One late afternoon, a rescue truck arrived at a washed-out bridge where a pickup had been swept into the water and was lodged on its side against some trees. The force of the water trapped an elderly man inside the truck, at risk of drowning if he tried to open the door or window.

Rain fell heavily and steadily, posing the additional concerns of the truck being submerged or dislodging and being swept farther away from secure staging areas. Officers needed to act quickly, gathering information about the scene, the truck's stability and the passenger inside. They had to determine the best way to get to the truck, extricate the passenger and transport him back to dry land. They had to identify a team in the area with the equipment and personnel to perform water rescue. And the light was beginning to fade.

Rescue operations place special demands on first-arriving company officers, who must balance the complexities of site management with the intricacies of victim management in order to stabilize both effectively, efficiently and safely. Every situation presents unique challenges that can be overwhelming without a methodical, predetermined series of response actions designed to guide the officers' thought processes and decision-making.

Option assessment

Officers must survey the scene; assess the scope of rescue operations and safety precautions; and identify available resources such as personnel, equipment, mutual aid, and agreements with private-sector entities like construction and demolition companies and hardware or lumber suppliers. The state of the environment and condition of the patient demand different strategies and affect the first-arriving officer's responsibilities.

The first series of decisions identifies the goals for the operation and the tasks required to accomplish those goals. The ultimate goals are rescue and life safety, of course, but information must first be collected about environmental hazards as well as the location of victims and the nature of their injuries. The ever-changing nature of these factors determines the specific goals that must be met to accomplish a rescue. Officers should use their own observations of the scene and talk to witnesses and victims, when possible, to know how the scene came to its current configuration in the first place. This gives them a better understanding of the challenges facing them.

Hazard recognition and identification also precede rescue operations. Starting at the scene's perimeter, the officer surveys unstable or weakened structures, unprotected edges, and extreme environments that present dangers to rescuers and victims. The officer also identifies chemical hazards and decontamination requirements. As chemicals mix with and become masked by the environment, they can be difficult to detect without some idea of what to look for. Reliable witnesses can aid in chemical identification.

Proper channels

The mission at this stage then becomes to remove or mitigate all safety and security hazards. Hazards include civilian and non-emergency personnel who may interfere, with the best intentions — putting themselves, victims and rescuers in further danger. After this scene survey, the officer demarcates the operational zones, which may fluctuate as the operation proceeds. The officer must stay mindful at all times of these fluctuations and adjust operations accordingly.

With information from the initial size-up, the officer can determine the rescuers' PPE and other safety needs, and then begin to identify the ingress and egress routes, equipment requirements, and escape routes. Multiple patients require greater attention to the severity of injuries to prioritize operations.

When the victim is extricated, officers should order rescuers out of the hot operational zones and shift their attention from rescue to EMS support, delivering the patient to a safe location, either on-site or at an area hospital. As patients are transported off-site, officers should transmit patient information to receiving institutions, including the condition when found, the environment in which the patient was found, the present condition, MSDS sheets if applicable, and any other information the officer deems necessary to aid medical teams.

If a helicopter is required to transport patients, the officer needs to review hazards, identify landing zones and establish communications. This requires an awareness of any regulations, standards and policies governing helicopter use, including those of the FAA and NTSB, as well as local and state jurisdictions.

Once rescue operations are concluded, the officer must follow up and control the scene. He or she does this by denying all access to the site to prevent further injury, tracking all rescue personnel, collecting and inventorying equipment, and overseeing decon if chemicals were present. The officer then completes all required reports and documents.

The officer should hold a debriefing as soon as possible after the operation's conclusion, while the events are as fresh as possible. A systematic and thorough debriefing, often under the direction of an outside party with careful documentation, should cover both the positive and negative aspects of the operation. This helps to identify issues that arose during the incident that can be better anticipated at future incidents. The goal of the debriefing is to learn from the incident and further develop the team's efficiency, effectiveness and safety.

James Hyles is the rescue program coordinator for the Emergency Services Training Institute, a division of the Texas Engineering Extension Service of Texas A&M University in College Station, Texas. He also serves as rescue specialist for the Texas Task Force 1 USAR team and as a rescue adviser for the Bryan (Texas) Fire Department. Hyles has spent 28 years in the emergency response field, having served as a training officer/lieutenant for the Brazos County (Texas) Precinct 1 Volunteer Fire Department, and as a firefighter/EMT for the Mineral Wells (Texas) Fire Department. He also worked in the rescue operations at the Alfred P. Murrah Federal Building in Oklahoma City.