By RUSSELL T. ACCARDI

It was 3:59 P.M. when the Margate, FL, Fire Rescue Department received a call for what sounded like a slip-and-fall accident at a nursing home. A second caller, however, reported three workers were trapped in a trench at an excavation site and one was presumed dead. The trench was in the parking lot of the nursing home, adjacent to a hospital.

The first-arriving fire unit was Rescue 118 with Firefighter/ Paramedics Ty Vassil, Rob Davis and Larry Henderson. Vassil gave the initial situation report. Engine 18 arrived with Lieutenant Hector Corona, Driver Engineer Sam Houston and Firefighter/Paramedics Luis Villar and Rob Reul. Corona took command and advised the shift commander and a second station to respond "Code 3," realizing this was not going to be a routine incident.

A boulder the size of a small pickup truck and weighing several tons had become dislodged from the east wall of the trench, pinning the three workers against the opposite trench wall. The trench was six feet wide, 60 feet long and 10 to 12 feet deep. One worker had been killed instantly and another had been helped out of the trench by fellow workers. This left two workers (designated victims 1 and 2) still alive, but trapped.

Pinned By Boulder
Rescuers saw that it would be difficult to dig out the victims – the boulder had pinned their legs and soil covered victim 1 up to his waist and victim 2 up to his chest. Also, the dead man's legs were tangled with victim 1's legs beneath the soil. Davis, Reul and Villar entered the trench immediately to assess the victims and implement any lifesaving procedures needed. They were soon joined by Paramedics Todd Kroupa and Adam Sitman from the second-arriving rescue unit.

Initially, the rescuers dug through the soil by hand, then used an army shovel and a pick found at the worksite. It soon became apparent, however, that this would be an extended operation. The Broward County Fire Rescue Department was asked to send its technical rescue team. While that team was enroute, a decision was made to also call for Fort Lauderdale Fire Rescue's technical rescue team.

After several methods failed to free the victims, high-pressure chisels were used to chip away at the boulder. Adding to the rescue scenerio, a high-power electrical conduuit ran the length of the trench and a 12-inch PVC sewer pipe was located along the bottom of the trench

Broward County's technical rescue team, led by Lieutenant Andy Berkowitz, initiated shoring operations. Broward County Battalion Chief Ben Alderson, the operations sector officer, set up operations adjacent to the excavation site. Margate fire personnel were responsible for patient care and kept two paramedics in the trench who initiated advanced life support, including large-bore IVs, high-flow oxygen and airway management (this was difficult because the victims were vomiting ingested blood).

While Margate firefighters were waiting for the shoring operation to be completed, they feared further collapse and attempted to shore the walls of the trench with anything they could find. They gathered backboards from their rescues, pieces of plywood from the construction site and cribbing off the engine. While they were treating the two live victims, a second collapse suddenly occurred. Reul sustained minor injuries.

Rescue Instructors Respond
While the operation was unfolding, Lieutenant Robert Hoecherl of the Fort Lauderdale technical rescue team remembered that an advanced confined space and industrial rescue class was being taught by South Tech Fire Academy at an industrial site in the Fort Lauderdale area. Hoecherl contacted the instructors, who had the fire academy's heavy rescue fully loaded with equipment that could be used for the rescue. Instructors Mike Reimer, Mike Nugent and Walter Knapp responded to the scene. (Knapp and Nugent also are members of the Broward County technical rescue team.) Having them involved proved beneficial in what turned out to be a seven-hour-plus operation.

Besides the victims being pinned by the boulder and soil, victim 1's left leg was wrapped around a 11Ú4-inch-diameter vertical metal stake; the weight of the boulder had pinned his leg against the stake under the soil line. Another potential problem was an underground high-power electrical conduit running the length of the trench. This had to be addressed by the Florida Power & Light Company. Groundwater intrusion was being addressed by dewatering equipment in place prior to the accident, but it was inadequate during the rescue effort.

After several methods failed to free the victims, high-pressure air chisels were used to chip away at the boulder. This was augmented with a booster line flowing minimum gpm at high pressure to remove dirt and rock from around the victims' lower extremities. Tools that were needed had to be operated out of sight under some of the mud and water to prevent further injury to the victims. Also, a 12-inch polyvinyl chloride (PVC) sewer pipe was located at the bottom of the trench, and rescuers feared it would be punctured by the air chisels, causing raw sewage intrusion into the trench. Another problem was that blood and fluids from the victims was mixing with water and exposing rescuers, due to the destruction of gloves and other protective components by sharp debris.

After three hours, victim 1 was rescued and transported by helicopter to a trauma center. Fearing "crush syndrome" for victim 2, Vassil contacted the trauma center via radio. (Crush syndrome occurs when a part of the body is trapped with no circulation for long periods. The blood in those limbs fills with deadly toxins that, when freed, could cause the individual to go into cardiac arrest.) Vassil asked for the go-ahead to give victim 2 whole blood and treat him for crush syndrome. The hospital agreed and advised to hang two units of blood and give an amp of sodium bicarbonate. Paramedics are not usually allowed to give whole blood in the field because it requires a registered nurse to administer; however, Villar is a registered nurse and was able to hang the blood and infuse it with no complications.

Rescuers needed an additional hour to rescue victim 2, who also was flown to the trauma center. After this was accomplished, the deceased man's body was secured and guarded. Technical rescue team members and local fire rescue workers decontaminated, reported to rehab and held a debriefing to discuss their strategy for removing the remaining victim. An update was given to rescuers at this time indicating the two rescued victims were alive at the trauma center, one in critical condition and the other serious. Victim 3 the fatality was removed at 11:21 P.M., more than seven hours after the initial call, and turned over to the medical examiner's office.

Specialized Training Available
It took an extraordinary team effort by many agencies working together to save the lives of these two workers. This was an example of the need for training in trench and excavation accidents being made available for fire and rescue agencies at the local level.

The South Tech Fire Academy of the Palm Beach County School Board in Florida provides a variety of specialized training programs. Many instructors are members of the two Federal Emergency Management Agency (FEMA) Urban Search and Rescue (USAR) Task Forces located in Florida – Miami-Dade USAR Task Force 1 and South Florida USAR Task Force 2. Members of these USAR teams as well as special operations and technical rescue teams from the region send their personnel to attend training courses at South Tech.

Lessons Learned