Administration and Leadership, Columns, Rescue & Vehicle Extrication

Essential Rescue Skills are Important for Every Provider

Issue 6 and Volume 40.

I was glued to the television on April 4, watching ABC’s television show In an Instant–a series that features actual incidents where responders are thrust into unusual and challenging experiences. The episode, titled “Buried Alive,” focused on the miraculous rescue of a 23-year-old Iowa farmer who became trapped in a massive silo after he was swallowed up and buried under tons of crushed corn.

The show was compelling and educational, and I wanted to pass along a few teaching points that flashed through my mind as I watched the review of this multi-hour rescue.

“Buried Alive” highlighted the complexity of farm rescues, which most of us never experience. I’ve responded to trench collapses and construction site accidents, and trained for confined space rescue, but was never involved in something that required many of the challenges and obstacles involved in this rescue of a man buried at the bottom of a six-story corn silo.

The Scene

Arick Baker and his father were emptying a silo full of 80,000 bushels of corn in Iowa Falls. With each bushel weighing 56 lbs., the total weight inside the silo exceeded 2,200 tons.

Trend Airshield Pro mask. Photo courtesy Trend Routing Technology

Trend Airshield Pro mask. Photo courtesy Trend Routing Technology

 

The auger that spins at the bottom of the silo and discharges the corn into awaiting trucks became jammed, so Arick descended a ladder inside the silo, walked through waist-deep corn and used a PVC pole to break up the jam.

As his dad watched from a small hatch at the top of the silo, Arick, tethered by a rope, unclogged the corn from the auger. When he realized the auger was cleared, his dad then exited, descended an outside ladder and turned on the auger to continue filling the tractor trailer positioned under the discharge chute.

As this process was underway, Arick decided to poke at the bottom of the corn one more time and disturbed an air pocket that swallowed him unexpectedly.

While enroute to offload his tractor trailer, Arick’s father had a funny feeling that something was wrong because he didn’t remember seeing his son come out the top hatch of the silo. He became worried when Arick didn’t answer his cell phone after several calls.

He called an employee and told him to check the silo and make sure not to activate the auger–he feared that Arick might still be inside it. When the employee arrived at the silo, he climbed to the top and found only the tethered line still attached from the top of the silo hatch area and extending down to bottom. He immediate realized Arick was buried and probably dead underneath the corn.

He called 9-1-1 and reported what he feared had happened, which activated a massive response of resources in the large rural area.

Surviving

There were several things that helped Arick survive. First, he was buried right-side up with his arms up over his head. This allowed the rope to be seen when it was later realized he didn’t come out after his father did.

Most rescuers know that when a person is buried under dirt or other granular substance, the weight of the substance exerts tremendous pressure against their body. As they exhale air from their lungs, the weight of the substance and the subsequent pressure exerted doesn’t allow their lungs to fully expand and, usually, very rapidly results in their suffocation from their inability to take in air and inhaling the substance that’s burying them.

The next factor that contributed to Arick’s survival was a Trend Airshield Pro air circulating face shield, an innovative hood he and his father saw at a farming exposition and decided to buy. The battery-operated Airshield system was originally designed to be used during woodworking where a lot of dust is created. However, because Arick suffered from an occasional bout of asthma, they decided to purchase the $350 device to avoid the dust inherently churned up when moving around in a silo and reduce his chances of activating his asthma.

The 2.2-lb. air circulating face shield has filters on the back and sides with 98% filter efficiency and features an elastic seal that secures around the wearer’s neck. It was also fortunate that the model used by Arick had a battery pack that lasted four hours because of the time it would take to extricate him.

The face shield/hood system offered much more than dust abatement to the trapped farmer–it offered him enough ventilatory support to keep his lungs expanded for five hours as the rescuers labored to get him free.

Although the fire, rescue and EMS resources arrived rapidly, most of the rescuers, familiar with grain silo accidents, assumed from past experience they’d probably be operating in a body recovery mode rather than in a rescue operation.

Incident commander and Iowa Falls Fire Chief Rick Gustin made a decisive move and had rescuers open multiple relief holes on four sides of the silo to empty the corn as fast as possible, reducing the pressure on the trapped farmer and providing access for rescuers.

It sounds simple, but once corn began to flow out the relief holes, 8–10 rescuers at each hole had to manually clear the piles to allow more corn to be removed. Then, rescuers trained in confined-space rescue and outfitted with full-body harnesses and tools entered the silo and began to circle and search the waist-deep corn for Arick. As they circled and approached the center/auger area, they could hear the faint sound of his cell phone ringing and began to call out for him.

Arick could hear the rescuers nearing–talking about the potential he was deceased under the pile–and began yelling. The rescue team zeroed in on the muffled sounds and were amazed to see a few of Arick’s fingers moving on top of the corn pile.

A rescuer then climbed to the top of the silo ladder to alert the incident commander Arick was still alive. The operation moved into high gear, with 10 mutual aid fire-rescue agencies activated and involved in the rescue.

As rescuers outside the silo used their hands, shovels and helmets to remove corn from the relief holes, the incident commander sent a firefighter to a nearby farm to retrieve a bulldozer he knew was available. The firefighter was a farmer himself, so was capable of operating it. He brought it to the scene and began to move the massive piles of extracted corn away from the openings to allow the remaining corn to flow out.

Inside the silo, additional rescuers worked to free Arick. However, as they removed corn from around his body, other corn continually flowed down and made it difficult to free his torso, hips and legs.

The rescue team then deployed a rescue assembly that I, and probably most of you, had never seen before: a five-section, interlocking, curved grain rescue tube–a sort of mini- rescue silo that keeps the corn from flowing in and increasing pressure on the entrapped party’s body. It’s assembled around the trapped victim using ball-and-socket joints to ensure secure panel connection and allows at least one rescuer to remain in its interior to remove the material from around his body.

Soon, a section of the rescue tube started to collapse on the victim. The rescuer inside the tube with Arick made a conscious decision to potentially sacrifice his life to save the farmer by extending his legs and shoulders against the side of the silo and serve as a human cribbing system to prevent a further collapse.

Then, as the rescue neared completion, the batteries allowing the special face shield to keep fresh air flowing around Arick’s face began to fail. When the rescuers attempted to remove it, Arick became anxious, fearing the corn would again flow in, bury and suffocate him.

So the rescuers innovated and slipped an oxygen connecting tube under the bottom of the elastic neck ring to continue to circulate air and oxygen inside the face shield. It was a simple but valuable improvisation that worked and significantly reduced his anxiety.

When the rescuers cleared the corn from around his upper body, he tried his best to pull himself up by grasping onto the two side rescue ladders, but the weight of the corn would still not allow him to move. The arduous rescue proceeded for another 30 minutes.

After five hours, the tense, complex rescue ended when Arick was freed and sent to a medical center for a full evaluation and treatment of minor injuries. His body exhibited thousands of red indentations where the tiny corn kernels compressed his skin.

The Takeaway

This amazing rescue reminded me how important specialized training is for responders who might be involved in a protracted and complex rescue. Like a mass casualty incident, this type of rescue requires the continuous infusion and coordination of rescuers who must be briefed and made aware of their roles and responsibilities at the incident.

We tend to focus a lot of attention on ALS, which affects about 20% of our patients. Although all the time and money spent on preparing to resuscitate adults and children is well worth the effort, this rescue reminded me we can’t neglect the BLS and rescue practices needed every day in EMS and fire systems.

As a young, eager responder, my dad took me to the first Hurst training classes offered by rescue instructors Harvey Grant and Bob Murray. I remember standing in a snow-covered high school parking lot learning how to use these incredibly powerful hydraulic rescue tools. Before they arrived, we used 4- and 10-ton PortaPower tools that worked but often failed when their pressure capabilities were exceeded.

It was priceless training that encouraged me to continue not just my EMS training, but rescue training as well. I took as many rescue classes as I could throughout my career, including vehicle and rope, high-angle, trench, and confined-space rescue classes. It’s invaluable training I recommend for all responders no matter what your level of involvement might be at a rescue scene because, although EMS care is our primary mission, one of our additional responsibilities is to understand, participate in or support the extrication of victims.

Many members of the new generation of EMS providers serve in non-fire-based EMS agencies that don’t routinely offer specialized rescue training. And, in many areas where rescue and extrication are primarily a fire department function, it’s felt independent EMS agency providers don’t need rescue or extrication training or to be involved in rescue operations. But nothing could be further from the truth.

In fact, as learned from past incidents and after-action reports from successful incident management, rescuers who were cross-trained and able to interact with each other at complex emergency scenes have contributed to the success of these incidents, whether it was in rehab and medical support roles or inclusion in the forward rescue operations.

All EMS personnel should receive as much rescue training as possible so they’re comfortable around ropes and tools and high-hazard scenes, interact with all agencies involved at a rescue scene, and be aware of the special needs of the frontline rescuers as well as those being rescued.