Welcome to Rope-Based Litter Operations
Setting the Stage
“Rope-based litter operations have become the hallmark of rope rescue teams around the world. The moving of an injured patient over, around, and through various terrain types is most often best accomplished by packaging that person in a litter. Modern litters are strong, rigid, and adaptable to many applications. Teams that are serious about patient care and transport will devote a considerable amount of training time perfecting their litter-based technique and operations.”
— Steve Crandall
Litter operations are a cornerstone of modern rope rescue. They embody the skill, precision, and teamwork required to move injured patients across challenging terrains safely. This course begins with the foundational concepts and techniques of terrain assessment and patient transport. Expect a dynamic learning experience, revisiting key concepts from different perspectives to master the complexities of litter operations.
Terrain Assessment: The First Critical Step
Effective terrain assessment is the foundation of a successful rope rescue. Understanding the environment allows you to develop strategies that maximize safety and efficiency.
1. Evaluate the Terrain
- Understand the Terrain Type: Terrain varies significantly—from flat, walkable trails to steep, high-angle slopes requiring technical systems. The first step is identifying what kind of terrain you’re dealing with. This includes determining whether the slope is low-angle (manageable without full rope systems) or high-angle (requiring mechanical support).
- Assess Travel Difficulty: Travel difficulty can be categorized as easy, moderate, or difficult. Easy terrain allows rescuers to walk without support, while moderate terrain may require safety precautions like prusiks or handlines. Difficult terrain, however, necessitates full rope systems for safe navigation.
- Gauge Risk of Failure: Consider the consequences of system or human error. For example, a seemingly moderate slope may have fatal consequences if an anchor fails. Always err on the side of caution when assessing risks.
2. Plan the Evacuation
- Decide the Number of Litter Bearers: The number of team members needed depends on terrain and the weight of the patient and equipment. For flat or low-angle terrain, more bearers may be required to share the load and avoid fatigue. On steeper slopes, fewer bearers are needed due to limited space and increased reliance on rope systems.
- Route Selection: Choosing the right route involves balancing efficiency with safety. Avoid paths with significant hazards like loose rocks, unstable ground, or sharp drops. Map the route in advance to minimize unexpected challenges.
- Prioritize Patients: In multi-casualty incidents, prioritize the most critically injured patients for evacuation. Stabilizing and transporting these individuals first can mean the difference between life and death.
3. Communicate the Plan
Clear communication among team members is essential for smooth operations.
- Before moving, ensure every team member understands the plan, including their role and responsibilities.
- Use visual or verbal signals to coordinate movements during evacuation.
- Establish contingency plans to address unexpected hazards or delays.
4. Stay Vigilant About Safety
- Identify Hazards: Look out for loose rocks, wet surfaces, or unstable footing.
- Move Deliberately: Take slow, careful steps in hazardous areas. This minimizes the risk of slips, falls, or equipment failure.
- Prepare for the Transfer: Once at the destination, safely transfer the patient to an ambulance, helicopter, or another transport method.
Pro Tip: Spending extra time on terrain assessment upfront can significantly improve the safety and efficiency of your rescue.
The Impact of Terrain on Rescue Operations
Terrain Types and Their Challenges
- Flat Terrain (Class 1): This is the easiest terrain to navigate. Rescuers can carry the litter without ropes, making it ideal for quick evacuations. However, even on flat terrain, consider obstacles like debris or slippery surfaces.
- Class 2 Terrain: Gentle slopes may not require full rope systems but often benefit from a belay line. For example, tying webbing to the litter and attaching it to a rope provides added security when navigating uneven or changing terrain.
- Class 3 Terrain: This category often requires scrambling, where both hands and feet are needed. A single rope may suffice for raising or lowering the litter, but careful attention to anchor points and team positioning is critical.
- Class 4 Terrain: Steep and hazardous, this terrain requires a two-rope system (main and belay lines) for maximum safety. Unstable footing increases the risk of system failure, so ensure all gear is checked and double-checked.
- Class 5 Terrain: Vertical or near-vertical slopes demand technical expertise and robust systems. Using tensioned systems, mechanical advantage, or other advanced techniques is often required.
Weather as a Factor
Weather conditions can dramatically affect terrain and rescue strategies.
- Rain: Wet surfaces increase slipperiness and reduce friction, requiring more careful footing and belay setups.
- Wind: High winds can destabilize equipment and increase the risk of falling debris.
- Snow and Ice: Frozen terrain demands specialized gear like crampons or ice axes to maintain traction.
The Role of Litter Attendants in Variable Terrain
When to Use Litter Attendants
- Smooth Terrain: In environments like grassy slopes, litter attendants may only be needed to guide the litter and prevent tipping.
- Obstructed Terrain: In areas with downed trees, rocks, or other obstacles, attendants are crucial to lift and guide the litter over barriers.
- Steep Slopes: On high-angle terrain, rope systems take precedence, and fewer attendants are typically required.
Techniques for Safe Navigation
- Minimizing Friction: When moving the litter, consider using wheels or sled attachments to reduce drag.
- Strategic Positioning: Attendants should be positioned at critical points to prevent the litter from snagging or tipping.
- Clear Communication: Use consistent signals to coordinate movements, particularly in areas with poor visibility or high noise levels.
Geo-Environmental Assessment and Strategy
Adaptability is key when dealing with constantly shifting terrain and environmental factors.
Classifying the Slope
- Angle of Incline: Steeper slopes require more advanced systems and experienced teams.
- Surface Composition: Hard-packed dirt offers better traction than loose gravel or sand.
- Changing Conditions: Rain or shifting ground can turn an otherwise manageable slope into a significant hazard.
Tactics for Complex Terrain
- Class 2 Strategies: Use belay lines sparingly, attaching and detaching ropes as needed.
- Class 3 Strategies: Anchor ropes at key points to assist in controlled movement.
- Class 4 and 5 Strategies: Employ multi-rope systems to distribute weight and minimize risk of failure.
Final Thoughts: Laying the Groundwork for Success
Rope-based litter operations require a methodical approach to terrain, weather, and patient condition. Mastering these foundational elements will prepare you for the hands-on techniques discussed in subsequent units. By investing time in proper terrain assessment and planning, you can ensure your team is ready for even the most challenging rescues.
In Unit 2, we’ll explore the essentials of converting between ascent and descent, and descent to ascent. These dynamic techniques are critical for navigating complex terrain efficiently and safely.
Equipment Recommendations
Top 3 Products from Rescue Response Gear’s Patient Care Category:
- CMC Rescue Litter Harness
This durable and versatile harness provides secure support for litter operations in both low-angle and high-angle environments. It is designed to offer comfort to the patient while ensuring maximum control for rescuers during transport. - CMC Patient Tie-In System
The CMC Patient Tie-In System ensures quick and efficient stabilization of patients in a litter. This tool is indispensable for maintaining patient security during low-angle rescues and offers an easy-to-use design that works across various scenarios. - CMC Stainless Steel Split-Apart Rescue Litter
Built for rugged environments, this stainless steel litter features a split-apart design for compact storage and easy transport. It is an excellent choice for versatile rescue operations across diverse terrains.
Incorporating these high-quality products into your rescue operations can significantly improve outcomes and ensure patient safety in challenging conditions.
Peace on your Days
Lance
