GEORGIA FIRFIGHTERS STANDARDS AND TRAINING COUNCIL TECHNICAL TRENCH RESCUE PERFORMANCE EVALUATION SHEET

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Objective(s): 8.1.1,8.1.2,8.1.3,8.1.4 Skill No. AMV-1 Primary Task: Air Monitoring and Ventilation -Simulated trench with ground pads in place -Air monitoring equipment -Ventilation equipment -Power source 2. The candidate will work alone. 3. The candidate will be given the instructions below before beginning the exercise. 1. The candidate, given a simulated trench and properly placed ground pads, shall be able to implement atmospheric testing and ventilation in support of the trench rescue with 100% accuracy. 1. Ensure scene size up is completed 2. Dons proper PPE including respiratory protection 3. Select appropriate atmospheric monitor for the situation 4. Checks and ensures proper set-up and operation of selected equipment per manufacturer s recommendations 5. Monitors general area of the trench starting on the upwind side 6. Monitors atmosphere in trench at appropriate levels (top, middle, bottom) Order of test: - Oxygen (19.5%-23.5%) - Flammability - Toxicity 7. Selects and assures proper operation of appropriate ventilation equipment 8. Establishes positive pressure ventilation to ensure fresh air to the workspace of the trench 9. Continues to monitor atmosphere in trench and records findings Total steps candidate must complete to Pass 9

Objective(s): 8.1.1,8.1.2,8.1.3,8.1.4,8.1.7,8.2.3,8.2.4,8.2.6 Skill No. HL-1 Primary Task: Heavy Lift: Site Operations -Appropriate prop for heavy lifting -Necessary heavy lifting equipment ( ie. Air bags, levers, cribbing) 2. The candidate will work alone. 3. The candidate will be given the instructions below before beginning the exercise. 1. The candidate, working as the leader of a team and given appropriate equipment, shall coordinate the lifting of a heavy load/object off of a patient in order to achieve disentanglement and extrication with 100% accuracy. 1. Ensures proper/continued use of PPE 2. Selects appropriate tools and equipment for situation 3. Estimates weight of object to be lifted 4. Determines appropriate techniques/devices based on weight and configuration of the object 5. Ensures object is adequately stabilized prior to beginning lifting operations 6. Appropriately rigs object to be lifted (if applicable) 7. Lift and stabilization/cribbing coordinated so that load does not fall greater than 1 should lifting procedure inadvertently fail. 8. Lifts object distance needed to extricate patient 9. Lift is coordinated and object can be secured in place 10. Safely lowers object back into place while recovering equipment Total steps candidate must complete to Pass 10

Objective(s): 8.1.1,8.1.2,8.1.3 Skill No. ISU-1 Primary Task: Initial Size up of Collapsed Trench -Simulated trench and witness 2. The candidate will work alone. 3. The candidate will be given the instructions below before beginning the exercise. 1. The candidate, given a simulated trench rescue incident with a victim, shall conduct size-up so that existing and potential conditions are evaluated within the trench and hazard area with 100% accuracy. 1. Establishes and utilizes an Incident Management System (NIMS) 2. Ensures proper use of PPE 3. Completes size-up using observations, victims, bystanders and/or site information 4. Identifies all present and potential hazards 5. Identifies any involved utilities 6. Determines basic soil classification 7. Establishes safe operating zones 8. Identifies stabilization issues and resources needed 9. Evaluates rescue vs. recovery considerations 10. Provides for non-entry/self rescue of victim 11. Determines trench dimensions 12. Formulates an Initial Action Plan Total steps candidate must complete to Pass 12

Objective(s):8.1.4,8.1.5,8.1.7,8.2.1,8.2.2,8.2.3 Skill No. IPS-1 Primary Task: Installing/Removal Pneumatic Shores -Pneumatic Shores -Air supply and controls -Rope, hammer, nails, ladder (if needed) -Simulated trench or props 2. The candidate will be given the instructions below before beginning the exercise. 3. The candidate will have assistance and is required to give commands as needed. 1. The candidate, working as the spotter and given the appropriate equipment, shall demonstrate the ability to install pneumatic shores properly with 100% accuracy. 1. The candidate shall select the proper shore for the trench/prop 2. Connects air hose to shore and adjusts the regulator to the desired pressure stated by the evaluator 3. Gives direction to lower the shore using ropes until it is in the proper position 4.While located at the end of the trench determines whether the shore is level and in the correct location 5. Initiates installation of shore by saying Shoot and Hold 6. Ensure the shore is locked manually as determined by type and manufacturer 7. Ensures the shore is secured and toe nailed before commanding release on air 8. Properly removes shores from trench/prop stating the order of removal Total steps candidate must complete to Pass 8

Procedures for Testing Trench Rescue Individual skills 1. Ensure that all equipment is available to test all individual skills 2. Set up stations for testing all skills 3. Need four evaluators 4. Candidate must complete and pass all skills 5. Continue until all candidates and redos have been completed 6. One redo will be allowed per candidate. If a second redo is assigned a failure for the entire skills event is administered. Team Skills 1. Ensure that site is adequate to ensure all objectives are met 2. Give event to team and allow 15 minutes to plan 3. The completion of the event takes no longer than four hours 4. If objectives are not met within time limit team fails event Team Event Team event needs to be set up so that a T-trench is used so that all necessary objectives can be met. Ensure as the proctor that all personnel are utilized and given assignments. There is also a check off sheet that needs to be included for the team and make sure that the event initial size up is included. Equipment for Team event 1. T-trench with one corner sloughed off, 3-4 feet wide and 10-12 feet deep.

2. 13 Trench panels set up appropriately for securing a T- trench. 3. All necessary shores for the panels. ( ie. Air shores, screw shores, or lumber) 4. Whalers and shores for the whalers. 5. Supplemental shoring. 6. Sheets and 2x12 lumber for ground pads, shovels, and rakes. 7. Hammers, nails, tape measures, buckets, and all other equipment necessary for securing objects and placing objects in the trench or removing items from the trench. 8. Air monitoring equipment 9. Ventilation equipment 10. Two means of egress from trench 11. Patient packaging equipment and patient 12. Air supply and controls for air bags and shores. 13. Appropriate PPE 14. Any other necessary lumber for building corners and back fill. 15. Ladder and materials necessary to build a bridge. Equipment Necessary for Individual skills 1. Pneumatic Shores 2. Air supply and Controls 3. Rope, hammer, nails, ladder if needed 4. Simulated trench or prop to shore that is safe and secure for one person. 5. Witness 6. Prop for heavy lifting 7. Air bags, levers, cribbing, and controls 8. Air monitoring equipment 9. Ventilation equipment 10. Power Source

GEORGIA FIREFIGHTERS STANDARDS AND TRAINING PRACTICAL EXAM TEAM EVENT TEAM: LOCATION: DATE: NOTE TO EXAMINER: EACH TASK MUST BE COMPLETED WITH 100% ACCURACY WITHIN THE GIVEN TIME FRAME. PLACE X FOR REDO, P FOR PASS OR F FOR FAIL IN THE CORRESPONDING BOX BESIDE THE STEP PERFORMED. IF THE TEAM FAILS THE TASK ON THE FIRST ATTEMPT, A SECOND ATTEMPT IS PERMITTED WITHIN THE GIVEN TIME FRAME. DIFFERENT EVALUATOR MUST EVALUATE SECOND ATTEMPT. FAILURE TO COMPLETE THE TASK AFTER THE SECOND ATTEMPT WILL RESULT IN AUTOMATIC FAILURE OF THE TEAM EVENT. THE EVALUATOR MUST SIGN IN THE APPROPRIATE BOX AT THE COMPLETION OF THE EVALUATION. THIS IS DONE IN A FOUR HOUR EVENT. TASK TO BE COMPLETED 1st ATT 2nd ATT EVALUATOR S INITIALS INITIAL SIZE-UP OF TRENCH COLLAPSE 8.1.1 DEVELOP AND INITIATE IAP 8.1.2, 8.2.5 MONITORING AND VENTILATION 8.1.3 SPOIL PILE REMOVAL AND GROUND PADS 8.1.4 SUPPORTING AN INTERSECTING TRENCH 8.2.1 INSTALLING SUPPLEMENTAL SHORING 8.2.2 RELEASING A VICTIM FROM SOIL ENTRAPMENT 8.2.6 PACKAGING AND REMOVAL OF VICTIM 8.1.6 RELEASED VICTIM TO EMS 8.1.6 POST BRIEFING OF INCIDENT 8.1.7 COMMENTS ON REDO(S): Circle one of the following choices and sign below: TEAM PASSED TEAM FAILED TEST PROCTOR S SIGNATURE: GFSTC