Sure, there are a ton of courses out there for confined space principles — how to do hole watch, how to monitor, etc. — but just how relevant is this material to a confined space rescuer? When should we build a tripod reeve? What kind of precautions should we take around a patient when getting them out of a space? When do we decide to pull back, regroup, and call this a recovery?
Our local health and safety regulations, where we operate, have taught that most confined space incidents are due to the lack of one of three items:
- The lack of monitoring
- The lack of ventilation
- Or the lack of onsite rescue or expedient rescue
When we show up to rescue, we’re looking at a few items here that we’re going to have to fix, primarily monitoring and ventilation. If that’s what’s causing the problems, we’re going to have to fix them.
Inside Confined Space Rescue Demonstration: Awareness, we’ve broken things down into
- strategies and tactics
- rescue rigging
- patient considerations
For all the ground search and rescue types out there, you’ll probably recognize the acronym L.A.S.T.
Locate, Access, Stabilize, and Transport
This acronym works well in confined spaces, too. When we show up to a confined space incident, it’s not like a high angle incident; the patient isn’t obvious to the rescuers. For example, they’re not usually hanging off the side of a building. Sometimes with confined spaces, we have to go and actually find the patient. Because of this, we’ve modified the acronym to include two major components of confined space rescue: atmosphere and time. Our new acronym, A.T.L.A.S.T., looks like this:
Atmosphere, Time, Locate, Access, Stabilize, and Transport
A – Atmosphere
In Confined Space Rescue 1: Awareness, we went over the “trifecta” of confined space rescue. This includes…
- The geography of the space we’re entering
- Patient considerations
- And atmosphere
Atmosphere conditions create quite a few decision points for us regarding confined space rescue. For example, if the atmosphere is not clean, respirable air, where we rig, then what we wear, and what considerations we have for the patient are all much different than if the atmosphere was clean. We may need to have our edge attendant on breathing air. We may opt to rig a tripod reeve in order to keep the maximum number of rescuers out of harm’s way. We may need to have our rescuers enter the space on air and bring air for the patient. As a confined space rescuer, we need to take a look at all of these tactics.
T – Time
Time plays a critical factor in confined space rescue, especially if the atmosphere is compromised. This tends to bring up that uncomfortable conversation. If the atmosphere’s compromised and the patient is assumed deceased due to the time which has elapsed, why are you risking additional lives?
A safer option may be better off backing out, ventilating — no matter how long that takes — and then carrying out the recovery at a later time. This is not like a high angle scenario; there’s most likely going to be media and onlookers present, but at least you won’t find pictures of you and the victim on the evening news. In situations like this, the patients are usually in a space, out of the viewer’s sight. This gives you and your team some time to deal with some of these issues should they arise.
L – Locate
This brings us to the regular L.A.S.T. acronym. Unlike a traditional high angle rescue or even a trench rescue, many times we may not know where the patient is in the space. Sure, you might get lucky; somebody there may know where they are, where they were working, or perhaps they’re attached to the lifeline and we can follow that bread crumb trail in. However, if not, we’ll have to kit up and send in a recce team to go and find the patient(s) in that space. The other concern we have here is if the atmosphere is not clean, we may have multiple patients in multiple locations. This is an important factor in locating any and all of the patients.
A – Access
Right now, you might be thinking, “Aren’t locate and access the same thing?”
Sure, we can go into a space (and we have been in spaces where we can have someone in a fall protection harness hanging inside the confined space) and locate the patient under L (locate), but we need to now access them. If we’re lucky, the patient’s lying on the ground, supine, ready to be extracted. Though, that seldom occurs in confined space rescue. Often the patient is suspended in a fall protection harness or within a space inside the space. This requires the rescuers to access the patient once they locate the patient.
S – Stabilize
Once again that trifecta we mentioned earlier comes into play here. Are we bringing air in for our patient? Is our patient deceased and this is a recovery operation? Does the patient have their own air in there that we need to supplement? When we package this patient, geographically speaking, are we going to have to bend them to get them out? Is the space we’re working with small? Are we going to be able to put them into the stokes basket? Are we going to have to put them in a webbing harness? First aid in a confined space is also directly affected by the trifecta. Is this a grab and go or a stay and play?
We’ll talk a lot more about patient considerations in the last unit of this course, so stay tuned.
T – Transport
Transport is the actual rope rescue of confined space rescue. This is where we’re going to start looking at our rescue rigging. Are we going to set up a tripod reeve? Are we looking at a split four-to-one? Do we have to cross-haul the patient across a pit or some sort of void inside of that space? That transport decision is what’s going to drive your rigging decisions.
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