This is the third article in a series on confined space emergency response at the company officer level and Part 1 of a section on action plan development. Even if the company officer and the crew have been through Operations Level training, unless the skills learned in that training are practiced routinely, there will still be an appreciable amount of anxiety in dealing with these complex situations.
As I stated in the previous article, the first arriving officer needs to exercise command options appropriate for the emergency scene. Given that this series of articles is targeted toward non-technician units operating as part of a confined space response, the first arriving officer should establish scene control and either assume or pass command. Generally, the rule is: unless you can take an immediate action that is going to make an immediate positive difference in the scene outcome, the first arriving officer should establish a strong, visible, centralized command. Confined space emergencies are too complicated to try to manage them "on the move".
Development of an IAP should be consistent with the organization's standard operating guidelines for entry-type confined space rescue. The IAP should identify the problems at hand and include strategies for dealing with those problems.
Components of a typical action plan might include the following:
- Size-up considerations: site assessment and confined space assessment, including review of any existing permits
- Resource organization and accountability (IMS)
- Control issues: perimeters and control zones, hazard evaluation and control (including energy control), and a comprehensive risk/benefit analysis that evaluates the viability of the victim
- Equipment needed: personal protective equipment, chemical protective clothing, specialized rescue equipment
- Rescue/recovery objectives: on-scene work assignments, communications procedures, emergency decontamination procedures for the victim
- Decontamination procedures for rescuers
- On-scene safety and health procedures, including personnel health monitoring, on-scene rehabilitation, emergency medical care procedures, and the designation of a safety officer
- Scene termination procedures
Size-up considerations should include a site assessment and a confined space assessment. As mentioned in the first article , not all confined space incidents are the same; conditions change, particularly from the time the original preplan survey was conducted until the time the incident occurred. Therefore, the information gathered in the initial size-up is crucial to the development of the plan.
Allocated resources must be organized and accounted for using an incident management system. As the incident commander, you need to know what resources are allocated and determine whether these resources will be sufficient to mitigate the situation. A properly utilized incident management system will also help the IC maintain an appropriate span of control and will aid in locating units operating on the scene.
Control zones must be identified and issues of defining the zones addressed. Physical or environmental hazards need to be managed. How do you plan to address these? First, perimeters and control zones must be established. The primary hazard isolation zone, known as the "Hot" zone, should at least incorporate the area where the hazard is immediately dangerous to life or health. My recommendation is that you give that zone a little more space than just that- just for a start, think about the possibilities for a change in wind direction and think about padding the initial estimate along those lines. The "Warm" zone is where operations will be conducted. The "Cold" zone is where your command post and the civilians will be located. Everyone else should be outside of those defined areas. A more thorough hazard evaluation must follow that and after that, a comprehensive risk/benefit analysis evaluating victim viability is required. The only pressing reason that a team should be considering an entry under any circumstance is to rescue a viable victim. In the case of a body recovery, all efforts should be directed toward mitigating hazards prior to entry; injuring or killing rescue personnel during a recovery is completely unacceptable.
So how do you plan on mitigating the incident? Is the team going to perform an entry? Can this situation be handled without entering the space? Non-entry retrieval may be the quickest and the easiest way to get the victim out, if they're so equipped. If an entry is required, determine whether or not you have the equipment needed: i.e.; personal protective equipment, chemical protective clothing, and/or specialized rescue equipment. If you're planning on entering a confined space with Level "A" PPE, have you first considered whether the victim is likely to be a viable patient? Ventilation is something that can be performed from the outside, is good for improving patient viability, and it makes the scene safer.
The core of the IAP addresses the rescue/recovery objectives. Getting down to the task level requires some hard and fast decisions regarding on-scene work assignments, communications procedures, and emergency decontamination of the victim. Set the tone for the incident by establishing your goals- life safety, property conservation, and the environment. What objectives must be accomplished to meet these goals?
Depending upon the incident, the incident commander must consider the need for decontamination and assign resources to facilitate that endeavor. Obviously, decontamination will be indicated by the type of material present or suspected to be present in the space or surrounding environment. Research must be done to determine if the decontamination planned will be adequate and appropriate for the scene. A high percentage of the space entries we make do not require decontamination. The only way to know that is to monitor the space before and during the entry and to find out what is contained within the space that we have the possibility of being exposed to. If decontamination is required, a decision should be made early on in regard to how many decontamination stations and what type of cleaning solutions will be required. If a hazardous materials release or exposure is suspected, as in any hazmat situation, one should not be sending in entry teams unless the decontamination group has been established and is near to operational as possible. This is done to insure that personnel can be adequately protected and evacuated if something goes wrong with the incident. Granted, decontamination will be required when they exit the hot zone, but contingency plans need to be in place for the accidental breach of protective barriers (SCBA failure, suit breach, etc.) which require rapid removal of personnel. Take care of your own first. If you don't look out for the welfare of these people, don't expect them to have their mind entirely on the mission as they'll be concerned for their own safety.
In Part 2, we will continue with the development of an Incident Action Plan. The remaining sections to plan for will include pre-entry medical monitoring, rehabilitation and treatment of personnel, rapid intervention, and scene termination. After that, we will begin to implement the plan.
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