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These incidents have a tendency to go from bad to worse. What may look at first glance like a simple removal can often disintegrate into a nightmare of failed efforts. Firefighter rescue is a lot different from the rescue of most civilians. For one thing, all firefighters are full grown adults (some of us are more "full grown" than others); there are no 55-pound children being thrown over one arm here. Second is the complications of the turnout clothing and SCBA, which add weight and get hung up on obstacles. Finally there is the psychological stress of knowing this is "one of our own" who will die if we don't get him or her.
If resources and fire conditions permit, multiple avenues of approach should be begun simultaneously. Whichever team gets the victims to safety first will have proven to be effective but if the first attempt fails, a backup plan will already be under way. At most incidents where a firefighter is trapped, the best resource you can have is additional firefighters. Much of the work, including transporting victims, debris removal, etc., will have to be done by hand. A clear chain of command is critical in these instances, though, with a single person designated as the victim-removal officer making decisions as to what steps will be taken and in what order.
Depending on the fire conditions and the mechanism of injury, various drags or carries may be appropriate. Since a large percentage of firefighters in trouble involve those who have run out of air or are otherwise overcome, most often our priority is to remove the victim to a tenable atmosphere with little danger from spinal injury. Under these circumstances, horizontal movement is possible by a single member under many conditions. Grasping the turnout coat collar behind the neck or a combination of coat collar and SCBA straps, will allow a headfirst drag, the preferred position if at all possible. Dragging head first protects the head from getting caught on most obstacles and also prevents the arms and legs from getting wedged into obstructions.
If two rescuers are available and space permits, they should work side-by-side, at the victim's head. It is not practical to try to push dead weight. If one rescuer works at the head and the other at the legs, the member at the head ends up doing 75 percent of the work, and the member at the legs only about 25 percent. If this is the only possible way because of space considerations, the stronger member should be at the head (or the member with the most remaining air supply). Be prepared to switch positions as one member becomes fatigued. If conditions permit, a cadence count i.e., "one, two, three, pull..." helps to coordinate this effort.
If the victim must be brought downstairs before reaching a place of safety, the technique used will vary with the resources available and the weight of the victim. A light- to moderate-weight victim can be brought down by one person using the same drag used to reach the stairs (use extra care to protect the head and neck). A very large firefighter victim in turnout gear and SCBA can be a very difficult challenge to move down a tight staircase. In this case two firefighters and one length of rope can readily solve the problem. Again, using the drag that was used to reach the stairs, one firefighter starts down the stairs with the victim's head and shoulders, shielding this area from harm. At the same time, the second firefighter, rather than trying to carry the lower body and risking being pulled down the stairs on top of both the victim and the first rescuer, simply ties either the handcuff knot or a clove hitch and binder around both the victim's legs at the ankles. This rescuer can the control the victim's descent by feeding rope hand over hand from the landing. Since gravity is assisting the first rescuer, even a small-framed person should be able to move a large victim once on the stairs. The rescuer at the top can provide braking action to control the rate of descent either by taking a half turn around an object or by laying the rope under his foot and flat along the landing, making the rope bend over the lip of the top stair.
Photo by Paul Hashagen
Rapid intervention crews must practice techniques for removing unconscious firefighters out windows, up and down stairs, and up through holes in floors.