over the edge, they can still be valuable members of their rescue team. Some can be very strong in many other rescue skills such as knot tying, rigging, friction control, mechanical advantage, etc. They can also be excellent in logistics, developing action plans and other key areas.

First, know your weaknesses as well as your strengths. Then, identify your weaknesses and strive to make them your strengths.

A second tenet I live by is to enter a rescue knowing that you will be an asset to the effort. But sometimes, it’s not possible to do this, and having an unusual fear of heights may be one of those times. Avoid crossing the line from being an asset to becoming a liability – creating a situation in which your team would then have to deal with “two” victims. This is huge – especially in an emergency. And that’s what this article is all about. 

Before I go any further, a bit about egos. There is simply no room for egos during a rescue. When the call comes in, it’s about one person and one person only, and that is the victim. We all have our pride, but we need to “park it” until everyone, including the victim and the rescuers, are safe and sound. As trained rescuers, we all have something to contribute. Each of us has a role to fill in the rescue effort and be an asset to the overall effectiveness of our team.

So, how do we learn what our best role as a rescuer may be? Here’s one way. Practice as a team in simulated rescues that are scenario driven and mimic the types of rescues that your team may be summoned to perform. It is during these practice sessions that you will discover your strengths and your weaknesses. It is important for ALL team members to honestly critique each other as well as themselves to help determine the best way to fill the different roles on the team.

As your team practices more often, trends will start to surface. One rescuer may be particularly strong at climbing and can rig cleanly and efficiently while hanging from work positioning equipment. Another rescuer may be your “ace in the hole” for rigging anchors. A third may be so good at converting lowering systems to haul systems, that it’s an obvious choice. Then, there may be some that don’t shine at any particular skill, but are reliable haul team members or can run the SAR cart with the best of them.

All teams have a spectrum of performers, whether it’s a football team, a production assembly line or a team of cooks and chefs in a large restaurant. The same holds true for a rescue team. Some of the factors that affect performance may be physical. Let’s face it, our 5’4” 150-pound “Hole Rat” can pass through tight portals and operate in congested confined spaces easier than most 6’ 6” 280-pounders. Sometimes it’s mechanical aptitude. We see it all the time in training rescuers. Some folks have a natural mechanical aptitude and can understand and build rescue systems as if it were second nature, while others struggle to get it right on a consistent basis.

And, yes, a pronounced fear of height that may inhibit a rescuer’s ability to perform effectively at height is yet another factor to consider. Other things include leadership qualities, attention to detail, general physical strength, comfort with breathing air systems, the presence or lack of claustrophobia and the list goes on. The only way to realize and understand these abilities and limitations is to practice as a team – and practice often – while staying attuned to these individual abilities and limits. Understand them and use them to your advantage in determining who is the best fit for the various team member roles on any given rescue effort. And please, please do not take it personally. Again, we all have our pride and want to shine; however, we all can shine as a team! And the best way to shine as a team is to understand, as best we can, where each member best fits and can contribute most.

Remember, so much of rescue is about mechanical systems, safety, victim packaging and other easily defined considerations. As rescuers, I invite you to take it to the next level. Think about the harder-to-define factors such as individual team member skills AND limitations. Help each other as a team arrive at the best mix of the right people in the right positions – and all for the good of the victim!

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.
 

From the basics of First Aid/CPR to Basic Life Support for Prehospital Providers, Roco now offers medical training from our professional instructors and experienced emergency responders. This training is designed to provide hands-on instruction for those requiring these lifesaving skills as part of their job – particularly those who work in industrial environments. Students will be taught the critical skills necessary to provide basic first aid for medical, environmental and traumatic injuries.

• Take your emergency response team to the next level in patient care.
• Let us add this training to your next rescue or refresher class.
• Train at your location or ours…the Roco Training Center.

Our instructors will provide insight to medical considerations through experience gained working as nationally registered paramedics and critical care flight paramedics. These new courses can be scheduled separately or incorporated into your next Roco training.

• Basic Life Support for Prehospital Providers (8-hrs)
• First Aid/CPR/AED Training (5 to 7-hrs)
• Bloodborne Pathogens (1-hr)

For complete course descriptions click here. To discuss program options, call 800-647-7626 to speak with one of our instructors.