"HazMat 17. Show this unit responding to the confined space rescue."
Captain Jeff Strickland, officer-in-charge of Miami-Dade Fire Rescue's Technical Rescue Bureau, overheard these words on the radio while in the middle of a telephone conversation in his office. He immediately called the fire alarm office to get more information about the incident and then quickly headed to the scene. Upon arrival, Strickland found units in a rescue mode at a construction site.
A concrete cylindrical lift station had been under construction, and a 26-year-old construction worker had fallen 12 1/2 feet down a five-foot-diameter space, where the bottom was covered with six inches of mud. In spite of the muddy ground condition, it was discovered that the man's airway had not been compromised. Suffocation had been avoided because the victim came to rest with his head turned sideways. Miami-Dade Fire Rescue crews now had a viable patient in an altered mental state who was in need of extrication, treatment and immediate transport.
The crew on Squrt 29, which had been the first unit to arrive at the scene, assessed the situation, established the rescue mode and called for resources. The members placed the truck's boom over the opening for a high anchor point and placed a roof ladder into the hole.
Lieutenant Chris Martindale, with bunker gear, self-contained breathing apparatus (SCBA) and a harness, stood by until Aerial 17 arrived with air-monitoring equipment. After metering was completed and it was determined that a safe atmosphere existed for entry into the confined space, he lowered himself with the use of the ladder to gain access to the victim. As a back-up, Lieutenant Argelio Cruz stood by dressed in appropriate gear.
Captain Alan Perry arrived and assumed command. Positive-pressure ventilation (PPV) was achieved by placing a forced-air fan outside the confined space. A 4:1 retrieval system was anchored to the boom; and a half-back harness and cervical collar were lowered to be placed on the patient. Cruz entered the space on a belay line to assist in the rescue operation.
Once the cervical collar was placed around the victim's neck, he was strapped into the harness, attached to the retrieval system and raised from the confined space. The patient was turned over to an awaiting rescue crew, which placed him on a backboard and loaded him onto a stretcher for transport.
After a reassessment at the medical sector, the patient was deemed to be in serious condition, and Rescue 40 transported him to the University of Miami/Jackson Memorial Hospital Ryder Trauma Center. The victim's condition was upgraded after further evaluation at the emergency room, and he was discharged within a few hours with no significant injuries.
"The outcome of this call was excellent due to the training of our personnel in confined space rescue," Strickland said. "These individuals dedicate off-duty hours to receive extra training for this specialized type of response."
Fire Chief R.D. Paulison stated, "Training and the team concept are vital to special operations such as technical rescue. Our strategies and tactics have been developed by highly motivated firefighters who serve beyond normal duty parameters."
Risk Versus Reward
A survey of confined space incidents in the South Florida area indicates that more than 90 percent of this type of rescue occurs in lift stations. Miami-Dade Fire Rescue dispatches a full technical rescue assignment for confined space entries, and personnel are trained to conduct a thorough risk-versus-benefit analysis on the scene.
The following conditions warrant an entry to be performed in bunker gear and SCBA:
- The patient is within 25 feet and in line of sight.
- The space is metered and then ventilated.
- A fall-arrest system is in place.
- Certified backup personnel are on the scene.
Miami Dade's Technical Rescue Team has streamlined procedures to cut down response time on this type of call. Through training and post-incident evaluation, they also have found that set-up and extrication times have decreased dramatically.
LaVerne Guillen is a public information officer with the Miami-Dade Fire Rescue Department.