Do you have personnel with the skills, equipment and confined space knowledge necessary both to extract the entrant and ensure the safety of the rescuers? Unfortunately, rescuers have often become victims as a result of not being aware of their limitations. Prior to enactment of the permit-required confined space regulations, 60 percent of all fatalities in confined space incidents where multiple fatalities occurred were would-be rescuers.
Emergency response to confined space incidents cannot be approached exactly like emergency response to other incidents, such as a fire. For example, if an industrial fire brigade responds to a fire and the fire grows beyond their capabilities, the team has the option to back out and let it burn -- suffering a loss of equipment rather than risking their lives. However, when an entrant goes down in a confined space and the rescue team stands down due to inadequate training, the result is the sacrifice of the entrant's life. Decisions to limit confined space rescue capabilities gamble with both the entrant's life and the lives of the rescuers.
Rescuers and non-rescuers alike should be aware of the limitations of their capabilities in order to avoid becoming victims. A perfect example of this occurred in the Middle East two years ago. Firefighters at a refinery responded to an incident in which an entrant was down in a confined space where hydrogen sulfide was the culprit. The fire officer realized that the firefighters had not received the training necessary to perform confined space rescue safely. In addition to not having adequate confined space rescue training, he knew that the level of the hydrogen sulfide might create an explosive hazard from which the firefighters would be unprotected if they attempted the rescue. The fire officer made a decision not to attempt rescue and to move the firefighters to a safe area. Almost immediately after evacuating the area the vessel exploded, destroying most of the processing unit. The fire officer's critical evaluation of the team's capabilities and the subsequent "no-go" decision saved the life of the firefighters. Other responders in similar situations have not been so lucky.
Evaluating the team's capability in terms of rescue skills is a multi-step process. First, a "paper" evaluation should be performed to determine if the proper skills have been taught to the team. If the paper evaluation indicated that the team has done what is required to be prepared for rescue, a "performance" evaluation should be conducted to determine whether the team is actually capable of performing rescue from the types of spaces and under the circumstances which they will be expected to operate.
An important item often overlooked is that in virtually every case the team should be trained in high-angle rescue techniques as well as confined space rescue techniques. Many confined spaces are located above ground, or have access portals that are located above grade where the only access is by caged ladder or scaffolding. The rescue team must be able to move the rescued entrant to the ground after extraction from the confined space in order to complete the rescue. Additionally, many of the same techniques used for high-angle rescue, such as lowering systems, are also used for confined space rescue. Unless every space in the facility is configured such that a rescued entrant would not have to be lowered, high-angle rescue training is an indispensable part of the rescue training.
Some of the specific skills that should be evaluated include rescue knots, anchoring and rigging, equipment selection and maintenance, patient packaging, lowering systems, hauling systems, safety belay systems and pre-planning for rescue. Additionally, if there are any spaces that have actual or potential atmospheric hazards, training should include the proper use of respiratory protection. This training must include performing practice rescues while wearing the appropriate respiratory equipment.
The person conducting the evaluation must have the knowledge and experience necessary to critically evaluate the capability of the team. Rescue experience is a critical factor in selecting the evaluator. The evaluator must have the experience and broad rescue knowledge necessary to recognize a safe application of the technique being used, or a safe adaptation of a particular technique to cope with the circumstances of the rescue.
Part of the performance evaluation should include a critique, or debriefing, to address deficiencies in the performance of the rescue. In this context, "deficiency" includes identifying how the rescue could have been performed more efficiently, or with less exposure to the rescuers. Even if the rescue is satisfactorily performed, the evaluator must have the requisite knowledge and experience to conduct this critique so that the team can improve its performance. It is difficult to get the most out of a performance evaluation if team members are conducting their own evaluations. Because team members generally have similar levels of training, they may not recognize deficiencies as readily as an experienced outside evaluator.
Some of the areas that should be specifically addressed in the performance evaluation area safety, rescue strategy, efficiency of the rescue plan, proper and effective team operations during the rescue, timeliness of preparation and insertion of the rescuer, appropriate patient care, and the speed of completing the rescue. Again, the evaluator's experience is critical in order to adequately evaluate the rescue and address ways to improve performance.
HAZARD EVALUATION AND ASSESSMENT SKILLS
In evaluating the state of training for confined space rescue capability, it is important not to develop tunnel vision and focus solely on ability to build and operate rescue systems. Technical rescue capability not only includes these skills, but the ability to critically evaluate the hazards of confined spaces and implement the measures necessary to protect against those hazards. In instances where would-be rescuers have been killed, it has been almost exclusively as a result of a hazard of the space, as opposed to the improper operation or failure of a rescue system. Therefore, it is necessary not only to evaluate the team's ability to perform rescue from a confined space, but to evaluate the team's capability to recognize, assess and address actual or potential hazards while performing rescue.
The team must be trained to properly assess the confined spaces and to evaluate the actual or potential hazards in the space. When rescue is required from a confined space, it is obviously because something has gone wrong in the space. Considering that the space was presumably evaluated prior to the initial entry, the rescuers are assessing a space where something was missed on the initial evaluation, or where something has changed in the space that was not anticipated in the initial evaluation.
In either case, it becomes easy to understand why the rescuers must be well trained in confined space hazard assessment in order to safely perform rescue. The rescue team must quickly and accurately reevaluate the confined space in a time pressure situation and continuously reevaluate the situation while performing rescue. They must determine whether a hazard was missed or changed, determine any required changes to personal protective equipment, develop a rescue plan , and safely enter the space and perform rescue ... all in time to save the entrant.
Skills must include hazard identification, methods for properly isolating the space from hazards, control of hazardous energy sources, air monitoring, and proper ventilation of confined spaces. For the safety of the rescue team, training in these areas must go beyond the basics. Consider the following scenario as an example.
Rescuers respond to a confined space where an entrant is down. The space is being mechanically ventilated, and air monitoring shows a good atmosphere. A co-worker states that the entrant was halfway down when he fell from the ladder to the bottom of the vessel. The entrant is unresponsive. The first rescuer enters, but halfway down he also falls from the ladder. What might have happened?
In this particular scenario, it may be that due to the configuration of the vessel and the ventilation equipment, the ventilation is "short circuiting" and not providing a full air exchange in the vessel. This would also account for a good air monitor reading at the entry portal. Further, there may be a hazardous gas in the vessel that is heavier than air and has settled in the bottom half of the tank.
Are your rescuers trained and experience enough to recognize whether ventilation is adequate given the configuration of the vessel, the location of open portals, and the substance creating the actual or potential atmospheric hazard? Are they properly trained in air monitoring techniques, including the sampling time of the particular atmospheric monitor they are using? Do they have the knowledge to quickly assess whether the vessel has been properly isolated? Training in all of these areas is critical to safe rescue.
In summary, rescue training and evaluation should be approached with the mindset that in addition to rescuing the entrant, the primary purpose is to protect the rescuers who are performing rescue. Paper and performance evaluations are necessary tools to determine whether the rescue team can properly and safely perform a confined space rescue.
Robert Aguiluz is general counsel for Roco Rescue. Contact Roco Rescue at (800)647-7626.