Why don’t we work an 8-5, sitting behind a desk? Easy- we as firefighters love the constant moving and changing of every call, training event, and research study. Fluidity is the essence of the modern firefighter. The constant need to adapt and overcome is a tool that only experience and training can build. The highest risk/highest reward job function we as a fire service can do is rescuing one our own. This, in turn, must be the most fluid time of all. This article will cover the options available to rescuers to have the highest positive outcome. Certain facts have to be covered, in order to establish a basis for thinking. These come from the Phoenix Fire Department’s study after the death of FF Brett Tarver.
1. It will take on average 12 rescuers to save 1 downed firefighter
2. A 30 minute rated bottle will last 18 minutes during a rescue
3. It will take, on average, 22 minutes to get a downed firefighter out of a residential structure
4. 1 in 5 rescuers will become victims themselves
5. Total time in building for Rapid Intervention is 12 minutes
So, we know the first team must provide air and package, second and third team remove through closest point or the way they came in, while taking their own safety and air consumption into consideration.
Time in the IDLH, air for the victim, and safe removal is the keys for a successful outcome. There are many acronyms for Rapid Intervention- the article will give one, and discuss the options with each.
The RIC officer leads his team to the command post. The team does a RIC 360, and a quick plan is devised on entry points, exits, and primary/secondary plans. Another question to ask is “How long have the crews inside been working?” This gives a lot of information on a simple question. Information gathered includes each company’s LUNAR, based off of the Incident Command’s answer, strategy, and tactics.
A is for AIR.
As the RIC is activated, the primary function of at least 2 of the rescuers is ABCD. Air is the stand alone highest priority in Rapid Intervention. There are 2 cases I can immediately name that AIR was a contributing factor for the death of the firefighter- FF Brett Tarver (Phoenix FD) and FF Mark Langvardt (Denver FD).
Is the victim on air?
- Mask Integrity/ Seal intact
Level of consciousness
- Alert, Voice, Painful Stimuli, Unconscious
- With careful consideration, unconscious victims should be removed as soon as possible. Nothing inside of the structure can benefit an unconscious firefighter more than being outside the structure on the way to a medical facility.
Update the LUNAR
- With the “MAYDAY” being a last second, desperate cry for help, updating the MAYDAY can give the RIC Operations Officer/Incident Command an accurate portrait of what is going on inside. Consider it an “Internal Size-up”. This will allow command to determine the next appropriate flow for actions.
Check for Breathing/Spontaneous Respirations
- Purge the bypass. This will allow 2 things. First, it will show the integrity of the seal, and second, it will determine the progression of thought for how to secure AIR for the victim.
B is for Bottle.
- Checking the bottle pressure can be done based on the physical orientation of the downed firefighter. Bottle gauge, remote gauge, digital gauge, and (if equipped) Heads up Display (HUD) can all be used to determine the bottle pressure remaining.
The MSA air pack in the photo has all 4. By pressing the green Data button, the HUD will display the air pressure in the lights of the victims mask. This will also illuminate the other two gauges- digital and pressure. This information will control the next few steps.
RIC bags can be equipped with Spare Masks, 2nd stage regulators, and Universal Transfer Connectors (UTC, Trans-Fill, etc.). A full mask replacement is the most difficult for a stressful, low visibility operation. With training and practice, it can be accomplished by controlling actions and pace.
The UTC/Trans-fill should, in my opinion, be a last option. While training with them, the MSA air pack has an intake “pop off valve” that limits the air coming into the cylinder through this UTC. They can be rated at many pressures. If a RIC pack has a 4500 psi bottle, and a Firefighter pack is a 3000 or 2216 psi bottle, there will be a free flow (waste of precious air) out of this valve. While some air will reach the bottle, at best, it will balance the pressures between the 2 systems. My argument is simple- why not just use the mask, 2nd stage regulator, and 4500 psi you brought in with you to secure the most air to the victim. If the study previously mentioned (Phoenix FD) shows that the first team to contact the victim will not be the one to remove the victim, why waste time and air using the UTC? In further discussion, if the firefighter is equipped with a harness, Drag Rescue Device (DRD), or is placed into a hasty harness- why not remove the SCBA altogether?
Pro’s– less weight, less resistance when turning/making corners, less height when having to remove from window sill (Denver Drill), and smaller profile for wall breach/ vertical removal (Nance Drill).
Cons– might be only harness system for the drag, not equipped with DRD or webbing/rope for hasty, PASS if team has to leave for next team (can be solved with manual PASS attached to RIC Bag).
C is for Convert.
This is where a lot of the fluidity comes into play. If you have a system that you have mastered, whether rope or webbing, stick with it. Have a secondary system for a back-up. There are many options, I will cover a few.
Air pack conversion to harness
- Once you grasp the buckle of the waist strap, DO NOT LET GO!
- Slide the victim side to side to loosen. Lift leg onto shoulder to reattach waist strap under leg. Keep the button depressed to allow easy reconnection in limited visibility.
- For larger victims, drive the victim’s leg into their chest to reattach waist strap.
Webbing offers a wide variety for securing the victim and the RIC pack. The following are some examples:
- Webbing through shoulder straps
- Carabiners on handles- the handles on the sides of the MSA air pack are rated at 500 pounds and top hole rated at 750 pounds. This is a quick way to snatch and grab the downed firefighter.
- Chest wrap with webbing (also can be used when SCBA removed for ease of dragging, lifting, etc.)
- Secure the RIC bag in the integrated or hasty harness, chest strap, the lapel microphone opening of the jacket, jacket snaps, etc. These options allow for the SCBA removal with consideration for ease of dragging and lifting also. The hose in most RIC bags is long enough to reach from most attachment points on the trunk of the body.
D is for Drag
The victim has air and removal device in place. Now comes the most physically demanding- the drag. A second means of egress, while ideal, may not be an option. The search rope placed on entry will lead to a guaranteed escape route. Options exist for removal through a team approach. Rotating rescuers and management of personnel becomes essential for the officer. Transition/trade out rescuers, after strenuous activities (up stairs, down stairs, through debris, through wall breach, etc.), to get the most work, strength, and efficiency of each rescuer. This takes discipline of the crew to switch, during long removals, to allow for work and recovery, instead of one rescuer doing all of the work and using all of their air. Efficiency is the key to safe and rapid removal.
- A belt/harness attached to the webbing/DRD allows for power muscle use. Driving with the legs at a low angle allows for full strength of the legs through efficiency.
- The integrated DRD can also be utilized for rapid removal. This can be checked after air is applied to the victim by the rescuer at the head.
The options become endless when rescuing a down firefighter. Be fluid, adapt, and overcome. The ONLY way to become familiar and comfortable with any removal technique is to get out and train on them. Reading and seeing pictures adds no value in a true emergency. With the content of the article, remember, use what you have and have trained on. If none of these options are your first “go-to” in a down firefighter situation, make them your secondary or tertiary method.
I hope this has refreshed and sparked interest in your idea of victim removal. A lot of these techniques can be used a fire victim removal techniques also.