Emergency response teams

THE RESCUERS

By Bob Salo

Accidents happen. But being prepared to deal with anything that may go wrong will reduce the impact, cut the cost -- and just maybe save lives

Rescue can be simply defined as the moving of an incapacitated person from an unsafe location to a safe location. Workplaces in which people may be located in confined spaces, elevated platforms, trenches, structures or buildings that could collapse, wilderness locations and even deep water have the need for rescue capabilities. Most workplace rescue situations, however, involve fire, confined spaces and "high angle" emergencies involving heights and structural accidents.

The emphasis on rescue (especially for confined spaces) in the late 1990s can be compared to hazardous materials awareness and training in the 1980s. Various regulatory agencies, such as the Occupational Safety and Health Administration (OSHA) in the United States and provincial workers’ compensation boards and labour departments in this country are addressing the need to upgrade older regulations. Additionally, recommended international safety standards such as those from the National Fire Protection Association’s (NFPA) newly proposed technical rescue standards are addressing techniques and equipment as well as team and individual qualifications. The new "NFPA 1670 Standard for Organizational Technical Rescue for Operations and Training" is due to be instituted in 1999. The "NFPA 1006 Standard for Technical Rescuer Professional Qualifications" is due out in 2000. Workplace managers should look to these regulatory agencies, standard setting organizations, and leading rescue training companies for direction in rescue response for the next decade.

For an employer whose facility has potentially dangerous situations, the need for the services of either an on-site or an off-site rescue team should be obvious. However, while employers have long understood that they are required to provide first aid coverage for workers, many administrators feel they can just call 911 in what they consider the unlikely event of a rescue ever being required.

Employers relying on the local public safety agency, such as the fire department, may not realize that most of these agencies are not prepared to provide such highly specialized services as confined space rescue. The local department may not be properly equipped, appropriately trained or able to guarantee a timely rescue response. As well, they cannot be expected to be fully familiar with hazards, installations and materials at every workplace in their service area.

It is for this reason that OSHA in the U.S. has recently changed its confined space regulation requiring the employer to have an arrangement with a verifiably qualified rescue service as well as requiring the employer to ensure a performance evaluation has been conducted of the service’s capabilities. In Canada, the recent changes to the British Columbia regulations agree with this kind of thinking: "If the rescue persons are employees of another firm, or an agency such as a fire department, there must be a written agreement detailing the services that are to be provided."

Currently, many Canadian regulations cover the subject of rescue to some degree, with most emphasis on confined spaces, and compliance open to a good deal of interpretation.

* The Canada Labour Code requires the employer to "establish emergency procedures to be followed in the event if an accident or other emergencies in or near the confined space" and "ensure two or more persons are in the immediate vicinity of the confined space to assist in the event of an accident."
* Alberta legislation requires "rescue procedures to enable the removal of the worker who has entered the confined space are in place, and rescue equipment capable of effecting a rescue is available for immediate use."

* Ontario’s Regulation for Industrial Establishments states a confined space shall be entered only when "suitable arrangements have been made to remove the worker from the confined space should the worker require assistance."

* New Brunswick’s General Regulation requires "an employee who is trained in emergency procedures... is in the immediate vicinity of the confined space to assist in the event of an accident..."

This wording does not give a clear direction to employers, rescue team members or enforcement officers. As a result, there are vast differences in rescue capability between different rescue teams. In 1998, B.C. revised all its regulations, including those dealing with confined spaces and rescue. These new clear, specific regulations are a good Canadian model to study. And, even though they don’t legally apply to Canada, many Canadian organizations utilize certain OSHA regulations and NFPA standards as a guideline.

NEEDS ASSESSMENT

Employers should consider that, while compliance with regulations is a good reason to have competent rescue services to call upon, it is at least as important to do the right thing for the benefit of employees. Capable rescuers who can provide safe, efficient and timely services can greatly reduce the severity of an injury -- and just possibly save a life.

Most safety personnel are more familiar with first aid, fire and hazardous materials than rescue. They are trying to do their best, but don’t fully comprehend the commitment needed for a capable rescue team. And there are still some companies that take a chance that a rescue will never be necessary, and elect to deal with the consequences and fines later. (Even with regulatory compliance, it is also possible to have a rescue team in name only, or what might be called a "paper rescue team".)

The first step in deciding whether or not a rescue team is needed is to conduct a needs assessment of the workplace. Four questions should be answered:

* What are the hazards? They can range from structural rescue problems to confined space problems. (When an inventory in industry is done, you usually find structural, fire and confined space hazards.)

* What is the desired level of response capability, based on the identified hazards?

* What is the current status of rescue capability, including availability, response times, equipment and training of outside providers such as municipal fire and rescue services?

* How will the site establish an action plan to get from its current state to its desired state?

A workplace may elect to conduct its own needs assessment at the facility. However, utilizing an off-site expert (private consultants are available to fulfill this role) who is knowledgeable and experienced in developing rescue teams results in an unbiased, objective report.

IN-HOUSE OR OUTSIDE?

Arbitrarily naming the fire department as your rescue team may very well not be acceptable. However, many private companies financially support fire department training and, in return, the fire department responds to rescue emergencies. Key to this partnership is a written agreement between the two parties. Such an agreement clearly spells out the responsibilities of both parties and can satisfy the regulatory agency as to compliance issues.

In general, however, large companies develop their own rescue teams. Smaller companies with manpower limitations, and which are close to established fire department rescue teams, and which have a limited number of hazards in their area will contract with the local department.

Key to developing a rescue team is management’s commitment. Like many highly skilled jobs, rescue is not something you can go into a little. In rescue, a little training and experience can be dangerous and sometimes prove fatal. Management must make a financial commitment for equipment and training. Equipment is a fixed cost initially, but has a maintenance and annual replacement component that must be considered when establishing budgets. The largest cost and greatest logistical problem is for training. Management must support the long-term commitment to training, which includes overtime, compensatory time off, and manpower shifts needed to replace rescuers while they train.

To gain the support needed from management for an on-site team, it is appropriate to build a case for a capable rescue team. An historical perspective of incidents in similar industries as well as at the specific site serves to point out what can happen and why there is a need to be able to respond. Another excellent tool is to have a needs assessment conducted by a qualified third party that includes a summation of where the site stands currently, where it needs to be, and a plan to transform the current program to one in which compliance and preparedness are accomplished. Managers can usually be convinced that these two goals must be priorities.

While compliance goals are self evident, the need for preparedness is best justified as a form of insurance. While rarely used, emergency response services are essential. Demonstrating a rescue team is trained to recognized standards and regulations can greatly diminish liability exposure if an accident does occur.

Generally there are three paths to follow when deciding how to approach rescue team training.

1. Use an outside rescue agency totally for all initial training, maintenance training and performance evaluations.

2. Use an outside rescue agency to train in-house trainers. This is called "train the trainer" model. The in-house trainers then do basic training with the rest of the team and bring the outside agency in for maintenance and performance evaluations.

3. Use an outside agency to do all basic training, continue to develop in-house trainers for maintenance, and bring in the outside agency for performance evaluations.

In-house training has the advantage that it tends to be more cost effective. Sometimes, however, the in-house trainer may find that it is hard to motivate team members who consider themselves peers of the trainer.

A professional outsider usually is more credible to the trainees and they are therefore more motivated to listen and learn. Rescue professionals should also have the latest in equipment, techniques and industry news since they are specialists in the field.

CREATING THE TEAM

Your rescue team must be properly trained, adequately equipped, and capable of performing a safe, successful rescue. But rescuers are not fully prepared after initial training. Follow-up practice is essential. This means regularly scheduled practice. Depending on the hazards, initial training for a fully capable rescue team may take from 40 to 160 hours. Within the following year at least 24 hours of practice time is recommended every three months. For best results, group the training days together, rather than having one a month. In the next years it may be possible to practice 12 to 16 hours per quarter depending upon the team’s skill level.

Selection criteria: In choosing potential rescue team members, the primary consideration should be the person’s attitude. It takes a "team attitude" and personal commitment to learn and keep up the rescue skills needed. For this reason it is recommended that the team be composed of volunteers. (Heights, confined spaces, potential personal harm and blood from medical emergencies can all be encountered in rescue situations. A person who has fears or reservations about any of those things, and who and has been ordered to be there, is not going to be the ideal rescuer.)

Qualification for team membership should not be limited by age, gender, or physical ability. Rescue activities generally do not employ brute strength but use technique and finesse. However, rescue can be physically demanding and stressful. Physical qualities needed include flexibility, stamina, reasonable strength and good health. The ability to wear a respirator is important in a lot of cases.

Rescue stands on two legs, safety and efficiency. Both legs have to be balanced. Redundancy in safety systems to a ludicrous point may prevent the rescue from getting done. On the other hand, efficiency should not be solely equated with speed. Shortcuts can compromise safety resulting in exacerbating the victim’s injury or injuring a rescuer. That is why it is critical who is on the rescue team and what kind of training is given.

Standards: The NFPA is the only nationally recognized agency with specific rescue standards. However, a rescuer needs skills covered in other areas, such as respiratory protection, fall protection, lockout-tag out, personal protective equipment, hazardous materials, and knowledge of provincial and/or federal regulations.

The trainer: The awareness of the need for rescue training has opened the door for many more trainers than there were in the 1980s. That has created competition and brought new ideas, but has not guaranteed quality across the industry. Many trainers have brought their experience from non-industry backgrounds without understanding the needs of industrial rescue.

A trainer’s competence is indicated by credentials and references, but also by experience and a background in emergency response. This gives him or her credibility when talking about performing under pressure and in dangerous conditions. A trainer should be able to supply training specifications (maximum 7:1 student /instructor ratio), course content information, instructor biographies, insurance coverage, daily roster documentation and copies of their manuals, tests and training equipment lists.

A trainer should also be able to supply you with their most important marketing asset -- a satisfied-customer reference list. Talk to the trainer’s customers and ask questions. Was the training realistic? Was safety constantly reinforced? Were the classes structured and organized? What is the level of competence of the rescue team now, compared to before the training?

Formal initial training from an experienced and competent trainer is only the first step in the educational process for rescuers. Regular, structured practice sessions are vital to learning the skills necessary to save lives in an emergency. These skills in rescue, communication, operating specialized equipment, teamwork and problem solving must then be tested regularly to ensure rescuer competence.

Experience shows that if there is not a goal to shoot for, rescue trainees can become complacent. The same training from month to month and year to year will cause most team members to lose their enthusiasm. This is especially true for in-house trainers. Personal and team skills get overestimated, team members start to talk the talk but forget how to walk the walk. Goals based on standards need to be established, training based upon those standards must be scheduled and a recognized outside agency must be brought in to test performance. This test must be objective, with the score compared to standards of established rescue teams.

EQUIPMENT

Select equipment that is designed to rescue live human loads. Sport rope and hardware may not be designed for or have the appropriate safety margins for rescue. For rescue, most people automatically think of rope, harness, helmet and carabiners but equipment for communication, ventilation, retrieval, fall protection, medical packaging, air monitoring, personal protection, lighting, barriers and egress are all part of a team’s list. Equipment should meet or exceed national standards and regulations.

Since timeliness of response is an important part of rescue effectiveness, it is a good idea for each member to be responsible for his or her own personal equipment. This allows any team member who arrives on the scene of an incident to start the rescue without waiting for the response vehicle.

A good rescue team needs a great deal of management understanding and support. This starts at initial training and continues with regularly scheduled training sessions. Compliance with new industry standards and regulations is essential. Whether an in-house trainer or an outside rescue firm is used, training and skills must be performance based. Don’t make the mistake of believing the team can do rescue without having a qualified, experienced third party evaluate their performance. Once your team has reached an acceptable level of competence, set new goals. Never rest on past achievements. The success of good rescue teams is a result of never ending growth and development.

Be cautious of the quick fix. A two- or three-day course may give rescuers just enough skills and information to get them into trouble. Most competent trainers can structure a 40-hour course to give rescuers the bare minimum of skills for confined space and structural rescue. Another 40 hours of training is necessary to elevate rescuers’ skills to an intermediate level. And if the hazard level is extreme, more advanced training is available.

Rescue is dangerous, and it is the responsibility of people organizing the rescue team to give the members the best possible training. A high level of rescue skills will go a long way to ensuring the safety of both the rescuer and the person being rescued.

Bob Salo has 28 years of service with the District of North Vancouver Fire Department, and is currently the manager for Roco Rescue of Canada.

HOW ONE TEAM WORKS

By Wally Dempster

Howe Sound Fire/Rescue is an industrial brigade providing emergency response services for a continuous operation pulp and paper mill located in Port Mellon, B.C., about one hour from Vancouver. The nearest municipality is Gibsons, which is 10 miles away. The mill employs approximately 600 people and covers an area of 700 acres. There are a number of other smaller industrial businesses in the area, as well as a small residential community of 20 homes, which are also protected by our brigade.

The team is composed of 32 volunteers from various areas of the mill who carry pagers for notification in the event of an emergency, just like most municipal or rural volunteer firefighters.

In-house training is conducted every Tuesday, and covers a variety of topics related to fire suppression, hazardous materials response, first aid and technical rescue. All firefighters are also enrolled in the Provincial Fire Academy’s certification program for professional firefighters.

At Howe Sound Pulp and Paper, we are fortunate to have management that places a high priority on emergency preparedness. A recommendation from fire crew officers, supported by risk assessments from our health and safety department and the WCB regulations, was all that was required to secure full support. This led to a plan to provide "certificate" training for all firefighters on the topics of high angle and confined space rescue, as well as the equipment necessary in order to provide these services.

Fire crew officers attended a few different courses to evaluate what was available and best suited to our needs. We send four of our firefighters at a time to training sessions conducted in Vancouver by ROCO Rescue. We select each group so as to limit staffing problems, trying not to remove more than one person from each department for each course.

Each firefighter attends one, and in some cases two, of the 40-hour programs each year. After three years of following this format, we have about a third of the crew trained to Level 1. We find this layered approach not only minimizes any negative impact on the operation of the mill, but it also gives our firefighters time to develop proficiency and confidence with their new skills. Our next step will be to enroll some of our members in the instructor development program, which will help us improve on the training and practice that we do at our mill.

To date we have not needed the rescue skills for an emergency at the mill, but we have responded to two incidents on the forestry lands adjacent to the mill property. In both cases, hikers had fallen off rocky cliffs. One rescue resulted turned out to be a body recovery; in the other case, a hiker with a broken leg and dislocated shoulder was successfully rescued. In that rescue we gained access to the accident victim, completed medical packaging, and prepared him for evacuation by the provincial search and rescue helicopter.

Wally Dempster is safety/loss prevention supervisor with Howe Sound Pulp and Paper in Port Mellon, B.C.

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