At 2:00 a.m. or 2:00 p.m., in a career or volunteer fire department, in a big city or rural community, all rescuers must share an important common trait: rescue readiness. So, what does this mean, and how does a department determine if it is up to the challenges presented by the ever-changing field of motor vehicle accident (MVA) extrication?
For some, this is an easy question to answer. Yet, for many, the answer is perplexing. Individually, the overall question of rescue readiness should not be tough if we're being honest with ourselves.
There are four basic areas of review to discuss when determining your rescue readiness. These include the rescuers' emotional grasp of the challenges presented, their physical capabilities, the apparatus and equipment capabilities, and the department's overall rescue service delivery capabilities.
Gauging a rescuer's mental capacity to perform under duress at a MVA is not always easy and must be viewed objectively. Officers must ensure that personnel assigned to rescue duties have strong enough mettle to work in close proximity to severely injured and trapped patients.
Although this scenario can be very trying for many-especially our younger, less experienced people-you can use your training and the experience of your senior staff to focus your personnel on the rescue priorities.
Hearing the cries of injured victims and seeing their deformities is quite disturbing and can push rescuers to their emotional limits. By adding children to the mix, the potential for rescuer mental fatigue increases greatly. Bosses who overlook the emotional aspect of these incidents are doing a tremendous disservice to the team. If not dealt with immediately, the overall effectiveness of the rescue team will be compromised, and on-scene performance suffers.
In every rescue situation, officers must recognize when their personnel are impacted by what is observed on arrival. If they do not, there is a greater likelihood that patient outcome, crew safety, and crew integrity will be compromised.
One of the most overlooked aspects of rescue work is the actual physical capabilities of our assigned rescuers. In many instances, writers, instructors, and officers often focus on the tools or "hardware" of the job and unintentionally skip the most important ingredient-the rescuer's physical ability. In some departments, this statement can be controversial, but it must be addressed. As in any team sport, the rescue crew is only as strong as its weakest link. In this case, the weakest link may be the difference between the life and death of those we are sworn to protect.
Also consider that the weakest link may pose recognizable hazards to the rest of the team. Rescuers don't have to be Olympic athletes, but they also can't be so out of shape that they're out of breath just carrying the equipment from the rig or be so weak that they are physically unable to operate the necessary tools to perform the rescue. Severe obesity and lack of conditioning may be viewed as acceptable in other vocations, but these issues lead to poor performance by rescuers and even poorer rescue scene outcomes. In obvious, time-sensitive rescue situations, too many of us have witnessed rescuers too obese to fit in a vehicle where immediate patient intervention was required. In the public eye and within our own departments, this is neither professional nor acceptable.
As we are learning from all of our new vehicle technology lessons, tool manufacturers are bulking up the equipment needed to manipulate today's metals. As tool weights increase (the average weight of today's hydraulic cutters is 40 to 50 pounds), so must our physical ability to operate them. In a climate where personnel numbers are being reduced or reassigned, or are simply not available, you cannot rely on having extra personnel available to assist with what has been designed by the tool manufacturers as a one-rescuer unit. With staffing levels being cut throughout the fire service, staffing is one of our biggest hurdles. You must not dwell just on those members whose physical conditioning is an obvious concern.
During my career, I have worked with some big firefighters who were strong, fit, and capable even though their proverbial six-pack abs are a bit less defined when compared to their younger selves. Remember, the rescuer who may be trim and look the part can be just as unhealthy as his counterpart. The two-pack-a-day smoker can be just as much a hindrance to the operation as the two-hamburger-a-day member. All rescue personnel don't have to be marathoners, but they must have the strength and endurance on the rescue scene when they are absolutely required.
Apparatus AND Equipment Capability
When assessing a department's apparatus and equipment capabilities, you must start with its means for transporting the required equipment and personnel to the scene. This is always interesting. Many times I have witnessed everything from cargo vans, pickup trucks, utility bed trucks, ambulances, engines, aerials, and heavy-duty rescue units assigned to get the equipment and rescue personnel to the scene. Perhaps, the easiest way to sum up capabilities needed for rescue rigs is that they need to be of adequate size and weight capacity along with being easily used for rescue company tasks and commensurate with the equipment and crew size. They must also be maneuverable for the types of streets and traffic encountered in each coverage area.
Today's apparatus are being designed with the safety of the rescuer in mind. With the advent of the slide-out and drop-down trays, moveable tool boards, and preconnected reels (hydraulic, air, and electric), the rescuer's job has been made safer and more efficient. When designing or upgrading apparatus, do all you can to eliminate potential rescuer injuries. Additional lighting and weight-related storage are keys to providing increased rescuer safety. Remember to store heavier equipment such as cribbing, chain, and large hydraulic tools in the lower compartments of the rig to prevent the back and shoulder injuries that are so common in our industry.
Rescue companies must store their equipment in a neat and orderly manner. The more haphazardly they store tools, the more inefficient they will perform. It is our personnel's job to know the exact locations and the operations of each piece of equipment. This is something on which rescue personnel must drill regularly.
The evolution of extrication tools is a continuous process that has shown no real sign of slowing down. As the auto manufacturer's fight for market shares of five-star crash-rated vehicles, rescuers must demand tools that are up to the new challenges presented; these challenges are changing rescue companies' capabilities. Departments with outdated tools have very limited capability when faced with new vehicle technology (NVT).
Many of the leading extrication instructors/researchers have stated that today's hydraulic cutters must produce approximately 250,000 pounds of cutting force to be effective on today's ultra-high-strength vehicle components. As tool testing continues, it is evident that this is a minimum number; many tool manufacturers are claiming cutting forces in the 300,000-pound range, while one North American company has advertised up to 500,000 pounds cutting force on its 10,500 pounds-per-square-inch model. Even the largest fire departments in the world are continuously evaluating their rescue company capabilities and are conducting intense field testing of multiple makes and types of extrication equipment. Therefore, departments of all sizes need to consider this same process.
Rescue company supervisors are responsible for evaluating the capability of their current equipment cache. This cannot be done by performing basic extrication maneuvers on junkyard relics. Not everyone can obtain new vehicles built to current standards, so it is important to improvise. An effective way to determine if your current rescue tools can match the NVT challenges is to attach a rebar, a schedule 40 steel pipe, or an angle iron to vehicle posts. This serves as a great simulation of the types of NVT materials. It also provides operating personnel with a more realistic view of the work they must be able to perform.
For all rescue company supervisors, accurately and honestly assessing the capabilities and readiness of their rescue companies is the key to their overall effectiveness. By evaluating these four basic facets of the teams, those charged with their administration can make educated and calculated decisions based on their findings. These evaluations must be based on fact and must be objective. Evaluators must be experienced enough to recognize the company's strengths and weaknesses equally and not be misguided by what they hope to see.
On completion of the evaluation, evaluators must give all personnel the opportunity to review the findings and provide input as necessary. If more rescue companies periodically review their readiness and capabilities, service to their constituents and the safety of personnel can only improve.