You’re the first-due company to the scene where you find a victim in a precarious position, one requiring rescue. You assume some version of mobile command and start your decision-making process.
When a victim presents in an environment that requires advanced technical rescue expertise and resources, you are immediately confronted with some of the toughest decisions you may ever make in your career.
4-sector command structure
When faced with technical rescue events, we advocate a four-sector command structure for operations. This approach can be expanded or contracted to an event of any magnitude.
1. First-due company: Command, safety, recon
This company establishes command and safety and then assigns a fast-acting team to perform recon. This can be a singular company or the first few companies depending upon staffing and the scenario. The command and safety officers’ primary objective is to conduct the initial interview with witnesses or on-scene site managers regarding the event. Command should focus on information needed for a rescue action plan, and safety should focus on information needed for a Safety Action Plan. While gathering information, deploy remaining members with operating boundaries based on capabilities. The recon team’s role is to get eyes on the victim and initiate a rescue sequence based on the victim’s presentation:
- Attempt self-rescue coaching when appropriate;
- Attempt reaching or rapid access rescue;
- Maintain verbal and visual support; or
- Retreat and enhance capabilities to affect a rescue.
2. Second-due company: Hazard management
This company should report to the safety officer and execute the safety plan to mitigate, manage or monitor hazards. This includes work zones, atmospheric monitoring, ventilation, edge protection, down river throwers and grab lines, etc.
3. Third-due company: Support
This company reports to command and executes the resource development for the rescue plan. This includes rope systems, tripods, trench panels and shoring, etc.
4. Fourth-due company: Rescue
This company reports to command and executes the rescue plan. This company is always responsible for victim packaging resources and deployment into the environment to retrieve the victim.
Leadership accountability and responsibility
To make go/no-go decisions, it is imperative that both informal leaders and formal leaders consider this scenario and prepare for it to the best of their abilities. To prepare, we all need to establish a process or a decision-making tree.
Before we get into defining that process, let’s establish some boundaries for leaders making critical decisions:
- Accept responsibility for others’ wellbeing: Whether you are an informal leader or a formal leader, your decision on the operating ground affects your fellow first responders and the victims who are depending upon us. We are not individuals free from the consequences or blessings of our decisions and how they impact the event. Translation: If you are leading, what you do or don’t do will be followed and will directly influence the outcome. So, be prepared to embrace the responsibility of others’ wellbeing. If you aggressively charge into an event and three followers pursue you into the battle, be ready to look in the mirror and own that decision and its outcome.
- Accept accountability for your delegation decisions: If you are a formal leader, it is impossible to negate “employer/supervisor and employee” roles and responsibilities within an OSHA and legal framework. Employers/supervisors are held accountable for training and equipping their employees to perform the tasks that will be assigned within the scope of their job. If, as a leader, you delegate a task to an employee who is not qualified, trained or equipped for the task, then there is a legitimate foundation for negligence and liability.
The solution is to identify your organizational missions and properly equip and train your personnel. Another solution: Empower your employees to know their limitations and operate within their capabilities. Encourage a culture that can be professionally vocal in saying NO when it is appropriate. We adhere to this concept with rigidity when it comes to EMS. EMT-Bs are not establishing IVs and pushing meds without serious accountability and consequences that include criminal charges. However, on the fire and rescue ground, we have developed a pattern of operating in gray areas where we’re not always qualified.
Building a decision-making process
Now let’s jump into the decision-making process. We have established that we need to be proactive in providing our personnel with the proper training and resources to perform the tasks that may be required of them, including technical rescue events. Identify the members with special capabilities and staff accordingly. Second, understand the roles and responsibilities of operating within your scope. Stay in your lane and be confident about communicating as a team to maintain accountability when the scope is being expanded beyond your level of operational ability.
Creating a process for decision-making:
- Rapid assessment for formulating an action plan: Gather information regarding the environment, the victim and their needs, and the rescue sequence that will be required to achieve a successful outcome.
- Rapid assessment for formulating a safety plan: Gather information regarding known and potential hazards to the victim and to the rescuers and develop a plan to mitigate, manage or monitor those hazards.
- Identify essential roles: Identify leadership and operational tasks and assign personnel accordingly with clear objectives and expectations.
In order to make proper decisions and formulate these three actions, you need to be equipped with the right information. When you do not have enough information to make a proper decision, you’re in the grinder. This does not mean you do not risk a lot to save a lot. What it means is you must be prepared to stand tall for your decision and defend it to a group of your professional peers. Knowledge and expertise are your best assets, and if you don’t have them, seek them. This can occur real-time on an event. Do not allow rank, seniority or ego to impede your ability to get guidance from the right people and obtain the right information.
Swiftwater rescue scenario
Let’s use a scenario to illustrate this.
Your district has experienced three days of torrential downpours with various flood plains that are experiencing rising water levels. Companies are dispatched on a report of a stranded vehicle in a roadway that has been washed out with moving flood water.
The first company to arrive on scene is an engine staffed with four. Your technical rescue team, which is equipped with a boat and proper PPE, is 10 minutes out. You pull up in the rig and see a male victim on the roof of a car with moving water up to the middle of the vehicle windows. Bystanders are on scene waving and yelling for you to get to work.
As the officer, you are riding out of class and do not have any technical rescue training or certifications in water rescue. However, your hydrant man on the engine is a three-year member of the department and just completed his swiftwater operations course this year.
Do not rest on your personal insight alone. Use your trained water member! Your engine is equipped with basic PPE for water responses, including PFDs, throwbags, and reaching devices (some Z hooks).
Apply the sector system and the decision-making process above, and follow this key rule: The victim drives the rescue. Your crews’ capabilities dictate the operation.
Establish command and bring your next most knowledgeable member with you to function as a safety officer. This is not your water-trained member; they should be assigned to the recon team with your remaining member. Instruct them to don proper PPE and equipment, then report when ready. You and your safety officer should immediately begin a rapid-fire interview with the bystanders while you make your way to a safe vantage point to evaluate the immediate environment and the victim.
The rescue plan and the safety plan should be fundamentally mapped out by the time your recon team reports. Lean heavily on your trained water member and share with them the high-altitude version of both plans. Allow them to vet the plans, quickly assess the victim and the water conditions, and then revise the plans as needed.
You notice that the water is moving fast and the car appears to be shifting. The victim is active and screaming and appears to be in good health and physical ability. Here are your options in your plan:
- Attempt self-rescue coaching;
- Attempt a throwing-or-reaching rescue;
- Attempt a swim-based GO rescue; or
- Maintain coaching contact and wait on additional resources.
When you weigh these options, the optimal choice for a rapid rescue attempt should meet the following criteria:
- Is it informed and within the scope of your team?
- If it is not informed, did you have any other viable options?
(Note: In this context, informed refers to decisions being defendable and rooted in the right technical, tactical and safe practices. Are you informed (through training) about the right technical options? Are you informed (through scene assessment) about the victims’ needs and tactical variables? Are you informed (through safety assessments) of the inherent risks? Can you justify your actions?)
In this scenario and rapid rescue attempt, the self-rescue sequence would not be optimal for a high-percentage viable outcome. The victim’s ability to execute a fast-moving water self-rescue swim without a proper PFD presents too much risk to be a first choice. Attempting a swim-based GO rescue would be out of the scope of your team. Only certified swiftwater rescue technicians have been exposed to adequate swim conditions and demonstrated adequate proficiency as rescue swimmers to perform this choice. Maintaining coaching contact and waiting on additional resources may result in further movement of the vehicle and loss of the victim.
The optimal choice here is deploying a throw bag with a PFD to the victim to don, followed by a throw bag with shore-based tending and then coached retrieval to safety through the water while holding onto the line. This would be an informed decision within the team’s scope and appropriate as a GO decision for rapid rescue even though a comprehensive team isn’t on scene yet. Additional considerations to improve the outcome of the event would be the deployment of additional down-river throwers and reachers from the remaining members of the engine company.
What’s key with technical rescues is to have a mental plan of attack that you practice and implement consistently. Repetition creates muscle memory and instinctive responses even when the adrenaline is flowing and circumstances seem overwhelming.
Stay informed and stay in your lanes. Only deviate from the path of the unknown and uninformed as an absolute last resort, and be prepared to stand tall for your decisions, whether you are operating in a formal or informal leadership capacity.
Stay safe and train hard.