I’ve heard many stories that make me think long and hard about the use of an aerial apparatus during vertical rescues. Why, for example, would a department even consider using an aerial to lift a patient? Decisions like this drive me a little crazy (OK, maybe a lot crazy), especially when it goes against everything we’ve been taught about vertical rescues. Has the safety of the rescue team, the patient and the equipment been carefully factored into the decision to use an aerial in this manner? What are the consequences and liabilities if something goes wrong?
Perhaps some key guidelines for how to perform successful emergency rescue operations should be dusted off, reviewed and applied to this particular subject. Aren’t we all taught at some point in our training to 1) protect personnel, 2) secure or stabilize the incident (basically making sure the scene is safe) and 3) preserve property (preventing unnecessary damage when we can)? Sound vaguely familiar? Mitigating risk should be everyone’s top priority, especially the incident commander and the safety officer. So let’s discuss how our key guidelines can be used to make safe on-scene decisions, especially when aerial apparatus and vertical rescues are involved.
Me, You & the Other Guy
Scene safety equates to personnel safety—now hold that thought for a moment, go back to the opening paragraph and ask yourself, “Why would a department consider using an aerial to lift a patient?” Do you think the safety of the rescue team and the safety of the patient have been factored into this decision? Of course not! But the bigger question is, why not? Whoever made the decision to use an aerial as a lifting device was not embracing the me-you-other-guy guideline and is therefore putting responders, patients and bystanders in harm’s way; in other words, they’re introducing an on-scene hazard, which ignores the second guideline—securing the scene and making it safe—as well.
Another question: Why didn’t the safety officer shut down the scene? In reality, if activity on the fireground has gotten to the point where someone like the safety officer has to step in, it’s already too late because the department and its personnel are already in a vulnerable position; valuable time and energy has already been wasted. This is one key reason why we adhere to things like preplanning, risk management, SOPs/SOGs, training, etc.—all of these concepts are meant to work together to protect our personnel from injuries and our departments from lawsuits.
Preparing for the Unexpected
We should know what’s going on within our response area at any given time, then prepare and train for the unexpected. That’s where preplanning and risk management come into play. We’re probably all very familiar with the types of structures (residential, commercial or industrial) that are in our area because they’re fixed assets. But what about new building construction or road projects or plant turn-arounds? All of these could potentially yield a situation where a vertical rescue may occur. And, let’s face it, vertical rescues typically fall outside of many departments’ realm of daily responses, thus falling into the realm of “the unexpected.” That’s why effective training is so important. Whether it’s conducted at a training facility, within your own department or with mutual-aid companies, training helps prevent departments from ending up in situations where responders and others may get hurt.
So, what type of training is the most appropriate for gaining valuable insight into vertical rescues? Confined-space, trench rescue and rope rescue classes clearly teach how to safely and effectively use an aerial as a high-anchor point during vertical rescues. These classes, as well as recognized references (e.g., Technical Rescue: Trench Levels I and II by Scott Richardson), reinforce the dangers of using heavy construction equipment to rescue patients.
Let me make one thing clear, though: Aerial apparatus can be used as an anchor point, but not as a lifting device. Why? One reason is that a trained team moving a patient via a haul system that’s anchored to an aerial would more than likely feel restrictions in the system and fix any problems without doing harm to the system, the patient or other responders. Conversely, if the team used an aerial apparatus as a lifting device, the aerial (or the aerial operator) would not feel any restrictions and may cause serious damage.
Note: If your department isn’t comfortable with constructing haul systems that are used in tandem with an aerial as a high-anchor point, then pursue basic rigging classes and train to become proficient in this skill. Or try locating technical rescue technicians who can respond with you and train with them regularly. Then take what you’ve learned from the classes and the training, and develop department SOPs/SOGs that clearly detail how to use the aerial apparatus (and who can use it) as a high-anchor point for vertical rescues.
A Question of Property Protection
So lets’ go back to the basics again: After sizing up a vehicle crash and ensuring scene safety, we check the doors and windows to see if we can gain access through them before picking up a tool (remember, “try before you pry”), right? Isn’t that the same protocol for an incident involving a structure (we check to see if there’s an unlocked door or window that could afford us easy access)? And what are we trying to accomplish by taking these steps? We’re trying to save time and minimize staffing levels and property damage. But whose property are we conserving in these two instances? The patient’s (or property owner’s), right?
But what about our department’s property? It’s our responsibility to use our department’s tools and equipment properly too—especially our apparatus. Damaging or losing hand tools is one thing, but sustaining damage to an apparatus because of improper use is a whole different (and far more expensive) ballgame. Are you willing to take that gamble? More importantly, is your department willing to gamble their valuable piece of apparatus and/or risk severely injuring or killing someone?
Hydraulics & High Risk
Fire department ladders and towers are no different hydraulically than commercially available pieces of equipment, such as backhoes, excavators and cranes. Each of these is designed with a specific function, and each delivers consistent results based on their design integrity. For instance, a 28-ton excavator with an 8.3-L diesel engine is capable of generating 340 horsepower and can swiftly dig out more than a cubic meter of dirt with ease. It does this via a pair of hydraulic pumps and pistons that can generate a digging force of 18 tons at the bucket. So, if this excavator is capable of moving 1 to 1.5 tons of dirt in one bucket, can you imagine the same piece of machinery moving a human who weighs 180 lbs.? The machine can’t even register such a small amount of weight. It’s comparable to stepping on an ant: We don’t feel anything under foot because there’s no mass or resistance. The point: The hydraulic system of a heavy piece of machinery (the lift cylinders and the systems used for ladder extension, retraction and rotation) can’t feel restrictions placed upon it by outside forces if those restrictions are, by comparison, so minimal by that they aren’t registered by the machine. And if the restrictions don’t register, the aerial can severely damage or destroy litters, ropes and hardware.
By pulling or pushing your aerial’s control lever, you can set in motion a chain of events that you can’t stop or reverse—actions that could result in serious injury or death to a responder or patient. This is why you must have a firm understanding of your aerial’s capabilities. Remember: We’re talking about tons of force (in comparison, the force needed for destructive testing of a carabiner is approximately 11,390 foot-pounds or 50.7 kN), so why would someone feel that it’s OK or safe to lift a patient with an aerial? It’s a function that clearly falls outside its intended design scope.
Leave It to the Pros
In addition to the power force that can be applied by the machinery, there’s the danger of lateral forces and their possible consequences (i.e., structural failure).
We’ve all seen the “things gone wrong” types of TV shows and YouTube videos where a piece of heavy equipment ends up in a precarious position. And, let’s be honest, we’ve all snickered and exclaimed “what were they thinking?!” without really understanding all the contributing factors. Load shifts, metal fatigue or failure, ground instability, overloading, equipment misuse and yes, even operator error, are some common factors. Some of these incidents involve professionals who have significant machine time and training, so it should make you stop and think: If a serious event can happen to one of these guys, what’s going to prevent one from happening to me? Yep, being a firefighter does not automatically make you immune to these types of situations.
Professionals who operate heavy equipment deal with moving and lifting heavy loads day in and day out, and they’re trained to watch and listen to their machines and make adjustments based on their observations. They’re also responsible for checking the machine’s systems for routine maintenance and service. On the other hand, the fire service doesn’t use aerial apparatus every day to lift anything (nor should we), therefore we don’t have nearly the same level of experience as a heavy-equipment operator.
Knowledge through Research & Training
So, are any warning bells going off yet? Are you willing to jeopardize your safety, the safety of your fellow responders and that of your patient(s) by using a piece of equipment for an activity that clearly falls outside its design scope?
And how about the operator—how well does he know his equipment? How well is the apparatus maintained and serviced? What type of training does he have? These are all questions that should not be taken lightly.
Answers to questions about aerial capability, safety, maintenance, required training, etc., can be found through a little research and a lot of training. Not sure where to start? Review your aerial’s specifications and the manufacturer’s information about exceeding tip loads—and how lateral forces can lead to structural failure. Yes, you need to pull out the owner’s manuals that came with your aerial and read a little. You may even consider contacting your manufacturer’s rep to pick their brain. Remember: You aren’t the only department that has that particular model of aerial. The rep may have helpful insight based on what other departments may have experienced (good, bad or ugly). Use them—they’re an invaluable information resource. There are also instructor-led courses available, as well as books and DVDs that teach proper and safe operation of your aerial.
Of course, you also need to build upon your own experiences with your apparatus. To do this, create training scenarios that require you to position your aerial from different vantage points, then position the aerial’s tip directly over the proposed work area (where the “patient” is supposed to be). Remember to keep about 15 feet of clearance to allow for sufficient room to negotiate, should you need to. Then check the tip capacity chart (on the turntable) to ensure that your apparatus can support at least 500 lbs. at your current angle and extension. If within capacity, then return the aerial to the ground and rig the anchor point and system. Take photos and notes of each scenario—do whatever you need to do to ensure that you become proficient with the apparatus as an anchor point. Clearly understand that the haul system and its components used to lift the patient should be kept in line with the center of the aerial. And never rotate, extend or retract the aerial with a person on the system!
As we all know, training scenarios such as these aren’t conducted in a vacuum, you work in concert with your safety officer and fire chief to determine the best way to mitigate risk on responses involving vertical rescues with your aerial. Using what you’ve learned through your training scenarios, you can contribute to the development of (or revisions to) SOPs/SOGs that your department will be able to use to develop their vertical rescue skills. The notes and photos that you recorded during training will become valuable resources that can be used as a basis for further training, which can be modified or adjusted accordingly to ensure your department delivers safe and effective patient care.
And what about those classes that you need to take (or have taken) to help develop your vertical rescue skills—who teaches them? Yep, those instructors are valuable resources too. In most cases, they’re perfectly willing to answer questions in or out of their classrooms, or they can point you to other resources that can help you develop needed skills sets for properly using your aerial.
Lastly, communicate with your department members. Discuss what you’re trying to accomplish by using the aerial during a vertical rescue, and share what you learn with others.
As an instructor, I’m very passionate about my students obtaining the right technical rescue training and using it correctly—after all, their safety and that of their patient are priority #1. We (as in instructors) must make sure that what we say in the classroom is clearly understood and does not contradict widely-accepted industry practices. We also need to foster an environment that allows our students to challenge us—to keep asking questions. It’s how we learn, how we embrace change and how we keep safe. So I encourage everyone to keep asking questions—the answer you receive might just be the information you need to keep your department from ending up on the evening news.