Rope systems... The following section is from Zone 1. It covers: patient packaging low angle, steep angle, high angle pick offs single point litter rigging* *Note: A stokes attachment setup is shown. Be advised that the Shoreline FD uses a pre rigged spider attachment system. Except for the above difference the Shoreline FD encourages and endorses the use of Zone 1 s described practices.
ROPE SYSTEMS
PATIENT PACKAGING Objectives: To identify, describe and define the advantages and disadvantages of each type of litter. To demonstrate securing patient to a littler properly. Equipment needed: Litter basket Tarp Patient harness Patient PPE Litter shield Head protection Eye protection Padding/pads Blanket for warmth Medical supplies as needed; Backboard Cervical collar, etc. 2- yellow webbing (internal lashing) 1- black webbing (external lashing, if needed) Medical and environmental considerations and the type of litters available dictate patient packaging. Careful packaging protects the patient while allowing access to monitor vitals. The patient should not move or shift in the litter during transport. SAFETY Patient(s) must be internally lashed to protect them from ejection out of the ends of the litter. They must also be externally lashed to prevent them from movement within the litter. All carabiners should have gates opening down and toward the inside of the litter basket. Ensure carabiners are properly loaded and will not torque or side load. Never tie patient lashing around top rail of the litter: Always weave webbing between uprights of the stokes or to internal areas of plastic stretchers. STEPS TO PATIENT PACKAGING: Stabilize the patient before loading; --Head/eye/face protection --Sit harness (for steep& high angle, maybe considered during medium) --C-collar, backboard, bandaging, splinting Prepare the litter to receive the patient Load the patient Lash the patient into the litter securely --Internal lashing (utilize only the amount needed for the type of rescue) --External lashing
INTERNAL LASHING 2. Secure torso webbing with round turn and 2 half-hitches on either side. NOTE: webbing is tied off to an upright stay, not the railing. 1. Connect yellow webbing to harness with an interlocked girth hitch. 3. Secure legs in same manner as torso. Ensure leg webbing is pulled taut against torso webbing. This may or may not be needed in low load angle environment.
EXTERNAL LASHING 3. Finish with a round turn and 2 halfhitches on one end, then pull slack back through h entire black webbing. Finish other end in same manner. NOTE: External lashing is required when performing high angle rescue. 2. Weave webbing around upright stays, not over the railing. 1. Start with middle of black webbing here.
LOW ANGLE RESCUE
LOW ANGLE RESCUE During this session we ll discuss the various degrees or classifications of Low Angle Rescue, and Patient extrication. OBJECTIVES Identify, describe & define when and how to perform a Low Angle vs. a Steep Angle rescue. The goal of the low angle evacuation is to keep the patient moving and get them out as safely and comfortably as possible. In order to achieve this goal follow these steps: Locate and stabilize the patient -- The first responder may have to rappel down to the patient to recon the area and initiate first aid/triage -- Load the patient into the litter Talk to the patient, whether they are conscious or not -- Make the ascomfortable as possible -- The patient is afraid and uncomfortable, being lashed to a litter completely helpless, exposed to the weather, relying on other hands not to cause them any further discomfort or harm -- Establish a rapport Plan and flag the best extrication/evacuation route while the patient is being packaged -- Best route on medical & terrain considerations, and resources available Start the carry-out and keep the patient moving -- Arrange litter handlers by height -- Keep the patient s head level or higher than the feet unless medical considerations require something different Only one attendant calls signals. Rotate attendants, if appropriate, to avoid rest stops and prevent rescuer fatigue. Have handlers use webbing loops as across-the-shoulders straps to distribute the weight of the patient and facilitate ease of the carryout. Tag obstacles along the route for quick belays before you need them, keeping ahead of the patient. If not actually handling the litter, rescuers s should be out in front where ethey are needed most.
PATIENT EXTRICATION / EVACUATION Keep your systems as simple as possible! In reality, most backcountry evacuations are low angle, not high angle rescues. This involves moving the patient in a litter over low angle rugged terrain. The number of ropes, the rigging used depends on the slope and terrain characteristics. When evaluating the conditions, and you come to the point when you need to make the decision weather to use a mainline and a belay, or just a main line, or just a belay, ask yourself this question, What are the consequences if you have a failure in a single rope system? Let s call this The consequence based decision process In General Low Angle Rescue Considerations: Use of belay line only: -- If the slope is of a low enough angle where it allows rescuers to carry the load up the hillside. -- Hillside has stable footing and attendants can safely carry the litter and patient up the hill without the use of a mechanical advantage system. -- Consequences of failure of the single rope system are not exposing rescuers and patient to potential death or injury. Use of a 2:1 mechanical advantage system, by itself, is allowed in low angle rescue situations when: -- You only need a slight bit of mechanical advantage to assist the litter and patient up the hillside past minor obstacles. (Attendants should not be hooked to the litter, if you lose your footing while handling the litter, let go of the litter). -- Once again, if the single rope system fails, rescuers and patient will not be exposed to death or injury. If litter is dropped to the ground and haul line is unattended the litter will not slide or fall down the hillside. Use of both a main line and a belay line: -- When consequences of a failure of a single rope system place rescuers and patient at risk. -- If the decision is made to in any way shape or form attach attendants to the liter or system, a mainline and a belay line should be used. Other important considerations for low angle rescue: -- If you need more than a 2:1 mechanical advantage system to overcome weight or slope angle, revise your system to a steep angle rescue system using a main line and a belay line with three litter attendants. -- Also consider upgrading to a steep angle system using a mainline and a belay if slope angle, poor footing or potential for death or injury dictate.
CARRY OUT The carry out should be performed when lashing is complete and webbing loops are established for each rescuer/handler. And most important, everyone should know what the Action Plan is. EQUIPMENT NEEDED FOR THE CARRY OUT: ½ static rope for belay line 2 locking steel carabiners Litter with patient lashing Red or yellow webbing for every tender to construct webbing loop RESOURCES NEEDED: The angle and terrain stability will determine number of attendants. Low angle, low hazard terrain with stable footing = -- 6 personnel, not tied to litter or main line. -- Rope = 0-1 -- Rigging = tandem Prusik belay Low angle, moderate to high risk terrain, poor footing = -- 3-6 personnel - if the angle and quality of the slope or terrain dictates use of a main line to haul up the load, only 3 rescuers will be used. For information on steep angle rescue, reference the next section in this manual. -- Ropes = 1 or 2 -- Rigging = tandem Prusik belay, main line lower (if needed) and main line raise (if needed). SAFETY The overall safety tip we can offer is that you always consider the environment you are working in, such as, terrain, angle and weather conditions. Also consider the resources you have available, call for help when in doubt. In making a good scene size up, most of these concerns will be answered. The first step to safety is to ensure that everyone is on the same page. Is this a Rescue? Body Recovery? Who s in charge? And what is the over all Plan of Action? What are the hazards we face? These are some of the questions that should be answered in your briefing.
Belay line attachment is with Long Tail Bowline with tail going to patient Webbing bridle needs to go around rail for strength...do NOT rely on plastic alone
Note the single yellow webbing attachment on the harness. Considering this is a low angle setting, the only risk to the patient is whether or not they will slide out the foot end of the litter.
In low angle rescue, the burden of carrying the patient falls upon the rescuers. single line shown is a belay line to prevent the load from sliding down the slope. The
STEEP ANGLE RESCUE
SAFETY CONSIDERATIONS 2 rope system - main line and belay (rope dependent). 3 attendants shall be used. 2 attendants are tied into the main line and belay via Purcell Prusik and a secondary Prusik. The strongest of the 3 attendants shall be located at the foot of the litter and tied into the system with a Prusik wrapped around the foot of the litter and hard tied using the long tail of the belay line. The patient should be lashed to the litter and also tied into the main line. The 2 side attendants weight must hang from the Purcell Prusik, not from the main/belay line. One person calls the commands.
Third attendant primary and secondary attachment points End of other long tail to patient One of front attendants primary and secondary attachment points Other front attendant primary and secondary attachment points Clove hitch around litter rail constructed from portion of bowlines long tail Interlocking long tail bowlines to connect the main line and belay line to the litter bridle
I t l ki l t il Interlocking long tail bowlines to connect the main line and belay line to the litter bridle
HIGH ANGLE RESCUE
HIGH ANGLE RESCUE High Angle rescue involves any rescue dealing with angles of 60 degrees or greater. Of all the rescues dealing with angles, this is the most dangerous because typically you are dealing with heights, along with obstacles. It is very important, as in all rescues, to work as a TEAM. As in all TEAMS you have ONE person that is lead, calling the shots. It is important to maintain that type of structure, although you may have many team members withmuchexperience there has to be one person who makes the final decision. The lead person also needs to listen to input from team members in order to establish the best plan of action, but once that decision is made it is important that all the players follow it to the T. There have been many incidents where rescuers were rushing to make the rescue happen, which resulted in serious injuries and in some cases death to rescuers, because time was not taken to check and double check the systems and they failed to work as a team. In this section we will be going over single point litter lowers, pick-offs, and guiding line operations. SAFETY A briefing shall be held with all the team members prior to starting rigging operations. It is required to have a rope technician as the Safety Officer, both on the ground and elevated positions.
SINGLE POINT LITTER LOWER The single point litter lower is used in the high angle environment. It uses one attendant. The evolution is comparatively simple and quick. The equipment set-up is easy to rig. It can be used in both the horizontal and vertical configuration, depending on the needs of the operation. However, it cannot be easily converted to vertical after the lower begins. Angle adjustment is limited to throw of the spiders. A lower is always easier and less dangerous than a raise. Opt for this if possible. If not the systems can be changed over to a raise utilizing mechanical advantage. OBJECTIVES: Demonstrate and explain how to rig a single point litter lower Demonstrate the single point litter lower as a team. Recite the standard communication signals. Demonstrate how to care for and protect the patient. Identify the advantages and disadvantages of the single point litter lower. Identify the advantages and disadvantages of a lowered pick-off vs. a rappel based pick-off. EQUIPMENT: --Litter with internal and external lashing and patient t PPE. --Anchor equipment for 2 anchors (yes, each system requires separate anchors) --Belay line --Main line: RPM Litter bridle Purcell Prusiks Etrier and carabiners Safety straps and carabiners Steel O ring Resources required: Attendant Brake Rack Operator Belayer Edge Tenders Team Leader Safety
SAFETY When building these systems, the rescue lines (main & belay) will not be simply flared out and tied into litters or people. Once the lines are attached to their respective anchors, they must be shortened, attached to the litter/attendant and immediately tied off at the brake bar rack and snugged upon the tandem Prusik belay. The litter attendant must have 2 points of attachment, the primary attachment being a Purcell Prusik attached through both bowlines of the main and belay line. The secondary attachment will be the long tail of the belay line attached to the front of attendant (keep in mind the belay line shall not be loaded). The patient will be secured into the stokes only. The long tail of the main line will be run through the litter bridle in case of O ring failure. All carabiners should have gates opening down and, if applicable, facing to the inside of the litter. The apex of the litter harness should be centered over the patient s navel. THE SAFETY OFFICER MUST CHECK THE ENTIRE SYSTEM once it is completely built from the anchors to the litter attendant. No one goes over the edge until this is done!
Single Point Litter Rigging
Bowline in long tail of main line to capture bridle in th he event of a ring failure Interlockin tied directl pound ring ng long tail b ly through 1 g bowlines 0,000 Purcell attachm for seco Prusik for a ment and lon ondary attac attendant pr ng tail of be chment poin imary lay line nt
Pick-offs Lowered & Rappel Based
Interlocking Long Tail Bowlines Long Tail of Main Line to Patient Long Tail of Belay Line to Attendant Purcell Prusik for Attendant Purcell Prusik for Patient