High-Angle Rescue in the Flat Prairies - Patient Care - @ JEMS.com

High-Angle Rescue in the Flat Prairies



Kevin Link | | Saturday, July 31, 2010

Is there much of a point training your department in high angle rescue when you’re in a rural farming community located in mostly flat prairies? When you can look out your car window and see for miles, noting the tallest object is often a power pole? Compound this with the fact your local fire departments are all volunteers—the many hours of initial training and then upkeep that’s required to ensure they remain fresh with these skills.

Now look again. Many farming communities have structures that require training to retrieve people from should they become sick or injured high above the ground.

On March 26, in a rural farming community about 40 miles east of Calgary, Alberta, a 22-year-old male was injured working atop a feed mill 134 feet above the ground. The patient, who was employed by a communications company that rented space for Internet equipment on top of the feed mill), got injured when he attempted to use a “counter weighted elevator” to get to the top. He hadn’t been trained on how to use the equipment and went to the top at a faster speed than he anticipated. When the elevator reached the top and came to a crashing halt he continued upward striking his head on some overhead beams.

The first calls to 9-1-1 came in for a male injured on top of the feed mill. An ALS ambulance based in nearby Strathmore, Alberta, was dispatched, as well as Strathmore Rural Fire Department. As more updated information came into the dispatch center it was determined that more manpower and expertise would be required to complete this rescue. Mutual aid was requested from Strathmore Town Fire Department for their ladder truck, which reaches 105 feet.

A high angle rescue team from a nitrogen fertilizer plant in close-by Carseland was also called, as was Royal Canadian Mounted Police. Due to the remoteness of this incident crowd control was not an issue. In total 30 rescue personnel with five pieces of apparatus attended the scene. Because EMS didn’t have climbing harnesses available to them early in the incident, it was decided a properly outfitted firefighter armed with basic first aid equipment would climb to the top to initially assess this patient. The patient was found to be conscious but had head lacerations and was complaining of neck pain. However, because of the mechanism of injury and neck pain complaint, spinal precautions were taken in lowering him from the feed mill to the EMS unit 134 feet below.

The attending firefighter maintained manual C-spine control while updating EMS and firefighters below. While preliminary rescue plans were being made at ground level spinal equipment and a basket stretcher was being hoisted up. An EMT-A completing his second year of paramedic training went to the top with firefighters and assumed patient care. The patient’s head was bandaged to control bleeding, and he was securely strapped to a spine board with a rigid C-collar and a blanket roll supporting his C-spine prior to being secured again in a basket stretcher.

Some of the discussions that took place and some of the limitations of the rescue equipment:
- 134 feet above the ground
- ladder truck can extend 105 feet
- high angle rescue with ropes limited to 100 feet
- the patient was stable so time was on the rescuer’s side allowing them to take all necessary precautions to ensure a smooth, safe rescue for patient and personnel It was decided the best way to get this patient down was to lower him 70 feet to a catwalk and then the rest of the way using the ladder truck.

It was also decided to lower him down the ladder from level to level rather than one long span over the side.

All personnel were equipped with helmets and safety harnesses to increase their safety.

Rope knots were checked and double checked by a rope tech with Strathmore Town Fire Department. Safety lines strung and readied and the descent began. Slowly and methodically, rung by rung, the patient was lowered. An EMT-A within talking distance the entire way down reassuring and calming him all the way. At each level crews would recheck ropes and knots while the patient was reassessed to ensure he still remained stable. Then down the next span until finally reaching the catwalk at which point he was lowered down the ladder to the waiting EMS crew. From time of call until transport to hospital was near four hours.

After being assessed by the waiting ALS crew he was transported by ground to a rural emergency department with minor injuries.

This was a challenging joint effort rescue by multiple departments in a rural area that was neither straight forward nor common. By working together, this was a successful mission and a great learning experience.

In a rural area with volunteers it may not be possible for every department to have every kind of training. But it is possible to know what training your neighboring departments may have. Having a professional, respectful relationship with those departments may someday prove to be an asset.

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Related Topics: Patient Care, Trauma, trauma, Strathmore Rural Fire Departmenf, Royal Canadian Mounted Police, high-angel rescue, feed mill rescue, Carseland, 134-foot rescue

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