Operations, Patient Care, Training

EMS Instructor Provides Search & Rescue Training

Issue 4 and Volume 37.

When we’re dispatched to a scene, sometimes the information we have about the location of the patient may be scarce. Depending on the dispatch information, EMS providers may respond to, standby for or assist in search parties. Unfortunately, initial EMS education brushes through these skills and continuing education is necessary to fill the gap.

The search-and-rescue term encompasses a wide variety of technical rescue specialties, including ground search and rescue, urban search and rescue, water rescue and cave rescue, as well as wildland and mountain rescue. The scope of the search-and-rescue activities, levels and associated training is defined and regulated by the authority that has jurisdiction.

Depending on the state, this may be regulated on a state, regional or local level. According to National Fire Protection Association (NFPA) 1670, levels (e.g., awareness, operation, or technician) should begin at the awareness level, which will include the most basic principles, advance to the operations level and culminate at the technician level.1 The technician level indicates a mastery of the skills.

Some independent organizations have developed search-and-rescue programs that may be used for training. The National Association for Search and Rescue (NASAR) has a variety of courses available that review search-and-rescue techniques, as well as K-9 search and rescue. NASAR teaches courses all over the country and offers a variety of certification examinations.

Other resources include the Civil Air Patrol and the Mountain Rescue Association. The National Emergency Service Academy of the Civil Air Patrol offers a variety of courses for ground search and rescue, with many of their resources available online. The Mountain Rescue Association also has a variety of training resources available online, as well as a wealth of international alpine rescue case reports.

The Theory

Search and rescue is an extremely time-intensive process that may overwhelm the area’s available resources. A large number of personnel from a variety of agencies may be present, so the training events generally take a significant amount of time to plan. It’s common to meet monthly for several months to plan a training event and exercise.

Before beginning a course in search and rescue, the instructor should become intimately familiar with the rescue structure that’s available in the service area. This structure can vary from local search-and-rescue team to regional search-and-rescue task forces, and may even include a state action plan. The major players should be contacted before any training is put together so that roles and involvement can be discussed.

Types of Search & Rescue
It’s important to evaluate your region’s needs and plan accordingly. As an instructor, you want to ensure your personnel have the training they need to respond to an event before that event occurs. Alpine search and rescue may be an exciting aspect to train for, but it may be more appropriate to focus on urban search and rescue (USAR) if your service area is a major metropolitan area. USAR focuses on search and rescue in urban areas and covers such topics as building collapse, shoring and body recovery.

Ground search and rescue (GSAR) generally reviews wide area searches in wooded areas. Topics may include searching for patients with dementia, children and lost individuals. Many search-and-rescue teams also incorporate K-9 search units. K-9 search units can include air-scent K-9s, which are dogs that pick up the scent of human skin cells without differentiating between people, and tracking K-9s, which can track a specific individual.

Wildland and alpine rescue operations tend to cover extremely large areas with various terrains, so these rescues may use a variety of rescue teams. Although GSAR is common in these operations, it also uses aviation search techniques with planes and helicopters, as well as rope rescue, cave rescue and water rescue teams.

Remember to thoroughly evaluate the needs of your service area before you decide to tackle a project of this magnitude. The training will be intense, and it’s imperative it fits the needs of your department.

Search Techniques
A variety of search techniques are used in search and rescue. Some techniques may be used in many different settings, but others are limited to where they may be performed. It’s imperative that instructors have a thorough understanding of the techniques being used, the equipment necessary to perform the techniques and the agencies that are available to perform the techniques.

Once an incident command structure is developed, search areas should be designated. The areas to be searched are generally drawn onto a map and labeled sequentially. Search teams are assigned to a specific search area. This helps maintain accountability of the rescuers, as well as ensuring that all areas are checked. With modern technology, the areas may be designated by latitudes and longitudes that can be put into a handheld global positioning system (GPS) by the search teams.

Depending on manpower available, a grid search may be used. This involves search team members walking shoulder to shoulder in a line through a designated area at a slow pace to allow for a thorough search. Rescuers will be looking for clues that indicate the patient has been in the area. However, this technique is immensely time consuming and requires a large number of personnel to perform.

Aviation searches may be used with a helicopter or plane flying at low ranges.2 Although beneficial, helicopter use for search and rescue carries inherent risk. Some air medical providers no longer provide assistance in search and rescue because of fatal crashes that have occurred in recent years. Other limitations of aviation searches include canopy cover, which may block the view from the aviation crew.

Some aviation services may have the ability to use night-vision goggles (NVGs). NVGs require some light source. Usually natural light, such as the moon, is adequate to provide a clear field of vision. NVGs generally don’t provide any magnification and may cause some problems in recognizing distances. The light magnification can cause the user to see lights miles away. It’s essential that the user not make any quick movements with the goggles, but they must also be constantly moving.
Thermal imaging cameras are a valuable resource, but a drawback is that these cameras require the body to emit some heat. So if the patient has been deceased for a prolonged period of time, these cameras may be ineffective. Also, these cameras don’t differentiate between heat sources; they just detect heat sources in the shape that they emit heat.

The Practice

Effective instruction requires educators to teach to all learning domains and all learning styles. Search and rescue can be particularly complicated to teach because of the grand scale associated with the operations, the required equipment and the amount of personnel. Instructors should attempt to encourage critical thinking by discussing scenarios, complications and means for responding in your service area.

Learning Domains & Styles
Instructors can explore the affective domain by discussing the emotional trauma the patient and the patient’s family may experience throughout a search and rescue. Encourage the students to be empathetic. Ask the students what they think is going through the patient’s mind during a search. Inquire how the family may feel, especially if the media becomes involved.

The cognitive domain can be evaluated by using case studies. Ensure you try to make the scenario fit your service area by implementing landmarks in your region. This will help your students to think about possible barriers and necessary resources. Have them discuss what resources are necessary, how they plan on allocating them and how long it will take to implement the resources.

The use of PowerPoint presentations or pictures will help visual learners. Handouts will be beneficial to visual learners, as well as for students who learn best by reading. Elaborate on the PowerPoint presentations to help increase the experience for auditory learners. You can also use videos from news channels that talk about search-and-rescue cases. This will also help students understand how to handle the media on arrival.

If you’re unable to find a case that meets your needs, use your imagination. Think about a plausible incident in your area and plan for it. Go out and take pictures for your presentation, obtain coordinates and all necessary permissions for land usage and get a feel for the area.

An ideal psychomotor evaluation would be to perform a mock search and rescue. Acquire patients, have them leave clues and have them hide. Involve multiple actors to help establish the last known point. It’s also beneficial to stair step the response to make it more realistic. Have resources show up one at a time rather than all at once.

Ensure you have adequately preplanned the area to reduce the likelihood of injuries. Have maps available, as well as GPS equipment.3 Review your organization’s standard operating procedures for search and rescue as well as the recommended equipment list. Require all participants to carry food and water. Some students feel that the exercise won’t last long and that they’ll be fine. Proper planning not only guarantees preparedness, but it also helps create a realistic feel of the operation.

Search and rescue takes a great deal of time and effort to perform correctly. This is a great opportunity to practice interagency training. These are skills that don’t get used enough with equipment that may not get used enough. Knock the dust off the equipment, strap on the boots and get ready for an all-day event. JEMS

1. National Fire Protection Association. (2009). NFPA 1670: Standard on Operations and Training for Technical Search and Rescue Incidents. In National Fire Protection Association. Retrieved Feb. 10, 2012, from www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=1670.
2. National Transportation Safety Board. (2007). NTSB Identification: NYC08FA071. In National Transportation Safety Board. Retrieved Feb. 10, 2012, from www.ntsb.gov/aviationquery/brief.aspx?ev_id=20080109X00032&key=1.
3. National Emergency Services Academy. (2009). Ground Search & Rescue Basic School. In National Emergency Services Academy. Retrieved Feb. 10, 2012, from www.nesa.cap.gov/GSAR.htm.

This article originally appeared in April 2012 JEMS as “Search & Rescue: Teach EMS providers the proper technique for these operations.”