The past series of articles discussed everything leading up to the actual air-bag lift. This article will focus on the lift itself. The lift must be carefully orchestrated to ensure it is performed safely and efficiently. Members must confirm they have gathered all of the essential equipment and each member’s role has been clearly assigned.
As reviewed in previous articles, all of the critical extrication equipment should be brought to the lift site. Members must verify that the air-bag system is fully assembled and any additional bags, hoses, shutoffs and air supplies are readily accessible. Members must also evaluate the amount of cribbing on hand to confirm that there is enough staged to crib the height of the load during the rescue operation and to further support the load after it is lifted.
Members should have the necessary EMS equipment ready for treating a severely injured patient and for safely removing the patient from the lift site. Equipment considerations are EMS bags, splints, C-collars, backboards and Stokes baskets.
As with any incident there should be a clearly defined incident command structure. There are a few roles at an air-bag operation that are similar to those at a fire incident, such as the incident commander and the safety officer. In addition to the standard incident command roles, there are many specialty roles that are vital to the success of the operation.
The incident commander (IC) is in charge of the overall operation. The IC should ensure that the appropriate resources are on scene, and crews are being assigned and managed appropriately.
The safety officer at an air-bag operation should focus on the “big picture” of the incident. The safety officer should evaluate the placement of equipment and confirm that all hazards are mitigated prior to the start of the operation. The safety officer should be in a position that offers an unobstructed view of the load that is being lifted. Once lifting operations have commenced, the safety officer monitors the conditions and activities to watch for any shifting of the load, to make sure the load is being cribbed appropriately and to assure members are not unnecessarily being placed in the hazard zone. Any perceived safety concerns or requirements are reported directly to the IC.
A medical officer should be assigned to supervise the medical aspect of the operation. The medical officer or their designee should be near the patient to assess his/her status and injuries. If the victim has crush injuries, it may be necessary to start treatment prior to the completion of the extrication process. The medical officer might end up providing stabilization to the affected body part during the lift operation. The medical officer should verify that appropriate EMS equipment and personnel are ready for victim removal. It is also essential that the medical officer confirm that an ambulance or helicopter is on scene and ready for patient transport.
The lift officer is in charge of the actual lifting operation and gives the command to inflate the air bags. It is critical to have only one person giving commands for the lift to avoid confusion from conflicting orders. The lift officer should be close to the victim and monitor the amount of lift needed to free the victim. If scene conditions do not allow the lift officer to be right with the victim, there should be voice contact with the medical officer who is with the patient.
The control person carries out the orders of the lift officer and runs the air-bag controls upon those orders. The control person should be positioned as far back from the immediate hazard zone as possible, but close enough to be in voice contact with the lift officer (Photo 1). The control person should monitor the pressure in the bags to confirm that the bottom bag is inflated to a lesser percentage than the top bag. This lower inflation allows the bags to be more stable by having the harder upper bag nest into the softer lower bag.