By: Jason Jefferies
The day we were awarded our badge we all had grand notions of the countless numbers of rescues we would perform. We also practiced our look of smug satisfaction we would exhibit on our stoic faces the day we were awarded medals for our harrowing and death-defying action. It did not take long for us to realize that there are many of us riding rigs that might NEVER be placed in the position to rescue an unconscious victim from death’s grip. Truthfully, that is the norm in most of the country. Furthermore, many of the victims we search for are long gone before the arrival of the first fire company. Does that make the fact that potentially we may be placed in that circumstance any less important? NO! Saving a civilian from the throes of danger should the primary focus of every single firefighter in the world. The more efficient we can make ourselves at performing the task of victim rescue, the better prepared we will be when faced with that challenge. The only way we can prepare is to train.
We spend numerous hours learning how to package and remove a downed firefighter from the interior of a burning building, and that is a good thing. One area that needs to be addressed is the removal of a civilian from the interior of a burning building. Before we continue, I am not speaking of assisting an ambulatory occupant out of an area that is somewhat hazardous. I am speaking of the removal of an unconscious civilian in immediate danger of death; the rescue that many dream of but many more never see realized.
When comparing the differences in removing a downed firefighter and a downed civilian, it does not take much to see that removing the firefighter is much easier. The downed firefighter should be equipped with an S.C.B.A. to protect their airway, turnout gear to protect their skin, and a P.A.S.S. device to give us an audible beacon to follow to their location. The RIT should be going forward based upon the firefighter’s LUNAR, last known location, or the Incident Commander’s direction, all of which are valuable pieces of information to assist us in rapidly finding the missing or injured firefighter. By nature of the firefighter’s protective ensemble, we have the luxury of improvised “handles” with which we can use to pull, lift, and manipulate the downed member’s body so that we can expeditiously remove them from the building. Civilians, on the other hand, do not have the same levels of protection from smoke and heat provided by turnout gear and an S.C.B.A. We do not have an audible beacon with which to locate them, and most of the time we are searching for them based upon incomplete and sometimes inaccurate information from bystanders and occupants that have made it out of the building. Lastly, victims do not have ready-made handles on them; we are forced to work with what we find.
Hollywood directors with overactive imaginations have dramatized the heroic rescue of civilians in movies and television programs in a manner that makes the task look glorious, noble, and even easy. In reality, the removal of a victim from a fire building is gritty, difficult, sloppy, and sometimes downright ugly. Why is that? Movie and T.V. portray an almost romantic version of our occupation—a damsel in distress cradled in the arms of a beefy firefighter. Actual fireground photos show a much different picture: wet and exhausted firefighters dragging a burned and lifeless body by whatever they can grab, arms, legs, clothing, etc. That is the ugly reality, but it does not have to be.
When training to remove victims after locating them during a primary search, we normally make use of a hose dummy or a Rescue Randy that has been equipped with an old set of turnout gear or has handles made into the prop. By default, this is what the participants in the training evolution will use to pull the “victim.” The dummies are rigid and easy to move when pushed from any direction. When moving a lifeless victim in the real world, the person is usually completely naked (for whatever reason!) or dressed in clothing that will easily stretch and tear when pulled by a strong and aggressive firefighter. There are no handles to pull them with and their bodies are limp and lifeless, making the task of moving them a frustrating and exhausting endeavor. Where do you think the term “dead weight” comes from? If the occupant has been exposed to extreme heat it is feasible that they may be severely burned, yet still alive. If we attempt to pull them by their extremities that have suffered damaging heat exposure the skin will slough off in our hands further injuring the person and getting us nowhere. If they have become wet by our fire streams, then their skin will be slick, making it difficult for us to maintain a firm grip while dragging. Sure, it would be nice to perform the aesthetically popular yet impractical maneuver of the “Fireman’s Carry,” but smoke and heat conditions may force us to operate in a posture that leaves us low and on the floor. After all, what good would it do to pick a victim up from the clear air on the floor and suffocate them in the deadly cocktail of smoke and fire gases at shoulder level? What we must do is train on multiple ways to either make a set of handles to drag the victim with, or use objects in the fire building to assist us in moving the victim from danger to safety.
For years I have carried a webbing sling made up of 15 feet of 1 inch tubular webbing tied in a water knot with a carabiner in the pocket of my turnout pants. I keep the webbing inside of a medical glove to keep it wrapped correctly and ready for deployment at any time. This vital tool has multiple uses, from lashing hose to securing a ladder, but the primary reason I keep this setup in my pocket is for dragging victims. Making a hasty drag harness is simply a matter of girth hitching the webbing around the chest of the victim and then pulling the ends beneath the armpits. This gives us a secure set of handles to pull with and lifts the victim’s head and shoulders off the floor, protecting the head and reducing friction while moving.
What if I do not have, or have lost, the webbing from my pocket? What if there are multiple victims? At that point we must use what we have available at the time to make a quick drag setup. There are multiple things that we can hopefully locate in close proximity to the victim that we can use to rescue them. Curtains, bed sheets, or blue jeans make excellent adapted “drag straps.” If you are using a long piece of fabric, such as a bed sheet or curtain, lay the middle of the item you have located across the chest of the victim, cross the ends beneath the armpits and shoulders, and you have created an improvised set of handles to pull with. Like the webbing sling, this will lift the victim’s head and shoulders off the floor, reducing drag and protecting them from further injury.
If blue jeans are handy, lay the crotch of the jeans across the chest of the victim and cross the legs of the jeans beneath the armpits and shoulders, and voila! You have created a hasty set of handles to assist you in removing the victim.
When moving the victim to safety, it is critical that others working close to your location are aware of the rescue attempt. Preferably, we would take the victim out of the window close to where they were located; however, there are situations where that cannot be accomplished: high rises, no access for ladders, no window in the room, and anything else you can think of. In low-income and even working-class neighborhoods, it is common to have two families living in a single-family dwelling or garden apartment with bunk beds and dressers blocking the exterior windows. In those cases, removal down the common hallway is the quickest option, provided the fire conditions are tenable in that location. Make sure command knows you are on the move with a victim, so that if additional resources are needed they can be sent to assist you in your efforts. Again, Hollywood shows victims that are beautiful, skinny, buxom females, or children with smudges of smoke on smiling cheeks. The reality is that there are many people that cannot rescue themselves; the morbidly obese being a common and difficult problem. Imagine the nightmare of having to drag a 500-pound civilian down a hallway, much less lifting them out of a window onto the tip of a ladder!
We have all worked a fire in a building where the common hallway is choked with members performing various tasks. Sending a firefighter ahead of the team removing the victim will help to clear the way so that the egress is not slowed by having to squeeze past every Jake trying to get to the seat of the fire. If we have to move the victim past the fire, we must do our best to shield their body from the tremendous radiant heat, or direct hose streams on the fire to put it out. Keep them as low to the floor as possible where the freshest air is, move fluidly and smoothly protecting their head as you go, and traverse the floor to the outside without delay, as quickly and efficiently as you possibly can. We owe them our best efforts, so when the time comes that we are called to perform the task we MUST be prepared to rise to the occasion.
This is a low frequency task that some of us may never get the opportunity to carry out. With that said, the rescue of victims from a fire building is one of the quintessential duties of every firefighter, so training on this task is critical. In any operation we are working against the clock, but more so with removing occupants from the building. The last thing we want to do is locate a viable victim that we might save and then waste valuable time pulling extremities, getting us nowhere, exposing the victim to lethal smoke and heat, and potentially injuring or killing them. Train on these methods and utilize the technique that benefits your fire department the most. By drilling on these methods we can make ourselves more efficient firefighters and potentially make the difference in a civilian’s life.
All correct. Victims are slippery. Expect it. Plan. Train. Win. Awesome JJ