After locating a downed firefighter the packaging and removal process of the firefighter will be the next step. Packaging and removing a downed firefighter will without question be one of the toughest and most stressful operations that a firefighter will ever have to do in his/her career because we are now rescuing one of our own, the patient is no longer a faceless person but a fellow colleague and fellow brother.
After locating the downed firefighter a rapid and thorough size up of not only the patient but of the scene and conditions of the area were crews will be operating can make or break your RIT operation. A failed size up can lead to costly time delays or even worse causing your RIT team to be caught in a potentially life threatening situation (i.e. floor collapse, wall collapse, flashover, etc.)
Once the downed firefighter is located the RIT officer can start doing his/her size up, part of the RIT size up can include the S.A.F.E.S. acronym.
S- Size Up
Not only must the downed firefighter be sized up but the surroundings and location must be sized up as well, the use of a thermal imaging camera will pay huge divides in this situation. Things you want to look for in your size up should include:
- Location of the firefighter
- Conditions (fire and or heat) in the immediate area
- Condition of the downed firefighter (is he or she breathing? Is there face piece still on? Are thy pinned or entangled?
If you do not have a TIC or the TIC is rendered useless due to fire conditions or a malfunction of the camera the size up will have to be done largely by feel. If the TIC does malfunction the RIT officer should call for an additional one to be brought to there location immediately should one be available. A TIC is an asset during the size up, that can sometimes be used to establish weather or not the downed firefighter is breathing. If the firefighter is passing air through the SCBA (breathing) the air bottle should be cold, this will cause the air bottle and air line to show up dark on the image from the TIC. This is not going to happen all the time based on fire/heat conditions and the downed firefighter exposure to heat or fire. As with all use of the thermal imager the user must be able to interpret what they are seeing in the image based on the fire/heat conditions around them.
You also want to get a sense of what kind of condition the downed firefighter is in:
- Are they entangled? – do we have wire cutters to cut them out?
- Are they pinned underneath something? – are we able to free them with the tools, equipment, and man power we have?
- Do they have a face piece on? Is the SCBA or face piece they have on damaged? – do we have a way of getting this firefighter air? Do we have a new mask?
You also want to pay close attention to the fire and or heat conditions around the area of operation, is the area tenable, can we maintain an air supply to the victim and is there extra time to properly package the patient? Or are conditions rapidly deteriorating and we must remove the patient as quickly as possible? Remember the TIC may not give you a good indication of rapidly deteriorating conditions, only you experience and senses will give you a true sense of the heat conditions.
A- Assessment
Once you have located the downed firefighter you will want to complete a quick, proper, and thorough assessment of the firefighter to be removed. The best way to do this is to sit the firefighter up, one firefighter in behind the downed firefighter and on in front. Once you have the firefighter in position you can start your assessment, using the acronym
M. A. B. C. you can size use the air needs of the downed firefighter.
M- Mask- is the firefighters mask and regulator on and in place? Is it melted? Is it leaking air? There is not much point in attempting to transfill the firefighter’s air if it is going to leak out. Does this firefighter need his/her face piece changed out?
A- Air Exchange- Is the firefighter exchanging air (breathing)? The best way to tell this is to hold your breath and get your ear down towards the exhalation valve of the face piece.
B- By Pass- does the firefighters By Pass work?
C- Cylinder Pressure- What is the cylinder pressure of the downed firefighter? Do you need to transfill there air supply?
If the firefighter is found without there face piece on I would recommend utilizing the face piece in the RIT Kit, the reason for this is you would hate to go through all of the work to put the firefighters face piece on only to realize that it is defective and that was the reason for the firefighter having removed it in the first place.
F- Firefighter Needs
After insuring that the firefighter has an adequate air supply you can start to figure out what types of needs the firefighter will require to help with the extrication of the firefighter, the firefighter may only require to be extricated form the environment or he may require some additional equipment and or personal. Some of the additional firefighter needs maybe extensive depending of how trapped the downed firefighter is, some additional resources maybe as follow:
- Bottle jacks
- Pry bars
- Air bags
- Air tools
- Saws
- Rebar cutter
- Etc.
You may also require additional personal to help clear out clutter or ensure that a clear path is ready for the extrication of the patient.
E- Extrication
Once the firefighter has been given a positive air supply we are ready to package and extricate the down firefighter. The quickest way to remove the firefighter is to do a conversion of his/her SCBA straps into a harness. There is nothing fancy about the removal of a firefighter in distress, it is simply a lot of work and there is no real way around it. There are some things that can and will make the removal of the firefighter easier, some of the ways are:
- Utilizing a 2:1 mechanical advantage
- Using your tools to help drag
- Using the push pull method
Remember don’t waste valuable time doing the fancy a creative things the best thing for that firefighter is going to be getting them out of the IDLH atmosphere and into the hands of Paramedics, remember that the more simple you keep it the easier it will be to remember in a pressure situation.
S- Situational Awareness
Situational Awareness is probably the most overlooked part of the RIT process, but it is also the most vital. Firefighters tend to get caught up in the tasks of the RIT operation and tend to loose sight of what is happening around them. Maintaining that situational awareness is a very hard thing to teach firefighters, and it is an even harder thing to ask firefighters to do when they are focusing so hard on the monumental task in front of them. This is where the RIT officer must come in, the RIT officer must try to stay as “hands off” as possible to prevent getting tunnel vision and loose his/her situational awareness. Some things that you will want to constantly be aware of and monitor are:
- Heat Conditions
- Fire Conditions
- Air Supply of your crew and yourself, you may have to call a “freeze” every once in a while and have the members check there air supply.
- Monitor the progress of the crew; are they trying something that is not going to work? Do you have a different idea in mind? Are they making progress?
- Monitor the radio
- Give Command up dates as needed
- Do you need a handline?
- Additional resources? Try to stay 10 steps ahead of the game, don’t wait until something is needed before calling for it…… try to stay progressive
- Is there another/better way out of here?
Remember that the best thing that you can do for the downed member is to get the out of the building as quick as possible, your size up should be very thorough but also must be very quick. A proper a thorough size up can make or break your RIT operation or it could make the situation worse by creating additional downed members that must be rescued. The only way to become proficient at the task of a proper downed firefighter is through aggressive, realistic, and frequent training.
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Continuing the Discussion