Obviously having the wheel under the litter takes a great deal the patient’s weight but if not used carefully and with consideration it can make a very rough ride for the patient. Indeed there are times when it’s much better for the patient and sometimes for the rescuers to skip the wheel and carry the patient with people power. Even with the wheel under the litter there is still a significant amount of people power involved. As a paramedic I was usually spared from carrying the litter. My job was to carry the medical pack in addition to my own pack and to stay with the patient at all times. That way if the patient had a problem or a change in condition I could be there with them to immediately address it.
We had teams of relief set along the route that we are going to take. A fresh rescuer stands on either side of the trail or the route and they would come around the back of the litter to take up their position, establish a good hold and tap the shoulder of the rescuer in front of them. The rescuers all move up in this fashion and the front two are released from carrying and actually trot on foreword ahead Trained Rescue Teams of the litter to establish more relief. Using this technique it is possible to carry very large people over very great distances while sharing the load between many rescuers. The best-case scenario for carry out is a nice, flat, clean well-established trail or road. That may have happened to me in my mountain rescue career I’m having a hard time remembering any of those. I do remember a number of carryouts that took place with no established trail, no wheel, and great distances.
It took about 40 minutes once we got onto the trail to get the patient down to the parking lot. There was an ambulance waiting for us there to take the patient to a nearby landing zone/Hellispot where the patient was then flown to a trauma center.
We spent the next 45 minutes or so cleaning up returning equipment to its serviceable condition and performing in after action review/critique/hot wash. The critique process is critical. During your critique we go over what was planned, what was actually done, how it worked, what worked well, and what we can do better next time.
The young man ended up having a broken pelvis and acute injury in his abdomen and did very well. He was not in a good place when we got to him. This is one of those stories that have a happy ending.
Although we in the UK are thousands of miles removed from hurricane Irene and its devastating consequences, we can nonetheless learn a lesson from a storm that swept up the eastern shores of the United States. That lesson is the need for emergency rescue preparedness. Like the thousands of emergency agencies throughout the U.S. that continually train and prepare for such disasters, similar teams in the UK do exactly the same thing. And at a moment’s notice they are ready to spring into action.
Just a day before hurricane Irene slammed into the States, a local Baltimore newspaper commented about preparations that were under way. They mentioned Maryland fire fighters specifically trained in water and confined space rescue checking all of their equipment and reviewing safety and rescue procedures. One particular fire unit was giving an extensive amount of time to ensuring its confined space rescue davits were in perfect working order in case they should have to deal with victims in collapsed houses and the like.
Training Is Key
Using the Maryland fire fighters and their confined space rescue davits as examples, it can never be said enough that training is the key to successful rescues. The best equipment in the world is useless if workers do not know the proper way to use it. They need to know how to correctly assess a disaster location, the health and risks of the victims, and how to best utilize the equipment available. Only through hours of training is this possible.
Though it may seem that emergency preparedness training is much to do about nothing, the idea is to make the skills learned second nature to rescuers. In other words, they need to be able to set up a rescue area quickly and effectively without having to pull out an installation manual or watch a video. In the case of confined space rescue davits, they need to go together quickly and seamlessly. The rescue team needs to get in, get set up, and get about the business of victim extraction.