On a daily basis around the nation, emergency responders must handle incidents in confined spaces. Not all of these agencies have technical teams at their immediate disposal or even in their first alarm assignments. Working a confined space incident can cause a little anxiety in the company officer if they have only minimal training or don't see a lot of confined space emergencies.
Confined spaces have unique problems to assess during size-up; they pose special safety considerations for responding companies. Initial actions that should be taken in order to make the confined space incident a more manageable one are a little different than a vehicle accident. This article is the first of a series that will clarify some of the issues at hand and help the first-in officer manage the situation prior to the arrival of technician level personnel.
Confined spaces are defined as areas large enough and so configured that one can bodily enter and work in them, but have a restricted means of access or egress and are not designed for continuous occupancy. Confined spaces are not just subterranean spaces. Sometimes they can be above ground, like in a supported overhead tank or a railcar. Sometimes, they may even have horizontal entries at grade. Whether or not you have a "permit-required" confined space or your garden-variety confined space has to do with parameters set forth in OSHA 29 CFR 1910.146 . A permit-required confined space is one that is not designed for continuous occupancy and has a restricted means of egress/access. These spaces also have other dangerous qualities that require consideration. Some of these characteristics include containing or having the potential to contain a hazardous atmosphere; hazards like converging walls, existence of sloping floors or engulfment potential, or other recognized serious safety or health hazards . All organizations should have a policy to deal with permit-required confined spaces, whether the direction is to send trained and equipped personnel in to deal with them, or to simply secure the space and await the arrival of a trained and equipped team.
Given confined spaces for which we have little or no pre-arrival information, the question arises, "What should the company officer do to keep personnel safe?" Well, to begin with, if you're not trained or equipped to enter the space, don't. Essentially, a confined space incident is a "HAZMAT on rope". Not to oversimplify the situation, but anything you can expect to see on a HAZMAT or a rope rescue incident will begin to frame the same expectations for your confined space incident. If you're not prepared to atmospherically monitor the space, ventilate the space, or control the energy or products going into the space, you shouldn't be putting response personnel into that space either. Remember that over 50% of the victims in confined space incidents are would-be "rescuers".
Before getting out and dealing with the incident, the first issue to consider is apparatus positioning. Even if the only thing visible is a manhole, apparatus placement is an issue that is sometimes overlooked or not thought completely through. If the space is below ground, vehicle exhaust can create a lethal atmosphere for the victim or for rescuers. Exhaust doesn't exclusively go through the entry either; parking closely to built-in ventilation intakes can pull vehicle exhaust into the space if you're not careful. In addition to atmospheric considerations, spotting apparatus in the wrong place could cause space instability if collapse hazards exist, especially in trenches and excavations.
The company officer's initial efforts upon arrival should be assessment and control of hazards, making sure the incident doesn't get worse after arrival than it was before you got there. Occupancy type, the presence of HAZMAT clues like placarding or containers, and tools like welders or pressure-washers may point toward what kinds of hazards rescuers will encounter.
Are there co-workers or bystanders on scene attempting rescue? Don't allow more victims to add to the complexity of the situation. Order everyone out of the hole that can get out or can be hauled out. Isolate the scene by creating a hot zone and move unauthorized personnel away from the entrance until you can secure the space. If attendants are actively belaying an entrant, relieve them and remove them from the immediate danger area to a safe area where they can be interviewed. If the attendant has a permit, obtain it to find out what factors exist. Whatever happens, don't become the next victim- SCBA and turnouts are not always going to protect you from some of the hazards that exist in these spaces. (What if the mechanism of injury was electrocution?). Get some clues as to what situation exists in that environment; controlling those hazards must occur in the first part of your incident action plan.
Victim contact is an important task to be performed as early as possible. Not only will the contact help establish location, but communicating with the victim assists in evaluating adequate airway, breathing, and circulation, and might help in determining the mechanism of injury. Furthermore, talking with the victim provides psychiatric first aid by lowering victim stress levels and giving them hope. Continued communication with the victim is important to convey what is being done and to get the victim to help in their rescue, if they are able to do so. If the victim has been in the space for an extended time and does not respond to repeated communication attempts, the lack of communication may indicate that the victim is no longer viable and should be considered when performing the risk/benefit analysis.
Size-up of the situation is required to gather information for the incident action plan and to determine what further hazards exist for rescuers and victims. Size-up consists of scene observation as well as interview of attendants or bystanders. Use tactical checklists to aid in incident organization and to make sure all pertinent needs are addressed. Checklists are easy to develop; they help rescuers cover all the bases and there's no extra credit for completing the incident without one.
Access points and the entry to the space should be evaluated. What is the size of the opening? If the opening is smaller than 24 inches at the smallest part, it will pose a challenge for the entry team wearing SCBA and protective clothing, not to mention that getting a litter through that opening may be very difficult. The shape of the opening may affect the choice between litter types. The angle of entry into the space, whether vertical or horizontal, is going to affect the choice of tactics. Approach, or the height to the opening, may mean the difference between a short twenty-foot haul and a one hundred-foot haul.
Evaluation of entry conditions can provide insight as to the complexity of the space and the nature of hazards in the space. What is the atmospheric situation? If the space was being properly monitored, obtain the last reported oxygen concentration, flammability and toxicity data. Don't, however, trust blindly in the contractor's readings. Incorrect readings might be why there's a problem in the first place. Early ventilation should be considered to make the space tenable.
What work was being performed? This may give a clue as to the nature of the problem as well. The type of work may indicate that the space has a problem atmosphere to deal with. Were they cleaning a railcar tank or were they welding in a waste pit? Cleaning a railcar may release chemicals previously transported and welding produces toxic byproducts of combustion that can quickly overtake someone working in a poorly ventilated space. Knowing ahead of time the possible effects of different kinds of work can provide some indication as to what may have happened or as to what hazards exist.
Mechanism and duration of entrapment is an important facet to explore. I will suggest to you that going into a space not knowing anything about the mechanism of entrapment is going to cause some significant operational problems. Don't get tunnel vision thinking that every confined space emergency is a HAZMAT situation and forget about some of the other serious hazards that are potentially lying in wait. I have responded on plenty of incidents where the space was atmospherically sound, but an electrocution had taken place, or someone had fallen, or the victim was entangled in machinery. What equipment should the entry team take? What protective equipment should they wear?
Consider the duration of entrapment when performing the risk/benefit analysis. Is this a rescue or a recovery? Take an objective look at the scene and assess risk versus benefit. Do not sacrifice personnel performing an obvious recovery. I have been on my share of incidents where as the Rescue Team Leader I had to take a hard look at the facts and pull back on the reins. I will risk a great deal if it means saving a life; I will take very cautious steps (and maybe even, in some cases, not take any risk) if it turns out that we're doing a body recovery. It's important to help the grieving family, but I'd just as soon keep the numbers of grieving families to a minimum and not have to conduct firefighter funerals. Call for additional resources if the clues point you in that direction at this time.
The good thing about dealing with a confined space incident (if there is a "good thing") is that if things were being done properly by the entrants and attendants, there will be at least someone who knows what happened that can brief the arriving companies. There should be an attendant or a supervisor that can give you some idea as to what is occurring. This, however, is not likely though, because if they were doing things right in the first place, you probably wouldn't be there right now, would you? We will go further in depth on entrant and attendant issues in a future article. In the meanwhile, though, we have a scene to deal with. We will assume command and account for personnel in the next article.
