Your department is dispatched to a basic life support response for a fall. En route, the lieutenant on the engine gets additional information that the patient is in a hole at a construction site and is partially buried. The lieutenant requests additional resources and a technical rescue response.
On arrival, you find a man buried up to his chest in dirt. The victim is in a hole alongside the outside of a large trench box holding onto the rigging hook of an excavator. There are numerous construction workers in the hole, frantically digging with shovels. The excavator is running, and workers want to use the machine to pull the buried man from the dirt.
Does your department have a plan for how to respond to this type of incident? Have your personnel been trained up to the awareness level for trench rescue? Are you prepared to manage the incident and the actions of the ad hoc rescuers? This article will discuss scene organization and management.
I am assuming that you currently have trench rescue standard operating guidelines (SOGs) that address the initial actions of first responding companies and your technical rescue personnel. If not, I recommend that you put SOGs together specific to trench incidents. It is much easier to manage an incident if all the responders are working from the same document. Most agencies will share their SOGS with you; more than likely, they used someone else's as a template to create their own.
The Initial Response
An engine company will usually be the first-arriving unit on scene. If the first-arriving officer does a complete size-up, calls for the appropriate specialized rescue response, has his crew place a ladder into the trench, and begins securing the scene and setting up a perimeter, then he has done a good job. Too often the unprotected lip of a trench is crowded shoulder-to-shoulder with people who do not need to be there—move them back. Until relieved, that first-in officer is the incident commander (IC).
As crews arrive prior to the arrival of the tech-rescue team, task out the jobs that need to be done. We can't work near the edge until there is edge protection in place, so assign an officer or firefighter to be in charge of getting the spoil pile moved back and ground pads placed. He can be designated hazard control. He may need three to six people working for him to get the job done. Other hazards that may need to be mitigated are heavy equipment that is still running or moving at the edge, unsupported utilities, and water that needs removal.
The Rescue Group Supervisor (RGS) is the rescue technician who is going to run the rescue. Initially, it may be the first-in engine company officer who was the IC and then became the RGS. As soon as rescue technicians arrive on scene, this position should be assigned to a rescue technician. The RGS is concerned with making the working area safe, establishing a safe zone to access the victim, and removing the victim from the trench and transported to the hospital.
To effectively do that, the RGS will need to stay within his span of control. As this is a fast moving environment, he should attempt to supervise no more than five individuals. Having an aide who can assist with assigning and tracking personnel will be very helpful. The aide can also make tactical worksheets and rescue SOGs available as well as document information for the confined space entry permit.
As rescue technicians arrive on scene, assigning the following positions will make management of the incident easier.
Shoring Officer: The shoring officer can supervise a team that will place shores to begin making a safe zone. Working for the shoring officer will be a panel team that will place panels prior to the installation of shores if you are building a sheeting and shoring system. (You may initially spot shore the area closest to the victim if appropriate.) It is critical that the shoring officer oversee the placement of the panels, as he will want to ensure that they are placed appropriately and strategically in relation to the patient and the route the victim has to travel to be removed from the trench.
With limited personnel and a small, simple shoring operation, the RGS may be able to oversee shoring and extrication. Assign a shoring officer early in the incident. As the panel team is placing panels, the shoring team should be getting measurements and be ready to place shores once the panels are in place. The panel team members do not need to be rescue technicians, but their supervisor needs to have been previously trained in panel placement.
Extrication Officer: If the victim is trapped and needs to be extricated, assign an extrication officer to work with a crew to make a plan and implement it as soon as the shoring team has made a safe zone. This allows the shoring team to continue to extend the safe zone as extrication begins. The extrication officer, or one of his team members, should make contact with the victim to assess the situation as it relates to extrication and also the victim's physical and emotional condition. The victim should be kept up-to-date on progress and what the plan is to get him out. If this is not done, the victim may disregard instructions and put rescuers at risk.
Safety Officer: Assign a safety officer. There will be a lot of activity and movement near a potentially hazardous work site, so do this as soon as possible. This allows the IC to concentrate on making assignments and following up to verify that the assignments are being done properly. As more rescue personnel arrive, assign a rescue technician as trench rescue safety. He will have an understanding of the trench shoring techniques being deployed and will know rescuers are working out of a properly protected area.
Equipment Manager/Quartermaster: Assign a rescue technician to stay with the rescue truck to locate equipment as it is requested. This position works for the RGS. In addition, he can keep track of what is being used so that if he anticipates running out of specific equipment he can let the RGS know and the RGS can request additional resources through the IC.
Control the Scene
Unless you set up a choke point to restrict access in and out of the site, you will have people lining the edge of the trench. If your law enforcement agency is not on scene, request assistance. You will need several officers to secure the scene. Workers who are involved in an ad hoc rescue attempt are difficult to control. The scene can be emotionally charged for them. Recognize that they are in pain and frustrated, but you and the members of your organization are responsible for performing the rescue.
Having nonfire/rescue service people doing their own thing puts all of your personnel at risk. Ask them step out of the trench. If they do not follow your instructions the first time, have them removed. They may be used in a support activity such as assisting with moving equipment from the rescue truck or trailer to the scene. Use the foreperson or lead as a consultant when dealing with the movement or stabilizing of their equipment. Shut off equipment, and remove the keys.
Rotate out fire and rescue personnel who are operating in a trench without a harness and replace them with personnel who are wearing class III harnesses. In the event of an injury or secondary collapse, it is much easier to remove a team member wearing a harness than one who is not.
At minimum, a trench rescue response should be a technical rescue truck and some sort of support trailer or truck with a lumber package. These vehicles should park as close to the scene as possible to enable rapid equipment access. Prior to the arrival of the rescue units, assign a crew to move fire apparatus that is not in use to make room for the rescue vehicles. It is not uncommon for the initial response units to block out access by the technical rescue rigs. Use nontechnical rescue personnel to shuttle equipment to the scene from the trucks.
If a contractor is digging the trench, have the contractor's lead, foreperson, or safety officer available. The operator of any heavy equipment on scene is a resource. You may be working with several public works organizations that are assisting with water removal or shoring equipment, so have one of their supervisors available.
Rather than having multiple people speaking directly with the RGS, it may be easier to assign one of your rescue technicians as a liaison officer to communicate with the organization representatives. The trench rescue (TR) safety, shoring, and extrication officers may all want to consult with them.
So what happened to the worker who was buried in the trench? Rescue technicians from the county tech rescue team worked with the local jurisdiction and the city public works to extricate him from the hole. The extrication was made more difficult when the construction workers at the scene would not get out of the trench. One of them took the victim harness from one of the rescuers and put it on the victim upside down. Police ended up removing two of them from the trench and one of them went to jail for the weekend.
The city Vactor truck was the tool of choice to rapidly remove dirt and rocks remotely with a long wand. As the patient was extracted from the hole, he grabbed a knife and cut the leg loop of the harness because he thought it was preventing him from being pulled out.
Lessons learned were to get control of the scene early and assign one person to communicate with the victim to establish a rapport and to keep him in the loop on what is happening.