1. Procedure for Rescuing a Casualty from a Duct Revision 0 – 18 th October 2011 Toolbox Talk

2. THE RESCUE TEAM At least four people who have been trained (i.e. have attended a one day training course) should be available. One of these can be the standby man already involved in the work, however none of those already in the duct can be included in this number. At least one member of the rescue team should be a trained first aider. They should be the first person to enter the duct to assess the casualty’s condition.

3. EQUIPMENT ON STANDBY CLOSE TO THE WORK LOCATION Tripod Skedco Oregon Spine splint SKED Stretcher Two nylon webbing straps for the SKED Stretcher Neck brace One spare radio handset (minimum requirement) Three climber’s helmets Disposable boilersuits Three head torches Three harnesses Gas detector (at least one, preferably more) Knee pads Protective gloves, thermally rated gloves and sleeves (if likely to be in contact with exposed hot pipework) First Aid Kit

4. TRAINING VIDEO CLIPS (ONLINE) The following training video clips should be watched (in this order): Demonstration of removing a casualty from a tight space: http://www.skedco.com/public/video/confined_space_rescue_demo.wmv http://www.skedco.com/public/video/confined_space_rescue_demo.wmv Performing a log roll onto the spine splint and SKED stretcher: http://www.skedco.com/public/video/sked_classroom_demo.wmv Instructions for the SKED stretcher are also available at: http://www.skedco.com/public/documents/Sked_Instruction.pdf

5. GUIDANCE FOR REMOVING A CASUALTY FROM THE DUCT Preparing for a rescue The members of the rescue team should be familiar with the procedure for entering underground ducts (including the PPE required and the pre-entry checks to be carried out). The following should be done: Decide who will take charge - this person must stay on the surface at all times. Be clear about what each person will do. Ascertain whether any services need to be isolated prior to entry. After clearing entry using the gas detector, send one rescuer down to start with (a trained first aider). If any detectors held by those already in the duct are known to be alarming, do not enter the duct.

6. Preparing for a rescue (continued) Upon reaching the casualty, assess their condition. If the stretcher is required, reverse roll the head and foot of it at the surface before putting it into the duct. This prevents it curling up when putting the casualty on it. Find out which direction the casualty is lying in so that the stretcher can be put into the duct to suit (there may not be space to turn the stretcher round in the duct).

7. Preparing for a rescue (continued) If the casualty is unconscious, has a suspected neck or back injury or is incapacitated in any way they will need to be removed from the duct using a stretcher. The following items will also be required: Neck brace Spine splint One rescuer must support the injured person’s head and neck at ALL times should they have a suspected neck or back injury.

8. Neck brace This is the first item which should go on to the casualty and should be fitted before trying to move them. Measure the height that the collar needs to be adjusted to by using your fingers to see how wide the casualty’s neck is. Adjust the brace height to suit before putting the brace on the casualty. Feed the brace under the person’s neck whilst one other rescuer supports the casualty’s head and neck and head to keep it still.

9. Moving a casualty from the horizontal position using the log roll method If the casualty is not lying in a horizontal position, they will need to be moved into one as this is the only way to get them onto a stretcher and out of the duct. Their neck, breastbone and centre of stomach should all be in line. The log roll manouvre should be performed when moving a person onto a stretcher, spine splint or if they need to vomit (i.e. to prevent them from choking). At least three rescuers (preferably four) are required for moving a casualty.

10. Moving a casualty from the horizontal position using the log roll method (continued) One rescuer must support the casualty’s head and neck during this manoeuvre, the other two (or three) must support the shoulder, hip and just above their ankles. The other 2 or 3 people will roll the casualty. The rescuers’ arms should be crossed over (crossed arms gives greater stability) The casualty’s shoulder, hip and just above their ankles should be held when performing this manoeuvre. On the count of 3 - all rescuers should gently move the casualty together onto their side. On count of 3 the rescuers should gently roll the casualty back down again into the horizontal position.

11. Skedco Oregon Spine Splint If the casualty has a suspected neck or back injury, then this is the second item which should be applied after the neck brace. The item has colour coded straps: The head straps are easily identified, since they are detachable, short and are the only straps without buckles. One shoulder cross strap is orange and the other is green. The male and female parts of the upper torso straps have white buckle parts The mid-torso straps are grey and the lower torso straps have black buckle parts. The groin straps are black. The left pair of groin straps has white buckle parts and the right pair has black buckle parts.

12. Fitting the spine splint: Fold straps in on one side. Make sure the neck, breastbone and centre of stomach are in line. Log roll the casualty onto the splint. Attach straps from in order from shoulder to bottom. Straps at shoulder/upper arm level should go over the arm unless there is a suspected arm/shoulder injury. Attach the head strap last.

13. SKED Stretcher Use the log roll method to move the casualty onto their side. Move stretcher under casualty Use the log roll method to move the casualty back into the horizontal position. Very carefully slide the stretcher so the casualty moves to the centre of it. Use the towing strap at the end of the stretcher for pulling the stretcher if necessary. Look out for any obstructions which the stretcher could collide with and injure the casualty further.

14. Using two nylon straps for lifting the SKED with the tripod. Insert one end of the head strap through the lifting slot at the head end of the stretcher. Bring the strap under the stretcher and through the slot on the opposite side of the stretcher. Equalise the strap. Repeat procedure with other strap at foot end of Sked. Equalise all four straps Secure these to the locking carabiner attached to the tripod (NEVER use the towing strap at the end of the stretcher for lifting, it is not designed for this purpose). Keep an eye on the stretcher as it is winched up to ensure it doesn’t collide with the sides of the shaft and injure the casualty further.