TX Department Applies Lessons Learned from Earlier Trench Rescue

On July 9, 2018, at 12:59 p.m., the Irving Fire Department received a call that was first dispatched as an investigation. Shortly after the initial dispatch of Engine 7,  additional information was clarified and the call was upgraded to a trench rescue.

The alarm office dispatched the Technical Rescue Team (TRT) consisting of Engine 6, Medic 6 and Rescue 6 and added Battalion 2, Truck 7 and two EMS supervisors (521 and 522). The temperature was 97 degrees with 86% humidity and no breeze.

This incident, being much more than an investigation, was very similar the May 2016 incident detailed on Firehouse.com.

This article will look at the similarities these two incidents had, how the lessons learned from the 2016 rescue were applied and how they improved the effectiveness of rescuers involved in the recent rescue.

The Irving Fire Department (IFD) is an ISO 1-rated, 361-member career organization. Irving, a suburb of Dallas, has a population of approximately 230,000 and is a mixed bag of occupancies from small residential neighborhoods to large commercial areas, high-rise office buildings, and hotels. The IFD has 12 fire stations, housing 12 engine companies, five truck companies, and 10 advanced life support ambulances (medics). In addition, the department staffs a hazardous materials response team, swift water rescue team, and a technical rescue team. The department is divided into two battalions with a staffing level of 80 members per shift.

The Coppell Fire Department (CFD) is also an ISO Class 1 career organization that is comprised of 81 operational members. They protect a population of approximately 42,000 people within 14.7 square miles. While predominately a bedroom community, Coppell is also home to numerous warehouses and also borders Dallas-Fort Worth (DFW) International Airport. The CFD serves its citizens from three fire stations that house three three-person engine companies, one four-person truck company, three two-person mobile intensive care units (medics) and one battalion chief. The coverage is divided into three shifts with each shift comprised of 26 members. Other than fire and EMS, CFD also provides technical rescue response and is a member of the Texas Intrastate Mutual Aid System.

Upon arrival 

Engine 7 Lt. Allen Herd was first on location and assumed command. His initial size-up stated there was one patient in a trench about 5 feet below-grade, buried to his waist. The patient was conscious and alert and was attempting to self-extricate. The patient’s co-workers were in the trench and command immediately directed them to exit the trench. The patient had been buried up to his neck and his co-workers had managed to clear away the soil down to his waist. Command immediately set up the hazard zone around the trench and denied entry to all except rescue personnel.

After hearing the initial size-up from command, Engine 6/TRT Capt. Paul Harris called for the TRT support trailer which carries the bulk of the department's shoring equipment. In addition, he directed the alarm office to contact the CFD for assistance from their TRT and requested that the alarm office contact the water department and request their heavy vacuum truck. Harris also contacted Battalion 1 to request that all available technical rescue technicians be sent to the scene. This brought the total IFD technicians at the scene to nine.

Developing an IAP

Harris and the TRT along with Battalion 2 Chief Hiedle Baskin arrived on location at the same time and conferred on command. Chief Baskin assumed command and assigned Harris to lead the Technical Rescue Division. Logistics and equipment staging were established and set up near the hot zone. Command requested an additional ambulance to be assigned for patient transport. The alarm office dispatched Medic 7 and added the department's air and light truck for rehab. The Irving Citizens Fire Academy Alumni Association responded with Canteen 1925 to assist with rehab.

After assessing the scene, Harris assigned EMS supervisor 521 Acting Lt. Charles Yancey as the safety officer and directed him to begin air monitoring and setting up the trench rescue command board.

Harris’ assessment revealed that the patient had been working to install a french drain system between a tilt wall office building and an adjoining parking lot. The initial collapse that trapped the patient had sloughed out from under the tilt wall building, creating a void approximately 5 feet wide by 3 feet deep while the soil under the parking lot remained in place. The soil in this area was compacted heavy clay that was moderately damp.

The Rescue Division tried to brief CFD resources—including an engine, truck, medic, rescue, and battalion chief—while they were responding, but there were issues establishing the radio connection.

When CFD crews arrived, the number of rescue technicians on the scene totaled 13, including the battalion chief and his aide.

The technicians were assigned to two-person work crews and sent to the staging area. This created six two-person teams in the Rescue Division.

Rescue Division assigned members to lead key positions:

1. Panel team
2. Rescue team
3. Support teams to clear soil from around the trench.

The Rescue Division assigned CFD Capt. Taylor Baze to oversee rescue operations.

Trench support pads were laid and Harris directed the panel team to insert the first set of strong-back panels. Ventilation was established using the confined space fan and hose from Rescue 6 and maintained throughout the rescue. Air monitoring was also maintained and recorded, remaining within a safe range during the entire incident.

Patient contact

After the first set of panels were installed, the first rescuer entered the trench via ground ladder. The rescuer evaluated the patient’s vital signs and determined all were within acceptable ranges. An IV of normal saline set at TKO rate was established as a precaution and the patient’s vital signs remained stable throughout the incident. The patient was cooperative and even assisted rescuers with soil removal as much as he could. Further evaluation revealed that the patient was now buried to his waist in hard compacted clay.

Extrication  

The water department vacuum truck was immediately positioned near the trench on the concrete parking lot and the suction tube was lowered into the trench. Rescuers used shovels and small hand spades to loosen the soil around the patient’s legs and the vacuum truck was able to remove this soil rapidly. The vacuum truck did become clogged on two occasions, but the water department crews were able to quickly clear the obstructions.

Harris and Baze conferred and decided to insert a second set of panels to allow more rescue personnel into the trench. It was decided that the rescue crews would work in 15-minute rotations. This later was shortened to 10-minute cycles due to the heat and high humidity. After crews exited the trench they were directed to rehab, and then to staging to await their next assignment.

Command noticed clouds building to the north and contacted the alarm office for an update on weather conditions. The AO advised that there was rain just north of the location, but it looked like it would pass by without impacting the incident. Shortly after this conversation, the storm increased and moved into the area.

The rain was significant for approximately 10-15 minutes. When it began to fall, Rescue Division requested a support company be assigned to the roof of the adjacent building to divert rain from the roof downspouts that were connected to the French drain system, upstream of the patient. The Rescue Division also requested a portable awning from rehab. This awning was readied and was set near the trench in preparation to cover the area directly over the patient.

Fortunately, the storm was brief and runoff didn’t become an issue. Shortly after the storm had passed, the patient was freed. He was placed in a stokes basket and transported to Medic 7 for evaluation and transport to Parkland Memorial Hospital in Dallas. The patient was treated and later released with no significant injuries.

Lessons from 2016 incident 

• Safety and communication: As in the previous incident, this rescue was extremely labor-intensive. Maintaining fresh rescue personnel is one of the highest priorities for command. The Rescue Division had decided that crews would only be required to enter the trench for two work cycles. Rescue Division communicated this plan to command as to when additional TRT crews would be required.
• Utilizing training opportunities: The Irving and Coppell fire departments have trained together since the 2016 incident and this has improved communications and our understanding of each team's capabilities. Additional drills for 2018–2019 are in the early planning stages. IFD recently completed a new drill field with props for not only trench rescue, but also confined space simulationd as well as numerous opportunities for high-angle rope rescue.
• Vacuum truck: The water department’s heavy vacuum truck is a tremendous asset and should be called anytime a rescue of this type is undertaken. The prompt use of the vacuum truck shortened the rescue time to two hours, as opposed to the 2016 incident where the vacuum truck was not employed as soon as it arrived. The 2016 incident rescue took approximately three hours.
• Two-person rescue teams: The Rescue Division maintained accountability during this incident by assigning members to two-person teams and sustained those teams throughout the incident. This allowed for greater control and overall safety of the rescuers.
• Calling additional help early: These types of incidents will deplete most department's trained rescue members almost immediately. Calling for help early will prevent delays. Command should have a plan for requesting additional resources, know how many trained rescue technicians are available from surrounding cities and how long it should take those resources to arrive.

Recommendations and lessons learned

• Regular training: Require quarterly training for all rescue technicians in IFD, and coordinate at least yearly training with neighboring TRT teams.
• Increase training levels: Train all remaining members of IFD to the awareness level so they can assist the TRT.
• Extra gear: Add extra rescue PPE to Rescue 6 for rescue technicians not assigned to TRT.
• Medic staging: Have medics positioned near the trench and call for patient medical status, updates, and maintain this information on the electronic patient record.
• Rescue teams: Utilize dedicated two-person rescue teams for greater accountability and tracking for safety purposes.
• City agency relationships: Foster good relationships between departments within your city so that resources and cooperation are readily available.
• Communication between agencies: Direct the alarm office to simplify or streamline the process to allow both departments to communicate via handheld and apparatus radios. Interoperability systems should be tested on a regular basis.
• Prepare for weather: Weather can cause unexpected modifications of the plan. Consider ahead of time how to deal with extreme heat, cold, rain, and other natural circumstances. In this case, limiting time in the trench for workers to prevent heat emergencies and fatigue. Also redirecting the run-off of water away from the trench to avoid worsening conditions, thus keeping the patient and rescuers safe.

In Sum

Rarely in life or the fire service do we get a do-over. This incident was the exception to that rule considering the similarities of these incidents. Because of previous experience in a similar incident, we were able to improve the process and shorten the extrication time of the patient by one hour, resulting in a positive outcome. The patient was released from the hospital with no lasting injuries.

All members involved in this incident can be proud of the outcome, including members of the alarm office, first-due companies, command staff, training division, Irving Citizens Fire Academy Alumni Association, Irving Water Department, as well as both TRT teams from Irving and Coppell.