What is in this article?:
- How to train first responders for structural-collapse rescues
- Monitoring the incident site
The structural collapse environment requires special considerations for responders to identify hazards and manage patients.
(Appeared in print as "Out of the rubble")
Extricating patients from a structural-collapse environment requires responders to work in unfamiliar and hazardous conditions. The structural integrity of the buildings are often compromised and material weaknesses and failure points often are not visible. Recent disasters around the country have demonstrated the complex circumstances in which firefighters and responders are required to work to extract patients trapped in damaged structures.
The fertilizer plant explosion on April 17 in West, Texas, created a shock wave powerful enough to remove the side of an apartment building and inflict significant damage to a nursing home filled with residents. The EF5 tornado on May 20 in Moore, Okla., leveled residential homes and damaged commercial and public structures, including the an elementary school. Heavy equipment working on a building demolition in Philadelphia caused a building to collapse onto an adjacent Salvation Army Thrift Store killing six and injuring 14. The last person to be rescued was pulled out of the rubble 13 hours after the collapse had occurred.
The structural collapse environment exposes responders to many hazards for which they must consider a variety of issues in order to ensure their safety and the safety of those trapped inside. It is imperative to have an understanding of the unique challenges and hazards that exist while trying to perform complicated or extended extrication techniques at an incident site.
Using a multi-hazard safety plan
An important question to consider arriving on scene is to determine why the structure collapsed. This central and important piece of information will drive other decisions. Did the building spontaneously collapse, did some outside mechanism cause the collapse (such as the demolition work in Philadelphia), was terrorism involved, or was it a gasline explosion?
Rescue personnel conducting extrications at structural collapse incidents need to follow a multi-hazard safety plan as their guide to the basic elements of safety for a variety of incidents. The acronym to use is LCES.
L: Lookouts. This is normally the function of the dedicated safety officer. Complex structural collapse environments need to designate a safety officer to be an objective observer not involved in the “hands-on” portion of the operation. They are assigned to watch over the entire operation, identifying potentially dangerous situations and mitigating them before they become disastrous. Responders tasked as the safety officer must resist the temptation to become involved in the tactical operations itself and requires extreme self-discipline. They must identify and anticipate safety issues in advance and warn the rescuers that are focused on the extrication. This safety officer must take a wholistic view of the incident site and realize that success of the extrication depends upon the ability to identify and counter hazards before they become problems.
C: Communication. The communications on site must be clear, concise and organized on radio channels based on function. Channels should be identified for command, tactical and other special radio channels, as required. These channels are responders’ lifeline to resources, support, medical assistance and safety. A common evacuation signal should be understood by all responders on scene, to include police, EMS, and public works. The following Emergency Alerting System is suggested to be used on scene in the event of problems at the incident site:
- Evacuate: 3 short blasts (1 second for each blast – think Run-Run-Run)
- Cease Operations: 1 long blast (3 seconds in duration)
- Resume Operations: 1 long and 1 short blast
E: Escape routes. When working in a structural collapse environment, responders must pre-establish escape routes to an area of safe refuge if the structure begins to exhibit signs of further structural collapse. These areas may be along a path where emergency shoring has been constructed, and it might not always be the most direct route out of a structure.
Extrication operations within a structural collapse are often dynamic and constantly changing. The situation can change as a result of external forces or as a result of the rescuer’s action. The escape route and plan should be constantly updated to reflect changes in the situation.
S: Safe zones. Safe zones, also referred to as “safe havens” are the pre-established areas of safe refuge, safe from hazards. This could be a designated area outside the incident site or agreed upon safe areas within the incident site. Responders working on the extrication of a trapped patient should consider the escape routes mentioned above and also consider where safe havens exist within the structure. If responders have to travel through unstable parts of the structure to get outside, it may be better to make it to a safe zone. Safe zones should be clearly marked and identified and personnel accountability reports conducted once you team evacuates to a safe zone.