Training Day - Firefighter Removal and FAST Unit Operations

 The rescue of a fellow firefighter can take many forms. The member may be lost, missing, trapped, in distress or some combination thereof. These situations will be among the most challenging that you can face as a rescuer. They can be exceptionally confusing and stressful, with time generally not being on your side. Those operating at the scene may haphazardly rush to the perceived incident, causing it to descend into chaos. This can leave many of the important auxiliary functions of the overall incident unfulfilled and the incident command unaware of this fact. It should be the IC assigning personnel to deal with the incidenteither the designated FAST unit or other personnel operating in the area. These rescues have the potential to incorporate any of the other emergency response skills your team is trained in, i.e. firefighting, collapse rescue, rope rescue, emergency medicine, etc.This article is not going to discuss specific rescue techniques, instead focusing on the psychology and training principals involved. Due to the severe time restrictions often encountered, the techniques that are utilized to extricate a downed firefighter are bare bones, calling for a minimal of equipment and time. These techniques must also be chosen for their simplicity as only the simplest ones can be replicated under severe life threatening circumstances. FDNY Special Operations Command (SOC) companies generally consider firefighter rescue to be their primary mission. Hence the saying “If a civilian is trapped they call the fire department -- if a firefighter is trapped they call the rescue.” When SOC designed the advanced firefighter removal course taken by all SOC personnel all the participants involved in curriculum development were experienced senior members who had been involved with rescue attempts int one or more firefighter fatalities. There were no unrealistic expectations involving a rescuers ability to perform under such circumstances. It is with these hard learned lessons in mind that I write these recommendations. OverviewThis topic is taught in sequence starting with self-rescue, progressing to buddy rescue and culminating with FAST unit operations. This progression parallels how a potential rescuer’s skills develop (with the most advanced skills being those of the FAST unit) and the order in which a rescue occurs, with the firefighter and his team generally starting operations and the FAST unit being deployed as required. We will cover all of these capabilities beginning with an overview of general principals and finishing with some of the mental aspects involved.When faced with of one of your own being in imminent danger the temptation is to abandon fire suppression or other emergency operations and directly assist with the rescue efforts can be overwhelming. You must not succumb to this temptation.  I was at a basement fire in a commercial structure in Staten Island, NY when simultaneously with the company operating the hose line began running out of air. Several mayday calls were issued.firefighters that had become lost in the basement. I ended up on my own operating the hose line to keep the fire at bay. While operating I could hear the lost members trying to find their way out behind me. Despite having always preached that essential operations must continue I had to fight back the urge to go help. Shortly thereafter I could hear my guys finding them and directing them to the exit. There is a saying about these situations that I have often heard: “If you put the fire out a lot of your problems will go away.” Essential firefighting operations must continue uninterrupted. It is not just the life of the missing or trapped member that is at risk but also that of the rescuers. As a rescuer subjected to this level of stress your ability to remember and perform all but the simplest tasks will be severely impaired. This means that in order to be successful the tactics you choose in a hazardous environment should be quick and simple. Self RescueSelf-rescue is the preferred conclusion to one of these situations. I include in self-rescue the skills and awareness as to not place yourself in a position requiring rescue. Some of these skills include: awareness (including remaining oriented and constantly planning a means of egress), size up, communications, and giving the mayday (members are often reluctant to admit they are in trouble). Many of these skills will assist in your own rescue should it become necessary.  Some examples of self-rescue skills include: emergency SCBA techniques and various bailout techniques (both with and without rope). Buddy RescueMembers in distress are most often found and rescued by those in their vicinity. In order to prioritize operations in these situations the FDNY uses the acronym FAIR. Fire/Environment                                                                                                                           Air                                                                                                                                        Immediate medical care
Removal
Fire/Environment – this involves dealing with any immediate environmental hazard. This can include positioning a hoseline to protect from fire or positioning shoring to protect from secondary collapse. Air – assure that the downed member has an adequate air supply. This is to protect from the smoke or from the byproducts of a haz mat release. This can involve providing the downed firefighter with an air supply, supplementing their existing air supply or possibly ventilating the area. Immediate medical care – immediately treat life threatening injuries that are within the rescuers capabilities.Removal – remove the downed member to an area out of the danger zone where they can receive medical care and be transported. Removal can accomplish the fire/environment and/or air steps.  It can be accomplished with anything from simple drag techniques to packaging the victim in a Stokes basket. How this is accomplished depends on the environment, the mechanism of injury and the difficulty involved with removal, i.e. removing a victim from below grade. While it may seem counterintuitive, attempting all but simple removals before some packaging can delay the overall removal. History has shown that firefighters will often be pulled out of their bunker gear and SCBA while other attempt to extricate them.   FAST TeamsFAST units also known by several other acronyms such as RIT teams (Rapid Intervention Team) and RIC teams (Rapid Intervention Crew). These are teams that stand ready to be deployed in the event of a missing or trapped firefighter. These teams are usually stationed at the incident command post (CP) with the IC. In an incident where the CP is some distance from the operations they may be forward deployed. The FDNY uses forward deployment at structures such as high-rise buildings. At operations of a larger scale more than one team may be desirable.These teams should generally stay together to be ready for deployment. An exception can be made for a member or members of the team to perform a reconnaissance to ascertain information such as the best access to various areas of the operation and the location of potentially important resources. In addition when they report for duty they should be suited up in the appropriate PPE and ready to go. If possible, there should be pre-plan for equipment. For example, FDNY firefighters designated as the FAST unit would report with equipment such as standard firefighting tools, a thermal imaging camera, a FAST Pak (designed to deliver supplemental air this can be replaced by a spare SCBA), a search rope, a stokes basket with a backboard and a 2:1 rope mechanical advantage system for firefighter removal. Other potential equipment include: rebar cutters, a lifesaving rope (used for simple rope rescue systems), saws, elevator keys and flotation devices. This equipment is dictated by the challenges that you expect to face. When operating at a warehouse fire one February the units were required to conduct operations on a narrow ice covered pier with about a 15 foot drop into the icy water. The FAST unit, recognizing the obvious hazard, added a life ring to their equipment cache. You should have an equipment preplan but be flexible and adapt to your situation. While the unit is standing fast they should conduct a thorough size up of the situation. They should also maintain an awareness of ongoing operations such as where the different members or groups are located. This is accomplished by observing and monitoring communications.  Sometimes it can be beneficial to station a member in sight of the CP. This member’s job is to monitor communications with a special attention given to emergency transmissions indicating a member in trouble which often go unanswered due to all of the activity at the CP.   If the FAST unit is called upon to respond to a trapped firefighter their pre-plan, their size up, and from monitoring the situation should give them an idea of what equipment to bring. They should also have an idea of the situation from listening, observing and from their reconnaissance. Depending on the situation they may want to consider a six sided approach like that used in collapse operations in which you consider trying to reach the trapped firefighter from all four sides, above and below. PsychologicalThe fire service fails to address the psychological aspects of these high stress situations to the level that law enforcement and the military do. The psychological aspects of performing under severe stress are many and have been the subject of books and studies. I would like to summarize a few of the points that are the most important and that will be the most useful to the reader.Not all of the effects of stress are bad. The increased adrenaline in your system can supply you with greater strength and endurance to support the fight or flight response. You can increase focus on the problem at hand. However, both of these have flip sides. With the greater strength comes a loss of fine and complex motor skills. We must design our tactics to rely upon gross motor skills. You cannot be expected to thread a needle when someone is shooting at you from close range. The focus you experience can also have negative effects causing you to have auditory exclusion and tunnel vision. Your body blocks out what it deems to be unimportant.  The problem is the body is not always correct. The best ways to deal with this is to design a training program that relies upon simple skills.  Then practice these skills adding increased stress and difficulty. Practice in zero visibility (blacked out), add noise such as radio chatter and anything else to increase the realism. As an example in one of the scenarios we added a blast of heat from a space heater. Many participants say his brought them back to actual operations. The last psychological topic I would like to discuss is breath control. As a young fireman I was often told by old-timers that in stressful situations you should stop and take a deep breath to calm yourself and better focus on the situation. They knew through experience what extensive research has borne out. Hyperventilation causes numerous negative mental responses. In the fire service this breath control has an added benefit generally not relevant to the military or law enforcement.  Breath control can greatly extend your air supply. Lost or Missing FirefightersAside from trapped firefighters another likely scenario is missing or lost firefighters. In these situations get them to give you specifics such as their last known location and their current surroundings. Ask what they can hear as well. Try to establish their last known location as well as their assignment. Where were they going and how would they have tried to get there? ConclusionIn review, when training personnel to respond to these situations, you must keep in mind the rescuers limitations. Generally the procedures used are down and dirty techniques lacking in the refinement of technical rescues. Train as close to reality as possible utilizing full PPE, with vision blacked out to represent an unfamiliar environment. When I was in airborne school we practiced continuously on the responses to various parachute emergencies. This is how we should teach emergency skills, so that they become automatic. Many psychological limitations can be overcome through training.
 
James Kiesling is a Captain with the Fire Department, City of New York’s Special Operations Command.  He holds a bachelor of arts in fire and emergency services from John Jay College of Criminal Justice and an associates degree in occupational studies in fire protection technology from Corning Community College. 
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