Technical Rescue: First Due to a Confined-Space Rescue

Two municipal utility workers arrive at a lift station in their community to check a potential leak in a pipe. The two enter the lift station, approximately two stories below grade, and check a flange connection on the pipe. The flange fails during the repair and toxic fumes are released into the space.

One worker is overcome immediately; another worker rushes to climb the ladder to safety only to become overcome approximately halfway up the escape ladder. The local fire department arrives in time to remove both workers from the bottom of the space. One worker is pronounced dead on the scene and the other succumbs to his injuries days later.


Stay out of trouble

While the fire department is due credit for jumping into action in an attempt to save the two workers, the department finds itself in trouble for entering the confined space without the proper training, necessary equipment or operational policies in place. Heavy fines and sanctions were put in place against the department, resulting in significant changes regarding the department’s response to these types of incidents.

The scenario described above was an actual confined-space event that could happen anywhere, at any time, in any community. Local fire and EMS providers can find themselves responsible for responding to incidents of this nature in their own response areas. The question is: How will you handle this incident when the time comes?


Recognition and identification

The Occupational Safety and Health Administration (OSHA) define both “non-permit” and “permit-required” confined spaces as enclosed spaces that:

1. Are large enough and configured so that an employee can enter and perform assigned work.

2. Have limited or restricted points of entry and egress.

3. Have not been designed for continuous occupancy.

What makes a confined space “permit required” is that the space has or has the potential to have:

1. A hazardous atmosphere.

2. An engulfment hazard.

3. An internal configuration that could trap or asphyxiate an entrant, such as converging walls or tapering floors and cross sections.

4. Any other recognized serious safety or health risk.

The scenario described at the beginning of this article lists a municipal lift station as a confined space. However, you need not look far in your response areas to find dangerous confined spaces. If your response area includes water towers, silos, industrial settings, sewers and storm drains, manholes and lift stations, then you have the potential to respond to an incident of this magnitude.


Common hazards

The atmospheric dangers lurking in confined spaces can be placed in four major categories: oxygen deficiency; toxicity; flammable and explosive materials; and airborne particulates. Oxygen deficiency is the most common cause for injury and death in a confined space. In normal air, the oxygen concentration is approximately 20.9%. Responders use a range of 19.5% to 23.5% as an acceptable scale for oxygen content. However, there are many reasons why there would be a variation from the normal concentration, such as rusting, organic and bacterial releases and chemical reactions in a confined space. Any change in air concentration should be investigated and identified when possible.

The toxicity of a material in a confined space carries a wide variety of safety and health concerns, depending on the material. The primary focus of the responder should be to protect against any route of entry into the body; most commonly through inhalation. It is the quickest route to all of the body’s organs, as the material is exchanged in the lungs and travels through the blood to all areas of the body.

We are taught in our entry-level firefighting course that four things are necessary to support combustion: fuel, heat, oxygen and the chemical chain reaction that brings it all together. Suppression techniques can vary to interrupt this process by removing the fuel, disrupting the chain reaction and isolating the heat source. In the confined-space scenario, it is imperative to identify any flammable and explosive conditions that exist in the space. Once identified, rescuers can define the materials’ flammable range, consisting of the lower explosive limit (LEL) and the upper explosive limit (LEL), and determine how to make the space safe to enter.

Some confined spaces can contain materials that, while seemingly harmless, can pose hazards once they become airborne. Once they are atomized into the air in the form of dust, the dangers from these materials include limited vision, respiratory irritation and distress, oxygen displacement and explosive potential.


First-due considerations

There is a significant potential that local fire departments and EMS providers will be summoned early to a confined-space incident. Many industrial settings list the local emergency services as the responding rescue team, often without the fire department’s knowledge. When this occurs, setting the stage early for a safe operation is critical.

While the rescue team is responding, there are a few steps to be taken initially upon arrival of the first-due units:

• Gather information. The first-arriving officer establishes command and begins the process of finding out what happened, who is involved and what is the nature of the incident. For example, the downed worker could have suffered a medical emergency or a traumatic injury or was overcome by a chemical introduction into the space. Depending on these answers, rescue teams can set the stage for specific operations to remove the victims safely and efficiently.

• Monitor the atmosphere. Begin to determine the safe work area around the space by monitoring the atmosphere around the entry point. Initial responders shall be on breathing air while monitoring until the area around the space can be confirmed to be safe.

• Ventilate. After determining a safe atmosphere around the space, begin ventilation within the space. Most times, it would be more beneficial to provide positive-pressure ventilation (PPV) within the space, as an increase in pressure will help purge the space and replace the atmosphere inside with fresh air. A word of caution here: be sure that atmospheric monitoring has confirmed no toxins exist within the space, as whatever is displaced outside will vent directly into the area where rescue teams will need to work. If this is the case, the space will need to be vented in a direction away from the rescuers. Additionally, along with providing adequate ventilation, the fan must be intrinsically safe; it must be able to operate in an explosive atmosphere without generating an ignition source. Fire department vent fans usually will not fit this need; specific fans for confined-space operations are needed.

• Lockout/tagout. Many spaces have moving blades and mixing parts within the space. Isolating energy sources and securing them must be done before anyone enters the space. Some processes take multiple steps in specific order for processes to be shut down. Find a qualified person on-site who is familiar with the isolation process to confirm that the energy sources for the space are shut down.

These steps to secure the scene and set up the rescue area will let the rescue team begin setting up for entry immediately on arrival. Information gathered during these operations should be given to the rescue team officer for consideration in making the entry. This information will aid in determining the best course of action related to removing the victim from the space.


In jurisdictions large and small, the dangers of confined spaces are countless and can cause injury and death at any time. Rescuers who accept this challenge must be well versed in hazardous materials, technical rope rescue, medical treatment and patient packaging and lockout/tagout, to name only a few concerns. This responsibility requires continuing educational commitments, administrative support from the top brass and interactive support from cooperating agencies.

Initial responders who are unfamiliar with these hazards may find themselves at significant risk; these responders should not operate beyond the scope of their capabilities, as it is possible the rescuer can easily become the victim at these incidents. n


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