FALLING FROM HIGH PLACES
April 11, 2014
By Journal Staff
Two construction workers were thrown from a boom lift when it was struck by a freight train on Dec. 16, 2013, in West Des Moines, Iowa.
At the time of the collision, the two workers were in the passenger bucket of the lift’s articulating arm, which was raised next to the train tracks so the workers could access the underside of an on-ramp. An Iowa Interstate Railroad Train coming from the west struck the arm, throwing one of the workers 200 feet. The other was wedged on top of a pillar, hanging in place by one arm, 40 feet above the ground.
Members of the high-angle rescue team rushed to the crash site from a fire less than a half-mile away, carrying their equipment part of the way because their truck was blocked in at the fire. Once on scene, firefighters attached a mechanical rope system to the boom of a vehicle already located at the construction site to maneuver another firefighter beneath the bridge. He latched onto the construction worker’s harness so the man could jump into his arms.
The rescue took about an hour, and the worker was taken to the hospital with non-life-threatening injuries.
“In 27 years, this is one of the strangest calls I’ve been on,” said David Edgar, the assistant chief for West Des Moines Emergency Medical Services.1
High-angle falls happen all the time, every day, requiring the expertise of highly trained responders to bring the victim to safety and, at the same time, completing the rescue operation without harm to any member of the response team. These situations require close communication with emergency medical services, especially in high-angle rescue situations where falls from a great height present potential for injury or death.
At the first, first response level—the 9-1-1 center—a calltaker should be prepared to give medical Pre-Arrival Instructions (PAIs) while the caller is waiting for response to arrive, since falls from heights as little as 10 feet can inflict various short- and long-term injuries, including strains, sprains, concussions, fractures, cuts, dislocation, back injuries, concussion abrasions, heart attack, and dehydration, as well as other major trauma.
Calltakers should also put EMS on immediate standby for both the victims and the rescue responders, particularly in view of the following statistics from 2012:
•Fatal falls, slips, or trips took the lives of 668 workers.
•Falls to a lower level (below grade) accounted for 544 (or about 81%) of those fatalities.
•Of those cases where the height of the fall was reported, about one in four fatalities occurred from a fall of 10 feet or less.
•Another one-fourth of the fatal fall cases occurred from a fall of 30 feet.2
In a 1977 “Study of Impact Tolerance Through Free-Fall Investigations,” researchers at the Highway Safety Research Institute found that the major cause of death in falls—from buildings, bridges, and the occasional elevator shaft—was cranial contact. A large number of falls occurred at buildings under construction and were the result of workers falling from loose scaffolds or open beams. Many scaffolds and ladders are involved in falls from buildings being maintained or repaired, and this category also includes falls from roofs and eaves.3
High-angle rescue is a subset of technical rescue that involves specialized skills and equipment to reach victims above or below grade—where conventional interior rescue is not possible—extricate them, and bring them to safety.
There are three primary types of high- angle rescue: urban/structural, wilderness/mountain, and cave rescue. As a rule, urban rope rescue involves heavier equipment and is of relatively short duration. Cave and wilderness rope rescues involve lighter equipment with extended rescue times.
Whatever the environment, responders are dependent on the ropes used to protect and secure them (and victims) from falling and to gain access to and egress from the rescue operation. Other equipment includes anchoring and belaying systems (carabiners, harness, and pulleys), lowering and hauling systems (friction control or descent devices, rope grab devices), litter/stretcher work, and in some cases, the use of dogs, electronic search equipment, search cameras, and air sampling/monitoring devices.4
Wilderness high-angle rescue operations are frequently defined in terms of the types and steepness of terrain: the steeper the ground, the more difficult and more technical the rescue. The condition of the terrain (e.g., rocky, muddy, icy) is also part of the equation when determining the level of technical expertise required and the type of rescue equipment (e.g., stretchers, ropes).5
Urban search and rescue is considered a “multi-hazard” discipline, combining structure damage and collapse from earthquakes, hurricanes, typhoons, storms, tornadoes, and floods. These types of rescues also involve construction accidents and incidents involving suicidal threats, among others.
FPDS Protocol 62
Fire Priority Dispatch System (FPDS) Protocol 62: High Angle Rescue (Above or Below Grade) defines HIGH ANGLE Rescue as “rescue or extrication situation of person(s) from elevated buildings/structures/terrain where conventional interior rescue is not possible. Also, to effect rescue of injured and/or stranded person(s) in areas where normal access is unavailable or hazardous due to height and/or terrain.” According to Rule 2: Evacuations at greater than 60 degree inclination are considered HIGH ANGLE operations.
The first Key Question determines the type of building/structure/terrain involved and whether the situation has occurred above or below grade. Determinant suffixes “A = Above grade” and “B = Below grade” correspond to the description the caller reports. A new “W = Above water” suffix has also been added in v6.0 to allow agencies to allocate different resources for reaching areas above water.
Above grade is the portion of a building that is above ground level.
High-angle rescue situations below grade (the portion of the structure below ground level) involve evacuations of people trapped in ship holds, barges, confined spaces, tunnels, and sewer and piping systems.
The second Key Question asks the caller “What is her/his approximate distance from the bottom/top?” Obviously, while asking this question, the EFD should choose the appropriate word—“bottom” or “top”—to fit the incident described.
After identifying the type of building/structure/terrain and approximate distance from the bottom/top, the Key Questions are designed to determine whether the victim has an intention to attempt suicide, whether anyone else is in immediate danger, and whether anyone is injured.
As with other protocols, the EFD should provide Post-Dispatch Instructions (PDIs) after completing the Key Questions and initiating the response. However, as described in the blue CEI section, the EFD may suspend Key Questioning when necessary to give safety PDIs, especially in circumstances when the EFD can hear the caller or others planning to attempt to rescue the person or instructing the person to move.
a.I’m sending the fire department to help you now. Stay on the line, and I’ll tell you exactly what to do next.
b.Do not approach or attempt to rescue the person(s).
c.Tell the person(s) not to move.
d.Do not touch any equipment that may be suspending the person(s).
After dispatch and providing important PDIs, the calltaker reviews the other CEI reminder items to notify a Technical Rescue Team (TRT) of the incident immediately, if applicable, and to provide responders with known information about the location and number of people.
The chances of actually saving the individual(s) may diminish with time, depending on the environment, weather, and the individual’s intent. The responder must evaluate scene security, safety, and the steps to the rescue and recovery operation.
As the First Law of Technical Rescue states, “The first 10 minutes on scene of a technical rescue often determine how the next few hours will go.”
The Rules on Protocol 62 clarify that HIGH ANGLE operations, at inclinations greater than 60 degrees, require the expertise of a TRT and that the EFD should contact the TRT as soon as possible to effect a timely recovery of the person. If no TRT is available, the EFD should consider utilizing MUTUAL AID resources.
There are hundreds of technical rescue teams, training facilities, and training programs across the U.S.
In November 2012, the Des Moines Fire Department opened a new fire logistics and training center that includes an on-site burn building, multi-story training tower, roof ventilation simulator, driver training course, auto extrication, covered shelter, simulated city buildings, draughting pit, obstacle course/confined space, Candidate Physical Ability Test (CPAT) course, technical rope rescue, rail yard, and HAZMAT simulations.
The Baltimore County Fire Department’s Advanced Technical Rescue Team (ATRT) was started in the 1980s to establish a high-rise emergency aerial team in cooperation with the Maryland State Police Aviation Division. The team is specially trained for unusually difficult, complex rescues, such as building collapses, water rescues, trench rescues, and high rise rescues.
The ATRT was dispatched to New York by the federal government on Sept. 11, 2001, to assist with rescue and recovery following the terrorist attacks on the World Trade Center. In 2007, Baltimore County used federal Department of Homeland Security funds to purchase a search-and-rescue vehicle equipped to handle building collapses, water rescues, trench rescues, and other tactical emergencies. In 2009, the vehicle was put on display at NAVIGATOR.
There are also campaigns, workplace regulations, and industry standards aimed at the safety of workers in occupations exposing them to high-angle situations and the responders who come to their aid at the time of an emergency.
In 2012, the U.S. Department of Labor announced a campaign to provide employers and workers with lifesaving information and educational materials about working safely from ladders, scaffolds, and roofs in an effort to prevent deadly falls in the construction industry.6
The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has a number of regulations for high-angle operations. For example, rescue team or rescue service evaluation criteria require both an initial evaluation and a performance evaluation for each incident. In the initial evaluation, employers decide whether a potential rescue service or team is adequately trained and equipped to perform rescues of the type needed at the facility, and whether such rescuers can respond in a timely manner. In a performance evaluation, employers measure the performance of the team or service during a practice or actual rescue.7
The National Fire Protection Association (NFPA) has three principal standards addressing the safety of technical rescue: NFPA 1670, 1006, and 1983.
NFPA 1670 sets standards on operations and training for technical search-and-rescue incidents; it “identifies and establishes levels of functional capability for conducting operations at technical search and rescue incidents while minimizing threats to rescuers.”8
NFPA 1006 sets minimum job performance requirements necessary for fire service and other emergency response personnel who perform technical rescue operations. The most recent version of the standard was adopted for the 2013 NFPA standards document.9
Manufacturers are the primary users of NFPA 1983, which sets standards for life safety rope and equipment, including minimum design performance, testing, and certification standards.
Rescue operations inherently involve some level of calculated risk. The key is to reduce the risks to a reasonable level whenever possible through effective planning, training, equipment, and appropriate emergency response that begins in the emergency communication center.
1Gannett News Service (Des Moines Register). Man Dangles From Bridge After Train Collision. 2013; Dec. 10. http://www.digtriad.com/news/article/308815/176/Man-Dangles-From-Bridge-... (accessed Dec. 17, 2013).
2U.S. Bureau of Labor Statistics. “Census of Fatal Occupational Injuries 2012.” 2013; Aug. 22. http://www.bls.gov/news.release/cfoi.nr0.htm (accessed Dec. 16, 2013).
3Richard Snyder, David Foust, Bruce Bowman. Study of Impact Tolerance Through Free-Fall Investigations. 1977; Dec. 15. http://deepblue.lib.umich.edu/bitstream/handle/2027.42/725/39604.0001.00... (accessed Dec. 16, 2013).
4Michael Dunn. “When SECONDS Count … TRAINING makes the DIFFERENCE.” Emergency Response Training, Inc. http://www.ertrescue.com/Article-HighAngleRescue.html (accessed Dec. 16, 2013).
5 See note 4.
6U.S. Department of Labor, Office of Public Affairs. “OSHA Regional News Release.” 2012; June 19. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELE... (accessed Dec. 16, 2013).
7U.S. Department of Labor, Occupational Safety and Health Administration, Appendix F—Rescue Team or Rescue Service Evaluation Criteria. [63 FR 66039, Dec. 1, 1998] https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=9803&p_table... (accessed Dec. 17, 2013).
8Melody Eady. “The Rescue Technician and NFPA Standards.” 2006; September. http://www.gpstc.org/wp-content/uploads/2013/06/gfa_resources_articles_r... (accessed Dec. 16, 2013).
9National Fire Protection Association. “Compilation of NFPA Technical Committee Reports on Proposals for public review and comment (for inclusion in the 2013 edition of NFPA 1006).” 2013; Oct. 22. http://www.nfpa.org/Assets/files/About TheCodes/1006/1006-F2012-ROP.pdf (accessed Dec. 16, 2013).