There are tens of thousands of aerial apparatus in service in the United States, and every department has its own take on how they are used in the fleet. Standards and guidelines exist to keep everyone safe, and prudent fire chiefs make sure operators are well versed in them, but there is room for ingenuity in aerial use.

One northern New Hampshire department has trained on using its aerial as a boom to help extricate obese medical patients from multistory buildings. A department in Pennsylvania uses its aerial as a decontamination station, the platform nozzles its shower heads. A volunteer department in Minnesota uses its aerial to illuminate night scenes and to give incident commanders bird's eye views of scenes for size up and strategizing.

Then there's traditional rescues of people from burning buildings, like the one firefighters in Washington, D.C., effected to boisterous applause from the gathered onlookers on the sidewalk below.

Joseph Mercieri has first-hand experience helping to extricate a 500-pound woman with a cardiac emergency from a multistory building with hallways too narrow to accommodate her and the cot. When he was with the Bristol (Conn.) Fire Department, he had his crews take out the window and its casing, and made a rigging system and boom, using the 80-foot Pierce aerial like a crane to extract her from the 3-story apartment building and lower her to an awaiting ambulance.

"It worked extraordinarily well," Mercieri says. "We had trained for just that scenario, and it did what we wanted to do."

He was so impressed with the technique, Mercieri took it with him when he took command of the Littleton (N.H.) Fire Department. His staff of eight career firefighters and about a dozen call members train on how to use his department's American LaFrance 100-foot straight-stick aerial as a boom to assist with EMS calls.

"We practice proper rigging for using our aerial like a boom," Mercieri says. "Some manufacturers want you to attach webbing to the rails and not the rungs, so you have to know your aerial's capabilities."

The boom technique also proved useful in rescuing an arborist pinned by a 3-foot-diameter limb high in the tree. Firefighters used the aerial to swing the limb away from the pinned man and lower it safely to the ground, freeing him and allowing rescuers to extricate him.

While Mercieri has yet to employ the boom technique in Littleton, he has used the aerial for an effective water rescue. Rescuers used the aerial for access to the banks of a swift river in which a young child had been stranded on rocks. Rescuers placed the aerial down the river bank, over rugged terrain providing egress to an area from which they could deploy.

Littleton firefighters also use their aerial for anchoring points for rope work. Deployed stabilizers, or outriggers, make excellent places from which to secure webbing and ropes for high-angle and below-grade rescues.

Littleton's aerial is dispatched on first-alarm structure fires, box alarms, water and technical rescues, and motor-vehicle accidents, but not for lane blocking. "We have state police for that," Mercieri says.