Written by Tracy Ertl, APCO Adjunct Instructor. She has been a dispatcher/field trainer with Brown County (Wisc) Public Safety Communications for 15 years. Dedicated to fire dispatch, she was one of the first civilianized fire dispatchers trained by her agency and focuses on 911 public education and critical incident containment.
A half-hour before quitting time, at the botton of a limestone quarry in Green Bay, Wis., everything was fine. Normal. Then the unthinkable happened.
What we discuss below is more thinkable than any fire dispatcher would want to imagine.
Several tons of limestone came rolling down the quarry wall and crashed through the cab window of a loader, partially burying the 48-year-old operator. Covered to his armpits in stone, the operator immediately suffered massive injuries to his limbs.
Mike Elliott, the company-employed, on-site EMT, called 911 for help that March 2007 afternoon. Trained to intervene, but helpless in this situation, all Elliott could do was watch from a distance and try to give the calltaker updates on the patient's status.
By definition, this wasn't a "pure" confined-space incident, but it had confined-space qualities, according to Rob Goplin, Green Bay Fire Department's training division chief. Goplin also works for a private contractor that provides confined-space rescue services nationwide.
The first call for help came in at 1640 hours. The telecommunicator who took the call had been employed by the Brown County Public Safety Communications Center for only a matter of weeks. It was her first rescue call with unusual circumstances. The fight for life started with calltaker Jennifer Winter linked to the EMT caller.
Veteran Fire Dispatcher Linda Safford had clocked 12 years as a telecommunicator, but nothing in her experience could have prepared her for this call. Fire operations are generally fast-moving. Technical-rescue and confined-space calls evolve much slower than a structure fire, which is what most experienced dispatchers anticipate. Safford made the dispatch, and the incident commander (IC) then orchestrated the crews and gave orders for equipment and resources. In that summoning, Safford was kept in the loop, which is our role.
Safford worked quickly, but anxiously, behind the scenes, summoning whatever she could to assist. "What I remember most was how the problem kept growing and how we had to be creative with responding equipment," she explains.
Crews on scene at the quarry appeared to have full access, but conditions actually restricted safe entry. Complications occurred: The stone was too heavy for the equipment sent. Machines failed to release the operator. Cables broke under pressure as rescue crews scrapped with everything in them to rescue the man.
In the end, the victim was rescued as Green Bay firefighters descended the unstable stone walls, crawling across the surface in teams of two until they reached him and dug him out.
At 1836 hours, the transmission finally came, "Extrication is complete. Patient is in the squad." The Green Bay quarry operator survived. He was not overcome by the atmosphere, but was trapped in an area not meant for continuous occupancy. It was a save. But it also involved risk--an undeniably dangerous rescue.
Background
What is a confined-space incident and/or technical rescue? As dispatchers, what can we think of to help? What can we anticipate in our jurisdictions ahead of time?
A confined space is defined as a space:
- Large enough for an employee to enter and perform assigned work;
- With limited or restricted means of entry or exit; and
- Not designed for continuous employee occupancy.
The limestone quarry accident is not considered a true confined-space incident because it does not meet all of these parameters, but it is the closest thing to confined-space incident my agency has encountered other than a rescue call in a ship cargo space, which we discuss later.
For many of us, our first recollections of a confined-space rescue incident might be the Baby Jessica rescue on Oct. 14, 1987. One that day, two-year-old Jessica McClure, who was playing in her aunt's backyard in Midland, Texas, plunged 22 feet below the surface into an abandoned well shaft. For two-and-a-half days, millions of people across the nation held their breaths as rescuers worked against the odds to get to Jessica in time. While she was trapped, she sang nursery rhymes, touching our hearts.
Television stations interrupted all programming when Jessica emerged from the well, strapped to her rescuer. Robert O'Donnell, a local paramedic, carried her out after 58 hours on Oct. 16, 1987, from an eight-inch opening. (Note: O'Donnell committed suicide in 1995 at the age of 37, and his death has been blamed on the effects of post-traumatic stress disorder.)
"These are what we call low-frequency/high-risk calls," says Steven Sellin, a member of Green Bay FD's Urban Search and Rescue (USAR) Team, which is trained to respond for structural collapses, rope rescues, trench rescues and confined-space rescues.
Jon Fredrickson, another member of the team, says, "(Confined-space rescues) are inherently dangerous. Then the problems are multiplied by the fact that we do not respond to them very often."
Examples of areas that could result in a confined-space rescue in your jurisdiction include tanks, vessels, ditches, silos, storage bins, hoppers, vaults, pits, ships, sewers, manufacturing companies, wells, trenches, aircraft, concrete trucks, grain elevators, manholes, pipelines, vats, milk trucks, railroad tankers and manure pits.
In addition, the U.S. Occupational Safety and Health Administration (OSHA) uses the term permit-required confined space (permit space) to describe a confined space that has one or more of the following characteristics:
- Contains or has the potential to contain a hazardous atmosphere;
- Contains a material with the potential to engulf an entrant (e.g., the limestone at the quarry could have swallowed the operator and/or rescuers);
- Has walls that converge inward or floors that slope downward and taper into a smaller area that could trap or asphyxiate an entrant; and
- Contains any other recognized safety or health hazard, such as unguarded machinery, exposed live wires or heat stress.
Industrial settings are notorious for confined spaces. A caller who reports someone "trapped in, stuck in or caught on" should raise red flags for the telecommunicator that this may be a technical rescue.
Comm Center Role
Much about confined-space rescues remains the same today as it was 20 years ago. But our knowledge and the way we approach them continues to evolve.
The intial scene size-up by calltakers should include asking callers:
- Are there any hazardous materials at the site? If so, is the hazard combustible, toxic, engulfable or entanglement related?
- What kind of environment is it?
- Is a material safety data sheet available on scene?
- What happened? ID the true cause.
- What are the atmospheric conditions?
- Is there a lack of oxygen or too much?
- Is there anything flammable?
- Are there structural stability issues?
- How many victims are there and what is their condition?
- How long has/have the victim(s) been unaccounted for?
- What is their specific location inside the space, if possible?
- What type of protection might the victim have on them, such as half mask, supplied air respirator?
- What are the possible physical hazards, such as sand or grain?
- If machinery is involved, has it been disconnected?
It sounds basic, but Goplin says that telecommunicators must absolutely verify that the person needing help is still indeed in the confined space. Many victims are removed prior to crews arriving, but callers won't always offer this information unless asked because of the emotion of such events.
Dispatchers should be aware that the rescue process will be time intensive. A considerable amount of time will be spent assessing the scene on arrival and in gathering resources before the actual rescue or recovery. Ultimately, all communication will be made from the IC to dispatch.
Would-be rescuers account for more than 60% of all fatalities in confined-space incidents. This is the area in which dispatchers can make the biggest difference in outcomes--by making sure our callers and those around them do not become victims.
"We need you to dissuade people from entering the space," says Goplin. "(Bystanders) want to effect a rescue, (but) in the process they can become another victim and make it more difficult."
The dispatcher must engage the caller and use their voice as arms, holding back that potential rescuer and/or victim from helping someone they love or work with--or even a stranger. Everyone wants to be the hero, explains Green Bay Battalion Chief Dan Truckey.
Farm silos pose one of the most common confined-space dangers. "The father goes into the silo and becomes overcome by atmosphere conditions. Who do you think is next? Of course, the oldest son. And next? The youngest son. One by one," says Truckey.
It's not uncommon for half a family to be wiped out during a confined-space rescue turned recovery at a silo. "They think they can make it in, effect a rescue. They are lost," says Truckey.
Grain silos are everywhere, and ethanol is becoming more popular. So telecommunicators in Iowa, Nebraska and Kansas should pay special attention because of the number of crop farmers.
Truckey attributes the recent lack of such incidents to greater education and increased standards and expectations by OSHA. Before OSHA regulations for confined spaces were issued in 1993, approximately 300 deaths a year occurred in the U.S., most caused by poor atmospheric conditions.
The IC must wear several hats on scene. One of those hats is to be the logistical person. The fire dispatcher helps to share that particular hat. Truckey describes the demands of an IC and why the dispatcher as logistical partner is critical.
"On scene, I have people knocking on both windows of the truck. Radios are blaring; the cell phone is ringing," says Truckey.
Goplin explains the need for telecommunicators to listen for instructions, make sure you understand your resources, ask for what is needed if the image is not clear and ask again if you're still unsure. "If I need a big loader, I don't want to end up with a rubber tired ditch digger," says Goplin.
"If you call and they give you a choice between two different sizes, tell them you want both. Give me both," says Truckey.
Resource coordination is critical, and it's an ongoing process, says Brown County Director of Emergency Management Cullen Peltier. To aid with this process NIMS (the National Incident Management System) has a new Resource Typing System to help jurisdictions organize available equipment by type. Generally, emergency management is for incidents involving the community or multiple communities, but Peltier says he doesn't mind being contacted if a dispatcher needs something special for an operation, and doesn't know where to get it. "Cranes, local rentals. Of course, I'll help. You can call me." He says others in his role would rather get a call than find out later that equipment that could have made a difference never made it on scene.
"The biggest thing we'll want from the dispatch center will be real good initial information," says Sellin. "The more we know going into the call, the better our planning. The top priority in technical rescue (and confined space) is the safety of the rescuers. Time will be taken to ensure we do not get tunnel vision and start rushing the operation and become unsafe. Hazards -- be it hazardous materials, utilities, special equipment needs--will need to be mitigated before operations start."
Time at one of these incidents is measured in hours rather than minutes.
Because such rescues are personnel and equipment intensive and because resources will become thin almost immediately, dispatchers must be prepared to move resources in the area. Move-ups and recall of personnel will be necessary. A move-up occurs when a crew and/or piece of equipment is moved to operate out of a different base to provide more consistent coverage. A recall is bringing personnel into work who would not normally be on duty.
Rescue Considerations
One of the terms telecommunicators may hear over the radio is lock-ou/tag-out. Telecommunicators need to understand this and other terms so they can document the call properly in the operation notes.
Lock-out involves making sure the machinery/equipment/power sources are at a zero-energy state. Actual locks are put on to ensure this, often double locks by the company and the responders. These locks are accompanied by a tag that alerts all on scene that the lock-out exists and it should not be reversed for the safety of responders and those being rescued.
It is a rule of rescue that all mechanical equipment must be isolated from power sources to make it inoperable. Most devices turn on in response to some type of automatic switch, such as a flow switch, float switch, timer or even thermometer. So if power remains on, the equipment does not sense when a person is in the space and will continue to operate mechanical devices.
Another important concept for dispatchers to understand and be able to differentiate is rescue vs. recovery. The IC must determine early on if the operation is rescue or recovery. "Is there viable life in the confined space? Can we bring this guy out alive?" explains Truckey. If the answer is "yes," it's a rescue operation. If the answer is "no," it becomes a recovery.
An operation can start out as a rescue and turn into a recovery. "This is tough," says Truckey. There is no time limit on a recovery. The safety of those doing the recovery is the priority. A lot of emotion can be tied to a recovery, and dispatchers need to be prepared to witness that aurally.
He discussed the recovery of one of the department's own lost firefighters in a house fire. "We all wanted to get him out of there, but once it turned to recovery, we had to ensure safety and get him out as we could."
Time checks by agency policy become critical in a confined-space or technical rescue. A time check is the announcement of time on scene by rigs or personnel inside a dwelling given at regular time intervals by agency protocol until terminated by the incident commander. The time checks are important in this type of event because of potential atmospheric problems and the need to monitor oxygen supply and rescuer fatigue. Because these types of operations can be long and because their focus is on several things at once, incident commanders rely on accurate time checks.
Telecommunicators will also hear the term metering, which refers to the ongoing monitoring of the levels of different gases within a confined space. By metering, the incident commander can be ensured that the atmosphere has sufficient oxygen levels and remains free of flammable and toxic vapors. This is the only positive method of ensuring a suitable atmosphere for entry. Metering spaces must be done not only before entry, but at all levels and continuously during entry procedures.
Ventilation is also important during the rescue to keep rescuers safe. Fresh air will often be pumped in to dissipate the effect of other atmosphere conditions.
It's important for dispatchers to understand the responsibility structure on scene.
The incident commander coordinates the entire operation and communicates directly with dispatch for needs.
The entry supervisor is in charge of entry to the space.
The attendant is outside of the entry space at all times and makes sure there are no other entrants, checks meters, ensures rescue ropes stay untangled, etc. The attendant stays in communication with entrant(s).
The entrant is the rescuer.
Some entrants will have a lifeline: a synthetic rope, an air tube or even a communications line, a hardwired sealed system used to navigate in unusual environments.
Incident Rate
Think you don't have many potential confined-space accidents in your area? Think again. A high percentage of "near" accidents are thought to go unreported, so the number of confined-space incidents is likely much larger than we will ever realize.
"There is not a communications center out there that doesn't (receive calls for confined-space rescues)," says Goplin.
Large industrial base areas contain numerous confined-space possibilities. Construction sites have trenches and ditches where confined-space emergencies commonly occur. With trenches and ditches, the walls have to be shored before a rescue can commence. To send a rescuer in without proper safety puts the rescuer at risk of being engulfed by the material. This is against basic confined-space rescue principles. This takes time, resources and coordination. Often, the victim does not make it due to suffocation.
Areas with new developments have water mains being installed at a depth of anywhere between 8 and 12 feet. A collapse of any of these will result in several tons of dirt covering a worker at high speed.
"Collapses are practically silent," says Goplin. "One or more workers can be covered in a matter of seconds without warning." In most jurisdictions, there is at least one active trench somewhere.
"This is a complex rescue," says Goplin. "We look at how much of the person is left above ground. If they are completely covered, we have very little time. We have tremendous problems with patient stability immediately. They develop compartment syndrome and bottom out on us."
Any agency with a port of call faces additional confined spaces inherent to ships and/or shipyards. Hazards include fires and explosions on board, falls and hazardous atmospheres.
Telecommunicators need to be prepared for frustrated, potentially enraged callers at such scenes because it will appear as though crews are crawling.
"There is a high potential for you to get more calls," says Goplin. "You may hear requests from incident command that you've never heard before."
Telecommunicators in a confined-space/technical-rescue operation should be prepared to obtain the following and any number of additional resources: thermal cameras; imaging cameras; air bags; cribbing/shoring materials; ventilation equipment; heavy equipment, including cranes, fork lifts, loaders, dump trucks, SCBAs; dive rescue equipment; special lighting; lighting towers; hazmat equipment; hydraulic tools; high-angle rescue materials, such as ropes; power tools; electrical equipment; and special communications equipment for hazardous conditions.
Conditions on scene can change rapidly. As a result, communication on scene may change as well. Some spaces have acoustic problems, such as echoes due to shape and construction. Use of SCBA can limit use of conventional radio equipment. Conventional radio communication is sometimes a potential ignition source for flammable vapors. Materials used in construction, such as reinforced concrete and steel, can prevent/limit use of radios.
Responders will sometimes need to use alternative means to communicate, such as cable intercoms, rope signals or public address systems.
Conclusion
Dispatchers need to be prepared to assist with all of these actions and more. Being prepared means knowing your agency's capabilities and how to get what you need, when you need it.
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