Byline: James Hyles
A worker and a rescuer die inside the floating cover of a sewage digester. One worker and one rescuer die in a storm sewer that’s under construction. Two rescuers die after rescuing a worker from a fracturing tank at an oil well. One worker and one rescuer die in a toluene tank accident. One worker and one rescuer die inside a waste-water holding tank. Another rescuer dies attempting rescue from a tank used to store spent acids. One worker and three rescuers die in an underground sewage pumping station. A worker and a rescuer die inside an empty 4,000-gallon molasses vat.
Even a short history of confined-space fatalities contains a long list of unfortunate deaths. But the tragedy is compounded because the list is more than twice as long as it should be. In each of these cases, at least one rescuer is killed. And this is not a special distillation of incidents to make a point.
A U.S. Fire Academy study of firefighter fatalities found that between 1990 and 2000, more than 5% of the firefighters who died on duty were participating in rescue attempts. Moreover, the National Institute for Occupational Safety and Health reports that would-be rescuers account for 60% of the fatalities that occur in confined spaces. Imagine that every time someone dies in a confined space, at least one rescuer will die trying to save that person. The rate simply does not have to be that high.
State the not-so-obvious
Confined spaces present a variety of hazards to rescuers, many of which are obvious. The space may have limited entry and exit. There may be equipment such as motors, gears or agitators that hinder movement and could cause physical harm. The space may be a container for grain, water or some other contents that can shift and engulf the rescuer – the second-leading cause of death in confined spaces. The structure may be poorly lit, have slippery surfaces, or impede communications among rescuers. But it’s the hidden dangers that are the most threatening and the easiest to ignore or forget.
Every confined space should be considered dangerous until proven otherwise and until precautions are taken to mitigate potential hazards. Asphyxiation is the leading cause of death in confined spaces in no small part because these atmospheres are easily corrupted and atmospheric hazards are impossible to detect without monitoring equipment.
Rescuers often rely on their senses to evaluate and identify hazards, a practice that is fundamentally flawed. Even when the physical senses may detect atmospheric hazards, the contact necessary for detection alone often is fatal. The only safe and reliable means for testing confined-space atmospheres is to use equipment designed for that purpose, deployed by rescuers trained on the devices.
Proper atmospheric testing requires deliberation and care. Approximately one-third of all confined-space fatalities occur after the space has been tested and determined safe for entry. Quick tests at the point of ingress are insufficient. Carbon monoxide, for instance, is lighter than normal air, so it likely would be detectable at openings or near the top of a vessel. Hydrogen sulfide, on the other hand, is heavier than normal air and will sink to the bottom of a vessel. Consequently, the only adequate means for testing the atmosphere in a confined space is to test at various levels, because stratified atmospheres in a confined space means that safe air near the opening doesn’t mean safe air throughout the space.
An initially safe environment can become corrupted during rescue operations. Water pumps may slowly saturate the air with carbon monoxide, a poisonous gas that does not register on any of the physical senses. Operations that disturb decomposing material, such as grain at the bottom of a silo, may release hydrogen sulfide, which at low concentrations smells like rotten eggs but at lethal concentrations deadens the sense of smell entirely. Even the simple act of breathing in an initially safe atmosphere will slowly replace the oxygen with carbon dioxide if the space is not ventilated well enough.
The first level of atmospheric testing that always should be conducted before initiating rescue can be done with a basic four-gas meter. This will indicate the levels of oxygen, which must fall within the safe range of 19.5% to 23.5% by volume for rescue to begin, as well as indicate the presence of carbon monoxide and hydrogen sulfide, the two toxic gases most commonly found in confined spaces.
Industrial fire brigades test their equipment as often as once a day, a practice that would benefit public companies as well. Months can go by with equipment sitting unused and untested on a truck as batteries drain and calibration slips. Routine upkeep eliminates the risk of finding equipment to be faulty when it is most needed.
Above all, proper and regular training equips rescuers with the presence of mind to apply calm mental calculation to any rescue incident. Rescue scenes often are cluttered, confusing and overwhelming, presenting responders with a rush of information that can be too much to handle without a clearly established plan. Rescuers often fall prey to the idea that time taken to think through the operation is lost time. But without adequate understanding of the dangers imperiling the victim, the rescuer risks becoming a victim.
These incidents demand a systematic approach from rescuers, who must proceed carefully through the phases of recognition, evaluation and control. This involves rescuers interviewing witnesses about the equipment and conditions that led to the situation at hand, assessing the perimeter to determine which hazardous conditions are immediately dangerous and which are less so, identifying which conditions may be deteriorating or capable of deteriorating, and taking steps to secure the area against all of these threats.
Once the area around the confined space is secured, rescuers begin to assess the space itself: analyzing the configuration of the confines; identifying products that may be stored in the space, as well as any mechanical or structural hazards the space presents; and locating important documentation such as entry permits and checklists, hot work permits, Material Safety Data Sheets, and a diagram of the space. As with the perimeter, the stability of the confined space must be ensured, and the responders must make sure the proper personnel and equipment are on scene for the operation.
After all of these efforts to secure the scene and protect rescuers, responders must finally stop and determine if their precautions and risk mitigation are enough. If not – and this is a decision responders are reluctant to make – operations may need to shift from rescue to recovery.
A successful rescue operation depends first on the degree to which the rescuers have been trained to recognize on-scene hazards, to evaluate them and their impact on ensuing operations, and to control the scene’s variables for the protection of all personnel. All of this precedes the actual efforts to gain access and stabilize, package and extricate a victim.
The natural inclination of any rescuer is to leap into action, understandably anxious to move as quickly as possible to save those in distress. The inestimable value of training is that, through time and practice, the natural inclination to act will be supplanted by the necessary process of rational consideration.
Only training can equip the rescuer with the mental tools that enable methodical, careful analysis of the scene to override rash action. Only training can equip the rescuer with the knowledge to take full advantage of the life-saving monitors and equipment available to them. And only training can provide the rescuer the patience necessary to remember that the conditions that overcame the victim can, and will, overcome the rescuer without diligent attention to life safety.
James Hyles is the rescue program coordinator for the Emergency Services Training Institute, a division of the Texas Engineering Extension Service of Texas A&M University in College Station, Texas. He also serves as rescue specialist for the Texas Task Force 1 USAR team and as a rescue adviser for the Bryan (Texas) Fire Department. Hyles has spent 28 years in the emergency response field, having served as a training officer/lieutenant for the Brazos County (Texas) Precinct 1 Volunteer Fire Department, and as a firefighter/EMT for the Mineral Wells (Texas) Fire Department.
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