Low Angle Litter Handling and Management

Introduction

Low-angle litter handling involves techniques for safely transporting patients across less severe terrain. While the challenges may be less technical than high-angle rescues, they require precise teamwork, equipment mastery, and an understanding of terrain management. This unit focuses on Class 1–3 terrain, covering essential techniques, roles within the rescue team, and strategies for navigating steep or confined areas.

Class 1–3 Litter Handling

Building Confidence in Low-Angle Terrain

Rescue personnel must navigate challenging terrain confidently while minimizing risk. This requires:

• Deliberate Use of Handholds and Footholds: Always search for secure hand and footholds before proceeding. Footholds are generally preferred because legs can bear weight for extended periods, reducing fatigue on the arms. Testing holds before committing ensures stability and safety.
• Understanding Terrain Difficulty: Class 1 terrain involves flat or gently sloping ground, Class 2 terrain includes moderate slopes where ropes might assist, and Class 3 requires scrambling, using hands and feet for support. Adapting techniques to the terrain is essential for safety and efficiency.

Securing the Patient in the Litter

1. Ensuring Patient Stability

Proper patient packaging ensures safety during transport. This process includes:

• Immobilizing the Patient: Secure the patient with straps, webbing, or a tie-in system designed for litter operations. Immobilization prevents movement that could worsen injuries or cause the patient to fall from the litter.
• Positioning the Patient Correctly: Place the patient so their head is slightly elevated compared to their feet, unless medical conditions require otherwise. This minimizes discomfort and reduces strain during transport.
• Padding the Litter: Use padding to protect the patient from bumps or jolts caused by uneven terrain. This can include foam, blankets, or specialized inserts.

2. Selecting the Right Equipment

The choice of litter significantly impacts the operation:

• Size and Weight: Ensure the litter is appropriate for the patient’s size and weight. Overloading a litter can compromise its structural integrity and increase risks during transport.
• Litter Wheels: Adding a wheel attachment can ease transport over rough or uneven terrain, reducing the physical strain on litter bearers.

Low-Angle Techniques for Litter Transport

1. Team-Based Operations

Effective low-angle litter operations rely on clear team roles and coordination. Key roles include:

• Team Leader: This individual oversees the entire operation, coordinates with other team members, and ensures that safety protocols are followed.
• Patient Attendant: Responsible for the patient’s well-being, the attendant maintains verbal reassurance and monitors the patient’s condition throughout the transport.
• Scout: The scout identifies the safest and most efficient route, marking hazards and providing real-time updates to the team.
• Rigger: Handles the technical setup of rope systems and anchors, ensuring stability and control during transport.

2. Responsibilities of Litter Bearers

Litter bearers play a critical role in patient transport:

• Clearing Obstacles: Bearers should clear the path ahead, removing debris, stabilizing the footing, or marking hazards for the rest of the team.
• Rotating Roles: To prevent fatigue, rotate bearers frequently. Fresh bearers ensure smoother movement and reduce the risk of injury.
• Maintaining Smooth Movement: Avoid jostling the patient during transport. Move with deliberate, controlled steps, and communicate changes in pace or direction to the rest of the team.

Route Finding and Navigation

1. Scouting the Route

The scout works ahead of the team to:

• Identify potential hazards such as loose rocks, unstable ground, or narrow passages.
• Mark safe paths and alternate routes for the litter team to follow.
• Anticipate challenges such as steep sections or constricted spaces, providing solutions before the litter reaches those areas.

2. Techniques for Constricted Areas

Constricted spaces require specialized techniques to maneuver the litter:

• Turtle Crawl: One or two bearers crawl under the litter, supporting it on their backs while additional team members guide it from the ends. This method is effective in narrow spaces where walking alongside the litter is impossible.
• Caterpillar Method: Bearers sit facing each other and pass the litter across their legs. This keeps the litter low to the ground, avoiding low-hanging obstacles.

Handling Confined Spaces and Steep Terrain

1. Adapting Techniques for Low-Angle Slopes

Low-angle terrain often presents challenges such as shifting surfaces or steep inclines:

• Quick Belays: Attach a single-line belay to the litter using pre-tied anchors and a Munter hitch. This adds control and prevents the litter from sliding in steep sections.
• Belayer and Safety Roles: The belayer controls the slack in the rope, while the safety ensures that the belay line remains secure. These roles are crucial for maintaining stability.

2. Managing Confined Areas

In confined spaces:

• Pre-position personnel ahead of the litter to streamline its passage.
• Use short, deliberate movements to navigate tight turns or obstacles.
• Maintain constant communication between team members to coordinate efforts effectively.

Best Practices for Low-Angle Litter Work

Proper Lifting Techniques

• Use your legs, not your back, to lift and carry the litter. This reduces the risk of back injuries.
• Keep the litter close to your body for better control and stability.
• Avoid sudden movements, which can destabilize the litter and increase strain on bearers.

Protective Gear

• Gloves: Prevent abrasions and improve grip on ropes and the litter.
• Long Pants: Protect against scrapes and minor injuries caused by contact with rough terrain.

Communication

• Use clear, standardized commands to coordinate movements. For example, “Lift,” “Hold,” and “Lower” should be understood by all team members to avoid confusion.

Common Challenges and Solutions

1. Unstable Terrain

Challenge: Loose rocks or uneven surfaces can destabilize the litter.
Solution: Use quick belays and scout ahead to mark the safest path.

2. Fatigue

Challenge: Litter bearers tire quickly on steep or rough terrain.
Solution: Rotate bearers frequently and ensure team members stay hydrated and rested.

3. Narrow Passages

Challenge: Tight spaces make maneuvering the litter difficult.
Solution: Employ techniques like the turtle crawl or caterpillar method to navigate constrictions.

Equipment Recommendations

Top 3 Products from Rescue Response Gear’s Patient Care Category:

1. 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.
2. 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.
3. 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.

Final Thoughts

Low-angle litter handling and management are foundational skills in rope rescue. Mastering these techniques ensures patient safety and builds team efficiency. In Unit 3, we will explore advanced techniques for transitioning between ascent and descent, preparing you for more complex terrain challenges.

Peace on your Days

Lance