The Split 4 to 1 M.A.

Rigging the 4:1 MA

Often during a confined space rescue there is limited room. Hence the name – Confined Space Rescue!

In an industrial setting this is not only the case inside of the space but outside as well.

We tie our knots as small and as tight as possible, avoid using beckets on pulleys, and try not to use that swivel or extra carabineer. We use every trick we have learned to gain an inch here or foot there. Inevitably, there will be a scenario where we will have limited height and have to use a full length spinal packaging device, like a SKED stretcher.

Quickly, our options become limited in regards to rigging.

Two solutions that can be used are to rig for a low point edge transition with a pike (or pick) and pivot or rig a Split 4:1 Mechanical Advantage system, the focus of this discussion.

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Equipment Review: Petzl ID

PETZL ID review

In this video, Pat discusses the Petzl I’D; a self-braking descender for rescue.

Overview of the device as well as demonstrations for rigging.

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RIT: Graduating From a Joke to Professionalism

Industrial Fire w RIT required

It was a sunny warm morning around in July of 2001. One of those mornings, that it is great to live on the West Coast. Not too warm, however certainly shorts and beach weather. The crew of Engine 3 (E3) was out in their area conducting emergency vehicle operator training for one of their upcoming drivers. At around 10 AM the tones in the truck went off for a structure fire that would drastically change the course of the day and the departments operating procedures for years to come. As the crew listened to the call on the radio for the first alarm fire, Ladder 6, Engine 3, Quint 3, Engine 5, Duty Chief respond emergency, Structure Fire…, they could look up and see heavy smoke in the distance. The crew quickly went back to their regular positions on the apparatus and the driver started emergency to the scene.

The fire was in another firehall’s district. As such, the crew from E3 had to drive over a large bridge onto the island where the other fire district was located. As E3 and E5 (E5 coming from yet another district and over the same bridge) crossed the bridge, the bridge deck was obscured by smoke from the fire. Cars has slowed down to a near crawl in the thick smoke that engulfed the bridge like toxic fog. The crews looked out the window and saw fire already burning through the roof of the nearly 5-acre paper storage warehouse that was on fire.
Industrial Fire w RIT required

Both E3 and E5 radioed this update to L6 who had just arrived on scene and taken command. The officer from L6 was into their 360 as E3 and E5 arrived on scene. E3 was tasked with catching a separate water source and hooking into the building sprinkler system and the E5 crew was split between RIT (Rapid Intervention Team) duties and interior attack. Once E3 completed the sprinkler hook up the E3 Captain and the two E3 firefighters reported to command (leaving the driver with the pump). By now two firefighters from L6 with the officer from E5 had entered the building. The two firefighters from E5, were assigned RIT duties and were situated next to the roll up door the attack team had entered through. This was in the inception days of RIT. Legislation had just been passed and RIT duties were still in their infancy. All Fire Department staff had completed training, and practical implementation had begun. As the E3 Captain reported to command, the two E3 firefighters stopped by the RIT team to provide a ribbing that they, as RIT, would be sitting this one out. On the fire floor no one likes to be “stuck” on RIT. Firefighters join the department to see action and watching others work while stuck on the yellow RIT tarp is seen as a let down. At least it was like that until this call occurred. It was around this time that the RIT team noticed that the 1 ½ hose the entry team had taken into the building with them had not moved in a few minutes. The RIT notified command and radio communication was attempted with the interior team. As the riders from E3 were there with the RIT team, command immediately created a four man RIT and asked them to take a look inside the building. As the RIT started to walk into the roll up door, the E5 Captain came out of a man door further down the Alpha Side of the building. He was missing his helmet, a boot and his jacket was torn open. He muttered out “Collapse, they are trapped”. Command then formally dispatched the RIT team in to find the trapped firefighters, updated the Duty Chief and called for additional resources.

The RIT entered the structure following the hose line of the entry team. They only made it in a hundred or so feet when they lost the line under piles of debris. The debris was predominately racking and paper products and was in a mound close to 20 feet high. Two firefighters, G and M1 were in the front digging by hand through the debris passing it back to the other two firefighters, S and M2 to clear out of the egress path. The visibility went from passable (the RIT could see each other within their 10 foot work area) to no visibility and back regularly as the air currents in the building and the PPV fan at the door moved the smoke and heat around. For those that fight fire you understand the engulfment in blackness that occurs as the black smoke blocks out all sources of light. The flashlight on the RIT teams helmets at times would not even penetrate it. Add to this blackness the sounds of debris falling and forklift propane tanks exploding. The sounds were different. Some of the paper stored in the warehouse was the minivan-sized rolls used in industrial processes, and of course not palleted. As the water from the broken sprinkler (the roof at this time had dropped in a section causing water to pour straight out of the sprinkler line onto the floor) soaked the bottom of these rolls they would fall over wiping out aisles of racking, other rolls and stacked product. This sound was a thud with additional crashing. When a propane tank exploded however it was a definite explosion. The floor would rock and the RIT could hear bits of shrapnel hitting steel and concrete. When the collapsing or exploding occurred the RIT would pause momentarily and uselessly look up at the ceiling or into the darkness beyond waiting to see if the next hit was on them.

Outside things were excited to say the least. Crews in halls that did not respond were pestering the Chief’s office to attend (while it may sound obvious not to do this as the Chief has enough to do, emotions start running high when its your team mates unaccounted for). Crews outside were deployed to the maximum and seeking assistance. At this point in the fire there was only a first alarm assignment on scene. 14 firefighters. Of which one was command, two were pump operators currently operating fire pumps, one was injured, two were missing, four were searching, two were performing fire control and the last two were conducting first aid and acting as the RIT to the RIT team. Full first alarm assignments from three surrounding fire departments were sent to assist as well as a general call back for the initiating fire department was enacted. This would put a total of 14 fire apparatus and associated staff (upwards of 80 firefighters) on scene, but it would take time. At this point the Duty Chief made what would become a controversial decision. He sounded the evacuation of the building.

It was a controversial decision, as firefighters will risk a lot for a savable life, even more so when those lives are their own. Many opinions came in about this evacuation call after the fact. Some opinion revolved around the idea that the Chief on scene should have been willing to risk more. That his training and experience were not up to the task. The other viewpoint was that the Chief was the “man on the ground” and as such had the best vantage point to make the decision. That he did use his training and experience, hence why he made the call. Throw emotion and type A personalities into the post incident analysis and it becomes almost a ballroom brawl. The take away however is that as a fire officer you require the training and the mental mindset that at some point in your career you will have to make a decision that will have a massive, negative effect on people on that scene. Whether that be to let a client’s home burn, triage patients and decide who is unsalvageable or remove your RIT from a compromised structure. As stated once about fire officer duties, you take the paycheck, feel free to do the job.

Inside the structure the RIT had no idea about the logistics in motion outside. While this may seem like hours, in reality this entire rescue took only 20 or so minutes. Not enough time to get mutual aid to attend, or multiple fire units to arrive. The RIT was digging, moving and searching in a chaotic environment inside the structure with debris falling. At times they had to shout to hear each other over the fire and collapsing materials. At times it was eerily quiet. There were always the screaming PASS alarms echoing through out the structure – until the batteries died (replace the batteries on your packs regularly – it may save your life). Tar was dripping onto their gear (the roof was compromised), however they were unaware of this, as they could not see the tar in the dark. Command could see this compromised structure from outside. Then the evacuation of the building was sounded. An announcement went out over the radio, the air horns and federal horns on the trucks were sounded. The RIT stopped and stared at each other. Evacuation. All of their minds raced. One of the firefighters eyes were like saucers in his mask – wide and concerned. If we leave can we find this area again? Will they let us back in? What happens to our mates? Are we abandoning them? One of the firefighters asked “Are we going?” and the response from another firefighter was “The only f*$king place I am going is to the bottom of this pile!”. A calm came over the RIT after this. No more looking uselessly into the air when explosions and falling racking rocked the ground. No more wide eyes. The decision was made. Live or die, the RIT was staying. While a calm came over the RIT, it was the opposite effect on the two trapped firefighters inside. Firefighter R was face down under 20 feet of debris. His nose was broken and his mask was full of blood. His back was also broken. He could not move. The evacuation siren was the last thing he remembers hearing until he came to in the Ambulance. Firefighter D was as mobile as one could be under a pile of debris. He took off his pack as it had run out of air (kids remember to turn off the PASS if you dump your packs – not that I am recommending pack dumping). He started trying to climb out. He was frantic – they were leaving him here and he was not interested in dying in this place.

The RIT continued their work at a frantic pace. They had removed close to 10 feet of debris by hand. And then they met firefighter D. He looked at one of the members with a cold, deliberate stare and said “Get me the f#$k out of here”. There was no emotion to his voice. He just wanted out. Two of the RIT escorted Firefighter D out while the remaining two RIT members continued their search. The RIT air packs had gone into low air alarm and since stopped vibrating. The members only had minutes of air left. It was looking increasingly desperate. At that moment the visibility cleared enough that one of the RIT noticed a hand sticking out of the debris. The remaining two RIT members, with their air packs now empty, took the regulators out of their masks, started breathing smoke and dug down into the debris. They dug out firefighter R, grabbed him from under the armpits and dragged him out of the building.

Shortly after the rescue the building started to collapse creating its own small firestorm in the process. Equipment was destroyed. A ladder truck was moved with a firefighter holding the override as it was still extended with outriggers out (raised a foot or so). The fight went on for another 27 hours until it was finally extinguished. The emotional toll took years. Some firefighters never returned to work, some firefighters retired, some had their whole attitude on life rearranged. No one died however. RIT proved itself to be a valuable asset on the fire ground. The attitude of “sucker, you’re RIT” changed to one of professionalism and responsibility. RIT was now a position not to take lightly. Incident commanders ensured that at least one member of RIT is a senior firefighter that knows the “ins and outs” of a fire ground.

Incident commanders should think about RIT as another tactic that is employed on the fire scene. Except this tactic is pre-planned. Imagine knowing where the fire was located and who was trapped prior to arriving on a scene. Imagine having a view of the area you will need to operate prior to the operation. The RIT does not have to imagine, the RIT has this ability. It needs to be created and then exploited if required by the IC. IC’s should utilize a senior firefighter at a minimum as the RIT Team Lead. It would be preferable to have an officer directly in charge of the RIT. The RIT team should not “rue this duty” of being “stuck on the tarp”. Equipment should be gathered for any potential rescue, a separate water line to a separate pump is preferable, a sketch of the building should be made and alternate means of entry/egress explored. The RIT should be able to identify where every attack and search team in the structure is located. Should the call come that an interior team is in trouble, the RIT should be able to deploy, immediately, to assist them. They should already have a feel for the structure and know the most direct entry and egress points to any team. They need to be prepared. Quite honestly, their teammate’s lives might depend on it.

Another point that was noted after this fire was communications. Not just radio comms on scene (that is always an issue it seems) however communications with the members on scene and the family at home. Imagine being on site, assigned to a pump panel, watching a medivac helicopter land, ambulances come and go and have no idea what has happened to your teammates. Imagine being the wife of a firefighter on duty sitting at home with their child listening to the radio as the breaking news of a massive fire with reports of firefighters missing and other firefighters being sent to the hospital hit the airwaves. And the fire is in your husband’s fire district. The Fire Service can learn from the Military regarding next of kin (NOK) notification. One advantage the military often has is the ability to lock down outside comms when an incident occurs. At a fire scene, the world shows up to watch. Every child with a cell phone can put a video up on You Tube. There is no ability to lock down these means of comms. At the time of this incident the department had no emergency contact forms for its firefighters. Staff were calling other staff who were friends of on duty members to get names and numbers of next of kin. Not an ideal situation, especially if the situation had turned out worse. Especially when you are trying to beat the 24-hour news media to reach the wife, husband, child, mother or father to tell them that their loved one is okay, however lying in a hospital bed. Create a quick next of kin form and keep it updated. Also be prepared for the onslaught of calls that will come into the department. The media will call, family members will call, off duty staff will call. Someone needs to be tasked to handle this communications traffic. None of these folks will take no for an answer.

And for the disclaimer. I attended this call. These are my memories. My mates may remember some of the small details differently. No one, myself included, is trying to “mislead” anyone. When “it” hits the fan and the adrenalin kicks in, the brain has a tendency to pick up on, focus on and remember different items, depending on the individual. Time slows, time flies, sometimes at once – those who have had these experiences understand this.

Lessons Learned at GRIMP Day: Dual Team Command

GRIMP Day lessons

Each year, I get the evaluation sheets from the teams who took part in the Grimpday. After reading it , I have noticed that there is often a correlation between the time taken by the team to execute a rescue operation and the points awarded to the work of the team leader.

Out of a total of 100 points , 25 are potentially allocated to the team leader, 10 are allocated to the controllers “appreciation” and 30 to the timing. The remainder are for the rigging and rescue.

GRIMP Scenario Evaluation Sheets

If the team leader’s job wasn’t good , the appreciation of the controller won’t be good either. And finally the timing used for the rescue will not be extraordinary.

I have read and seen a lot of publications about the technical part of the job of rope rescuer, but I’ve never found anything on the way to command a rescue team.

While remaining humble, to put his finger on a problem or failure is still very easy but to propose a solution is always more delicate…

What I propose is not my own idea. I’m just using knowledge of military operations. The following is a basic infantry technique:

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The Other Side of Search and Rescue

When most hear the term SAR (Search and Rescue), they think of a group in brightly coloured jackets surrounding a lost hiker or a basket being raised from a sinking boat. For many this is mostly true, but SAR has a darker side that people outside of the community don’t like to talk about.

What happens when the rescue team doesn’t get there in time?

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Combat SAR vs TRAP


I am going to pre-qualify this article by saying that this information is based on my recollection of the subject matter and that I have been out of the active duty Marine Corps for over 20 years. Times have changed and perhaps some of the methodology has as well.

First off:
CSAR = Combat Search and Rescue
TRAP = Tactical Recovery of Aircraft and Personnel

What occurs when a pilot goes down behind enemy lines or in a hostile region?

Pilots are put through several different types of training to increase their survival odds should such an occurrence happen. Training like the SERE school (Survival, Evasion, Resistance, Escape) is designed to help them survive post crash or grounding of an aircraft, avoid being an easy capture, and give them tools to stay out of the reach of the enemy force looking for them.

How do we get them home?

What about sensitive information and equipment aboard the downed aircraft?

We’ve all heard about the infamous USAF Pararescuemen or “PJ’s”, the tactically elite SAR specialists of the military. Primarily these high-speed, low-drag (HSLD in “mil-speak”) guys are a major component in the Combat Search and Rescue (CSAR). Essentially they are search and rescue personnel with combat or tactical training. Primary mission is to locate, treat and extract assets that have come into dire circumstances. For the most part, that means downed aviators.


“The history of CSAR demonstrates the need for detailed planning and Dedicated efforts for combat rescues during war. The Marine Expeditionary Unit (Special Operations Capable) is very capable force that conducts tactical recovery of aircraft and personnel. Too often, commanders confuse CSAR with TRAP and task the MEU to conduct CSAR missions. The U.S. Marine Corps’ position on CSAR is that it does not conduct the search in CSAR. However, the limiting factor is the U. S. Marine Corps inadequate capability to conduct recovery. Joint doctrine is vague on assigning CSAR responsibilities contributes to the confusion between CSAR and TRAP. Other service component’s force structure for combat rescue, particularly during OOTW, adds to the JFC’s tasking dilemma. USSOCOM, with its specially equipped aircraft, is the force normally tasked with theater CSAR even though it detracts from their primary mission.” 1

The Marine Corps, in its insistence on being self contained and self reliant for most of it’s needs, has it’s own capabilities. The Marines have always been the United State’s “9-1-1 Force” and it’s Marine Expeditionary Units (MEU) are strategically stationed aboard US Navy warships and bases around the world. Essentially, these units are an expeditionary quick-reaction force, used for anything from humanitarian aid to combat missions. An MEU will consist of Marine units from the Aviation (fixed and rotary aircraft) units, Ground (Light Armor, Infantry, Artillery, Heavy Armor) units and Logistics units for a troop strength of approx. 2300 Marines and commanded by a Colonel. In order for a MEU to become “Special Operations Capable” (MEUSOC), they must be proficient in several mission packages. These include:

  • 1 Amphibious Raids
  • 2 Non-Combatant Evacuation Operations
  • 3 Security Operations
  • 4 Tactical Recovery of Aircraft and Personnel (TRAP)
  • 5 Direct Action
  • 6 Humanitarian/Civic Assistance


The training package can take upwards of 18 months to complete prior to deployment.

Therefore, “the primary objective of the MEU(SOC)…is to provide the theater Commander In Chief’s (CINC’s) with an effective means of dealing with the uncertainties of future threats, providing a forward deployed unit that is inherently balanced, sustainable, flexible, responsive, expandable and credible.”

The US Marine Corps has three MEU’s which deploy from the West Coast (MCB Camp Pendleton), three from the East Coast (MCB Camp Lejeune, NC) and one based in Okinawa, Japan (MCB Camp Smedley D Butler)

Although ParaRescue missions are part of a larger, planned rescue operation (CSAR), TRAP missions are spur of the moment and due to the strategic location of a MEU as part of a Battle group, probably more highly reported. They are typically teams of 20-30 Marines and utilize rotary aircraft for the mission.

Two such missions that pop into mind are the rescue of US Air Force Major Kenneth Harney and Capt. Tyler Stark who ejected out of their F-15E over Lybia in March of 2011.

The other one that made headlines was USAF fighter pilot Scott O’Grady who’s F-16 was shot down over Bosnia in June of 1995 and provided the film “Behind Enemy Lines” with its plot.

If there are any readers out there who have current knowledge of USMC TRAP missions and USAF PJ CSAR missions and wish to add to this, please do not hesitate to contact us through the Rescue Report.

1The JFC’s Dilemma: The USMC TRAP mission verses the Combat SAR mission” by Major Matthew D. Redfern, United States Marine Corps

Confined Space Rescue Standby: Repairing a Water Leak Under the Skytrain

Confined Space Standby-Watermain Leak

A few years ago, a Lower Mainland, BC, municipality undertook an initiative to better develop its confined space rescue capability. The first goal was to train a group of 60 workers in confined space rescue. To maximize the learning experience, class size was limited to 6 students. The second goal was to create a pool of highly trained personnel which could be temporarily utilized to provide rescue services for more difficult and hazardous confined space entries. They were referred to as “Go To” personnel. For two years this group underwent advanced exercises, assisted in selecting and standardizing equipment and coached their fellow workers during training and entries. Before this group was stood to, the municipality had to hire contractors to provide rescue services.

Who better to provide such services than internal personnel who have experience doing the work and intimately know the spaces?

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Tailboard Talks

Tailboard Talks: Safety meeting pre-entry

An industrial confined space rescue team has a distinct advantage over a public services one, such as a fire department. They have the ability to know when and where an entry is going to occur as well as the tasks to be completed within it. To ensure they can utilize this information, the rescue resources should be involved in the pre-entry preparation process.

An essential part of this preparation is the toolbox/tailboard talk. During confined space entries the rescue plan is often not considered until it is required, which is often too late. Either those that are part of the entry work do not discuss their assigned rescue duties or the designated rescue team is seated on the sidelines waiting to be called into action. There is critical information that can be shared to contribute to a successful response.

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Report on the Ch’iao Rescue Competition

ch'iao rescue competition

During last year’s GRIMP Day competition I met Jay Chen who had come to Belgium to visit us. He is the owner of a company called AIRAS, providing training for rope access workers and rescue teams in Asia.

Jay had already organized one rescue challenge in Taiwan called Ch’iao (The bridge ). He asked me to join him and his team for the second edition held this month.

This event takes place in the middle of Taiwan, in the mountains. The concept is to use bridges to provide a sense of elevation.

The Ch’iao event is held across two days.

The first day is an 100 m ascend race competition . You have to climb (attached with your buddy ) and pass knots (one on each work rope ). This race is an open race to all ropes access specialists (tree climbers, rope access workers, firefighters and rescue personnel).

I participated in this race along with my partner Damien of Petzl Asia. It was physical! Your equipment has to be prepared and you have to have excellent coordination with your teammate. It was a very good experience ! ! !

The second day was devoted to the rescue. 4 tests were organized.


Test 1 : The same location as the 100 m ascend competition. The teams had to rescue a patient from the bottom of the valley back up to the bridge.

Test 2 : One patient was hanging on the bridge cables. The mission was to access the victim and then have him descend to a secure area.

Test 3 : One patient is laying in the riverbed. Bring him back up to the bridge.

Test 4 : An intervention for a patient hanging on a highline.

In my opinion, Jay and his team have done a wonderful job! This was a fantastic event with excellent organization. 11 teams took part in Ch’iao (10 from Taiwan and 1 from Hong Kong ).

Participants were very interested in engaging other teams to exchange techniques and experience.

Ch’iao has a very nice future and I hope to see teams coming from all over the world for the next edition.

ch'iao rescue competition


Confined Space Suicide? Case Study

Underground Vault

Many years ago I responded, as part of my fire department’s technical rescue team, to a confined space incident. The call was dispatched around noon on a Monday. I was a fire fighter, and one of the Technical Rescue Technicians on the responding crew. Our Fire Department is comprised of both full and paid on call staff and covers a response area of 318 square kilometers. This call was attended to by our full time crews.

The initial response to the incident consisted of a four-person Engine company (their district), a battalion chief and the technical rescue team (consisting of an Engine + Technical Rescue Truck, six more personnel) and the duty Chief. In total we had 12 staff on scene, six of whom were technical rescue qualified.

Upon arrival, the initial information relayed to the crews from onsite staff was that a worker had entered the space in an attempted suicide. The space was a concrete, underground electrical vault approximately 20’ x 25’ with a hatch approx. 4’ x 4’. A permanent ladder provided access and the space had approx. 6’ of head room. There was a concrete dividing wall which essentially created a confined space within the main space. This space was accessed by an opening approximately 4’ x 4’.

Underground Vault

As part of the first in Technical Rescue (TR) apparatus, the initial request we had on scene was for documentation on the confined space (hazard assessment, entry procedures, etc). At this point we knew the worker had entered the site (verified by proximity entry card swipe) on Saturday approx. 36 hours prior. When the patient’s co-workers showed up on site for work on Monday, they found the patient’s personal effects on the their desk and a cryptic note alluding to the patient hurting themselves. The co-workers had initiated the 911 response.

Out in the facility yard, there was a hatch to the confined space propped open. When we asked the co-workers who found the note and personal effects about what had occurred to this point, they indicated that one of them put a fan into the hole and made entry into the space. The entrant noticed that the entry points into one of the interior spaces (confined space within a confined space) was covered by a sheet of plywood from the inside and appeared to be caulked or sealed shut. At that point the co-worker then left the space. The co-worker reentered the space with a second worker and a sledge hammer to ‘force’ their way into the interior confined space. When they finally broke thorough, the plywood ‘hatch’ fell inward and partially covered a compressed air cylinder of Nitrogen (to be determined later). From this point they are both unclear about what occurred. One worker indicated they immediately vacated the space. The other worker indicated he could ‘see’ the missing worker 20’ away in the space laying on the ground, meaning he had entered the inner space. He did not say he approached the patient however said the worker was ‘dead’.

Topside, some decisions had to be made and a rift began between responding agencies.

One group of responders took the stand that the worker had been in the space for over 36 hours and with the presence of the Nitrogen cylinder, they assumed a successful suicide attempt. They were of the opinion that it was an unsalvageable situation and therefore until HAZMAT team confirmed the atmosphere was safe, they would standby and consider it a ‘recovery operation’.

The Technical Rescue Team (TRT) took the stand that a subject isn’t ‘unsalvageable and dead’ until they are in the hospital ER, warm and confirmed dead. In the interim the TRT received the nod to get the rescue team dressed and ready to access the space and set up the associated rigging. The entry team of 2 responders dressed in full FR PPE and SCBA (the entrance to space was 4’ x 4’, ladder access and 6’ ceiling as ascertained by blueprints and confirmed the previous workers who entered). In the after action report, a concern about not using SAR and hardline communications was brought up. The TRT felt we had adequate PPE for the operation and that there was no need to set up SAR as the access point was large enough to allow for SCBA.

Law enforcement (LE) arrived on scene and considered it a crime scene. Police insisted on entering to document and collect evidence. Upon discussions however it was determined that neither LE or BCAS (British Columbia Ambulance Service Paramedics) staff are trained in confined space entry which prohibited either agency from entering the space.

It was finally decided to let the confined space rescue team into the space under the auspices that they document by digital camera every angle and item in the space. The entry team was equipped with FD issue radios and after confirming no atmospheric changes (the space had remained clean respirable air since our first monitor went into the space), we sent the team in. The team was told to progress slowly and methodically, then focus on gathering evidence via camera versus rescue. After a few minutes I looked down into the space to find a team member trying to get my attention (the radios had failed to transmit out of the concrete vault). The rescuer indicated that they had a ‘living patient’. This was repeated to all those around the site and the team continued to set rigging in place to extricate our ‘dead’, now ‘live’ patient. The team went from “recovery/evidence gathering mode” to ‘rescue mode”. Once the patient was extricated to the space opening, the patient was attached to a 4:1 mechanical advantage and extricated from the space. The patient was quite disoriented and lethargic and patient care was turned over to the paramedics.

The entry team confirmed that the patient had set up a small bed including foam mattress and 5 gallon bucket as a commode in the space. The patient had several prescription drug wrappers around the bed and a caulking gun. The nitrogen cylinder valve was closed and had not been discharged into the space.

What appeared to have occurred, was the patient had intended to seal themselves into the space, take a high dose of the medication, plug in their iPod earbuds and open the cylinder in order to displace all the oxygen in the space. It appears however that the medications either rendered the patient unable to operate the valve or unconscious.

Lessons learned from this event.

  1. At a rescue event, the trained and equipped Rescue Team needs to be utilized in the planning phase and their expertise considered.
  2. Never assume a recovery vs rescue.
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