In the last few weeks there has been a particular video circulating through various online firefighter and rescue groups that caught my attention. In the video firefighters are using a ladder, backboard, and rope to move a patient from a roof or second floor to the ground. Depending where you were watching this video there were some great comments about thinking outside the box and using alternative methods to raise and lower patients. There were a large number of comments that were a little deceiving; comments attributed this rescue technique -- a ladder hinge -- to the fire department in the video. It's great to see this technique being used, but by today's standards it may be considered an old school technique. The ladder hinge gets overlooked or forgotten about when so many people are arguing over which friction device is the best. Depending on your location in the country or the world this technique is still taught, relied upon, and used regularly. For another take on a ladder hinge rescue see video link below.

It is not my intention to thoroughly train you to use this rope rescue technique; only to provide a few things to consider in order to operate safely.

Patient Packaging

Before you tie any knot for rescue consider the patient packaging device -- not all spine boards, litters, and rescue baskets are created equal, nor can they be easily substituted on the fly without some loss of strength. Ensure you aren't exceeding the device's load rating. It may be rated for an 800-1,200 pound patient when carried or used to drag a patient horizontally, but that does not necessarily mean that can rig this patient basket for any type of rescue situation. Injuries or suspected injuries must be considered and protected and we can provide these things by lashing the patient to a long spine board and then lashing patient and board into the rescue rated basket.

Stability

If using a rescue basket (ensuring the patient is lashed appropriately), this basket needs to have three points of contact. If the basket has a single connection to the ladder and a single connection to the lowering rope the basket is less stable. One connection to the lowering rope and two connections to the ladder, webbing, or some other means to secure around each ladder rail, will prevent tipping or rotating the basket.

Control

With enough personnel to support the ladder on the ground, and rigged with guy lines, the rescuer with the lowering rope may feel that they can control the rate of patient raising or lowering by hand alone. A safety consideration is to secure your rope to the rescue basket and then find an appropriate anchor for a friction device such as an MPD, bar rack, or Rescue 8. Rigging your ladder hinge with one of these devices on the line prevents catastrophic failure of your load should something happen and the rescuer lose control of the line.

As a rope rescue technique, a ladder hinge is a great option available to the fire department or an industrial rescue team. When performed safely and practiced regularly this rescue method can quickly evacuate patients to the ground or to higher elevations. And always remember: before implementation of any new equipment or techniques always seek out training from a qualified instructor.

If you have spent any length of time working in a trade, chemical facility, manufacturing plant, warehouse, or anything in between you have probably been through your fair share of safety briefings, orientations, and safety audits. While these are, hopefully, giving you site specific safety information let's focus on one often repeated misconception about confined spaces.

If you work on, in, around, or near confined spaces you're familiar with the roles involved - attendant, entrant, supervisor
 - and you know their functions and responsibilities. Generally speaking, in a permit-required confined space operation the supervisor supervises, the entrant makes entry, and the confined space attendant does nothing but attend, right?

What most programs will state is that the attendant is responsible for monitoring the safety of the workers working inside the confined space. The attendant is responsible for log-keeping, air monitoring, summoning help, and maybe even attempting non-entry rescue. Some of these subjects vary in their teachings and to what extent you're permitted or required to do them. One thing they always agree on, THE ATTENDANT NEVER ENTERS THE SPACE!

This information is true, to some degree. OSHA requires an attendant and the attendant is responsible for everyone inside, but, when you investigate the confined space standard an attendant is allowed to enter a space.

In the standard, 1910.146, it states:

"Attendant" means an individual stationed outside one or more permit spaces who monitors the authorized entrants and who performs all attendant's duties assigned in the employer's permit space program.

1910.146(i)(4) gives a seldom-mentioned exception to the rule of "an attendant never enters:"

NOTE: When the employer's permit entry program allows attendant entry for rescue, attendants may enter a permit space to attempt a rescue if they have been trained and equipped for rescue operations as required by paragraph (k)(1) of this section and if they have been relieved as required by paragraph (i)(4) of this section.

While this is not drastically different from what you may know, it is important to know that an attendant is, under specific conditions, permitted to make entry. I have yet to see this procedure as part of a confined space program in the real world but it doesn't mean it is impractical or without merit. If your attendant is trained and equipped for rescue, and they've been relieved by a competently trained attendant, they could enter to initiate patient treatment or extraction.

A problem in relying upon this method of rescue would be locating a second attendant. It is more expedient to have an attendant and rescuer(s) present at the confined space job site, but if this is your cost-effective consideration you may have shortened the length of time it takes to rescue the entrant. 

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If you are looking for more information on confined spaces, confined space training, or if you are looking to hire a confined space attendant or a confined space rescue team, contact Safety Training Services today!

In our training classes we often say that safety programs and documentation are "living and breathing." Meaning, a safety process or an aspect of your emergency action plan gets developed and implemented and it gets revisited, often. No program should be developed with the intention that all of your work is done for the next ten years regarding safety. Safety and emergency programs should be evaluated and re-evaluated. Ask yourself if they are effective or if they are meeting the needs of the employees. Often times a business relies on programs developed "years ago" but that program didn't incorporate the new hazardous material process that the company now manages. Having a safety program in place may afford you the opportunity to scratch an item off of your To-Do list but if it isn't effective, if it isn't relevant, who's interests are being served?

Safety within your organization should be viewed holistically--emphasizing the importance of the whole and the interdependence of its parts. While each part of your program, such as fall protection, confined space, hot work, annual employee health screenings, and personal protective equipment (PPE) requirements are each vital to your operation, it is the way in which the overall purpose of your safety program works together through these programs.

An example: Your company will begin a new process which includes a chemical that has never been used on your site, "Chemical X." Prior to the arrival and use of this new chemical the Safety Data Sheet (SDS) has been evaluated alongside a job hazard analysis (JHA) or job safety analysis (JSA). This is a very simplified work process but without becoming too elaborate these two documents will help you establish PPE requirements and engineering controls for employees who handle the new chemical. The safety of the employee does not rely solely on these two documents, they must receive the training on the chemical and the PPE they will be using. However, that is not the end, a medical surveillance program may be required, the results from which the effectiveness of your PPE, engineering controls, and other practices can be evaluated.

In short, you're not just sitting in another training class this year, you aren't just being forced to undergo another physical--each piece of the safety puzzle comes together, relying on the other programs, to maintain and improve worker safety on a daily basis. Remember, this is only effective if your programs are updated, evaluated, and maintained. Knock the dust off your safety programs this year, ensure they still apply, and that they're still relevant.

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Safety Training Services provides a full range of OSHA compliant industry training and services. If you are unsure how compliant your programs might be contact us today, we can help develop and implement a complete safety program and training that meets your needs.