At about 2 P.M., the man was working for a contractor, cleaning and repairing a dam gate at the Elk City Reservoir, a small lake located a few miles northwest of Independence, KS, when he fell from the top of the gate. He landed first on the concrete floor, then fell into the gate chamber and into a pool of water of unknown depth. The total height of the worker's fall was between 50 and 60 feet.
Photo courtesy of the Cherryvale Fire Department The victim of the fall is prepared for extrication to the top of the dam gate after he was examined and emergency medical treatment was begun.
Located in Montgomery County in southeastern Kansas, the city of Cherryvale is protected by a small combination paid/volunteer fire department. Fire protection is limited to Cherryvale but the department also provides EMS coverage to the city and surrounding area.
The Cherryvale Fire Department/EMS, headed by Chief Paul Newton, operates with one member on duty 24 hours a day. Eleven volunteers provide additional personnel for fires and EMS runs. Newton has four full-time firefighters, all of them continuing their medical training to the paramedic level.
Seeing the need for a high angle rescue team, Newton and Lieutenant David Boles attended a basic high angle rescue course in 1993. Growing more interested in the subject, they attended an advanced course, bringing these techniques back to the department. The rescuers continue their in-service training one day per month in the warmer months, and average every other month during cold weather.
The area of the lake is protected by the Independence Rural Fire Department and Independence EMS. Due to the nature of the emergency call, however, the Cherryvale Fire Department was immediately placed on standby by responding members of the Independence EMS. When it was verified that the man was still inaccessible, Cherryvale was asked to respond, being one of the few departments in the area trained and equipped to handle such incidents.
Cherryvale responded with three trained personnel Newton, Captain Chad Russell (a lieutenant at the time of the incident) and Firefighter/EMT-D Richard van der Lek. Constantly being updated on the patient's condition and location, Newton had a very good picture of the incident scene by the time of their arrival.
Making this possible is no accident. Just the prior weekend, the Cherryvale Fire Department held a training session with Independence EMS and an Independence Community College paramedic class. They had gone over a scenario similar to the incident they now were facing.
Fire and EMS personnel on the scene advised the responding rescue crew that the victim was in a pit filled to approximately ten to fifteen feet from the top with water. It was unknown how deep the pit was. The worker was wearing a harness with a half-inch rope tied on but this did not stop his fall. Co-workers had thrown him a life ring in an attempt to keep him afloat. They also attempted to lift him out, using his harness rope. This was abandoned after he was out of the water, due to the weight of his water-soaked clothing and fear of increased injury.
Independence EMS had responded to the initial call and, upon arrival, had secured the scene and the victim as best they could, having no way to reach him. Dennis Long was in charge of patient care and immediately called for Medflight, from Joplin, MO, to respond. This was because of the mechanism of injury, estimated extrication time, Medflight's response time of approximately 30 minutes and the fact that there is no trauma center nearby. Air evacuation of the patient was the quickest way to get the patient to definitive care.
Photo courtesy of the Cherryvale Fire Department Fire and EMS personnel pull the victim to safety on top of the dam. Note the safety ties (blue webbing) on two members.
Hearing the initial page-out for EMS, John Strange, an off-duty paramedic with Independence EMS, was the first rope-rescue-trained member equipped to reach the victim. He had brought his personal equipment, knowing that the responding EMS personnel were not equipped to reach the victim if still in the pit. After being assured the atmosphere was safe and getting approval from Long, Strange tied off his rope and rappelled into the water. He could now evaluate the patient and advise of his general condition. Strange would remain in the pit for the duration of the rescue because of the patient's condition, close working environment and the technical aspects of the extrication, there was no room for Strange to come up.
Upon Cherryvale's arrival, Independence Rural Fire Chief Bill Caflisch advised Newton that, due to the technical rescue nature of this operation, he would give Newton command of the scene and that Indepen-dence personnel were there to help. Newton then gave command to Independence EMS Director Rex LaCore, using an ambulance as the command post, due to the communications equipment it carried. Newton then went to inspect the area and plan for the extrication of the injured man.
Newton and Russell soon discovered they faced a two-staged extrication. First, the victim would have to be removed from the pit. Problems were encountered because the lines tied to his harness and to the life ring were twisted around his waist and upper torso. The Cherryvale team tied a three-to-one rigging, anchoring to steelworks on top of the dam's catwalk. Then, removing a section of the catwalk just above the gate, fed the line down to Newton, who also rappelled down into the pit, joining Strange.
With the ropes tangled around the victim, Newton was forced to directly transfer him from his harness to his own. This is something rescuers do not like to do because the victim's harness has already been stressed by the initial fall.
After the transfer, Newton maintained C-spine precautions and gave the order to slowly raise them both to the surface of the pit. There, the EMS crew was ready to begin treatment. The patient was stripped of his wet workclothes, given a full primary and secondary survey, and wrapped in a space blanket and a heavy warm blanket. An IV was started and the patient was completely packaged on a full spine board, again with full C-spine precautions. He was then placed in a Stokes basket and secured with Prusik cord.
Russell was directing the operations topside. With the patient being treated and packaged, Russell went to work resetting the rigging for the next step. This proved to be the most difficult because it was not a straight lift. The lift would have to go over the gate at an angle, then come up to the opening. Newton would be hooked in and be ascending to the opening with the patient, assuring that the patient was constantly being monitored in case a problem should arise.
The anchor and high point for the system was made up of two inch webbing, with a tensile strength of 7,000 pounds, tied and doubled over to increase the strength. A directional pulley was hooked into the rigging at midpoint over the hole, with the three-to-one lifting system on the top end and the load end going down to Newton and the patient. The three-to-one system was used because there were plenty of people for the lift and it allows for more lift per pull over a higher ratio system.
Off-duty personnel familiar with this type of rescue were utilized for other, more technical jobs. Off-duty Independence Firefighter Cody Collier was the set man on the three-to-one lift rigging. Van der Lek, the Cherryvale firefighter, was in charge of the high-point for the system.
Once the patient was treated and secured in the basket, the second lift was initiated. Newton guided the basket, giving directions to Russell above, who directed the score of volunteers pulling on the three-to-one system. Newton found that the offset lift had advantages in that he could "walk" the gate up, giving the basket more stability and eliminating the spin you might get with a free lift.
When they reached the top, the basket had to be turned vertical to facilitate bringing the patient up. Newton had to come out first, due to the load weight and being tied in to the rigging. Two-inch webbing had been attached to the head and foot of the basket, then fed into the anchor plate used in the lifting bridle. The "head" webbing was handed up and pulled by rescuers above, to rotate the basket to a "head-up" position. Newton then walked up the basket and rigging to get out, allowing for the final lift, bringing the patient out and onto the catwalk.
At this point, the Medflight paramedics took over treatment. The patient was again assessed, removed from the Stokes basket and placed on an EMS gurney. He was then moved to the awaiting helicopter in serious but stable condition and flown to St. John Hospital in Joplin.
In his accident, the worker had received fractures to his foot and heel, some upper extremity nerve damage and mild hypothermia. The doctors at St. John Hospital told him that injuries to the heel such as he sustained usually result in a permanent gait deficiency but, because he was not allowed to use his extremities while being extricated, they have seen little or no deficit. Newton said the victim was a "remarkable guy" he was conscious the entire time, trying to help in every way.
Newton also said of the operation, "We couldn't have pulled this off without the assistance and cooperation of every person and department that was out there. I would like to thank all of them for their tremendous effort and assistance. Everything just clicked."
He continued, "It took a while. I believe from time of call until we were putting away our equipment was close to three hours but technical rescues such as this one take time to set up. Everyone out there knew this from the familiarization and training that we had conducted, showing everyone what was involved in this type of operation. It was a true team effort. It is something that we went that far from our station to rescue someone who turns out to be from our own town."
This was the first actual rescue the high angle rescue team had performed, and only the second time it was placed on standby. Since this incident, interest has spread in high angle rescue has increased. A committee of members from Cherryvale and Independence fire departments and Independence EMS has been put together to train and purchase the specialized equipment needed for a team such as this.
Cherryvale started its team mostly with money raised from hosting a "haunted house." Help in buying some equipment also was received from Independence Community College's director of allied health, Debbie LaCore, who is in charge of EMS training at ICC.
Bradley D. Denney has been a firefighter for over 23 years and an EMT for over 18 years, moving up the ranks to assistant chief of a combination department. He is a Certified Hazardous Materials Technician and an Instructor I through the University of Kansas, Fire Service Training, where he is an associate instructor.
