1. Search Operations and Victim Management

2. Objectives (1 of 4)
Discuss the use of search tactics during search and rescue operations.
Describe emergency medical response system levels of service.
List general hazards that may be present during victim management at a technical rescue event.

3. Objectives (2 of 4)
Describe victim access considerations and procedures.
Describe victim stabilization.
Identify the need for triage at a technical rescue incident.

4. Objectives (3 of 4)
List common victim injury patterns related to technical rescue events.
Describe types of patient packaging devices and their use.
Explain the safety procedures for working around helicopters.

5. Objectives (4 of 4)
Describe response planning and incident management requirements related to victim management at a technical rescue event.

6. Victim Management (1 of 2)
Identifying hazards to which a victim may be exposed
Accessing victim or victims
Performing triage for multiple patients

7. Victim Management (2 of 2)
Assessing and stabilizing patient injuries
Interacting with victims
Moving and transferring victims requiring technical rescue assistance

8. Awareness Level Responders
Identify the location of rescue victims upon first arrival.
Gain access to the victims’ location.
Assist more qualified rescuers with patient movement and transfer.

9. Search Phase (1 of 2) Time during which patients are located
Location may be clear or unknown
Entrapment makes more complex
Can be prolonged and require many resources depending on situation

10. Search Phase (2 of 2) Search operations involve combination of:
Detective work
Analysis work
Speculation
Use of search tools, equipment, tactics

11. Search Environment Determines
Difficulty of search operations
Amount of required resources
Tactics utilized

12. Examples of Environments
Water
Wilderness
Structural collapse

13. Search Tactics
Methods depend on type of rescue, drives decisions regarding tools or techniques
Reconnaissance to gather information regarding type, size, complexity of situation
Witness interviews to obtain information
Includes victim’s last known location

14. Factors That Determine Urgency
Time elapsed
Victim profile, including experience and available survival equipment
Environmental conditions
Terrain/hazards
History of incidents in area/site

15. Search Plan Based On Urgency of search Available resources
Existing hazards to responders
Known information about victim or victims

16. Define Search Area Search grid: Segmentation:
Identifies, prioritizes, documents search area
Starts search in specific area
Segmentation:
Allows for search of large area
Establishes specific search area boundaries

17. Primary and Secondary Searches
Primary search:
“Hasty” search
Deployment of resources to initiate rapid search of area thought to contain survivors
Secondary search:
Slower, methodical search to ensure no victims overlooked

18. Search Resources (1 of 2) Determined by type, complexity of problem
Might include specialized personnel resources, such as:
Incident management personnel
Trained or specialized searchers
EMS
Search dog handlers

19. Search Resources (2 of 2) Specialized vehicles, such as:
Helicopters
Off-road vehicles
Horses
Watercraft
Require plan ahead of time

20. Basic Life Support (BLS) (1 of 2)
Medical first responders or EMT-Basics
Limited set of emergency medical skills
Can perform cardiac defibrillation using AED
Cannot administer medications beyond:
Assisting patient with prescription medications
Administration of IV fluids

21. Basic Life Support (BLS) (2 of 2)
Courtesy of Yellowstone National Park/NPS

22. Advanced Life Support (ALS) (1 of 3)
Extensive training required; greater investment in equipment and personnel training than BLS
Operate as extension of physician, using standing orders, protocols, radio direction

23. Advanced Life Support (ALS) (2 of 3)
May require more personnel at emergency
Training levels include:
EMT-Paramedics
EMT-Intermediate includes limited ALS skills

24. Advanced Life Support (ALS) (3 of 3)

25. Primary Hazard May be larger event, such as a natural disaster
Specific type of technical rescue may be secondary factor or cascade event created by larger event
Can create other hazards for rescuers, such as flooding, electrical wires, debris
Rescuers may also create hazards at rescue site.

26. Hazard and Risk Assessment Identifies
Hazards rescuers will be exposed to
Hazards victims must be protected from
Level of personal protection equipment (PPE) required
Necessary safety procedures

27. Hazard and Risk Assessment
© Dennis Wetherhold, Jr.

28. Vehicle Accident Hazards Include
Fuel spills
Jagged metal, broken glass
Uncontrolled traffic flow
Unstable vehicles
Air bag systems and hydraulic systems
Possibly hazardous cargo

29. Trench Collapse Hazards Include
Potential for secondary collapse that may entrap rescuers
Atmospheric hazards
Exposure to broken utility lines

30. Confined-Space Hazards Include
Exposure to oxygen-deficient, explosive, toxic atmospheres
Engulfment potential from flowing products
Uncontrolled energy sources
Reduced visibility
Slippery surfaces

31. Needs Identified by Hazard and Risk Assessment
Special technical rescue protective gear
Placing and staffing of protective hose lines for fire hazard
Controlling broken utilities or uncontrolled energy sources
Obtaining flotation device
Additional or specialized resources

32. Perform Hazard Evaluation Before Initiating Patient Care
Critical to rescue
Patient care shifts focus away from environmental hazards.
Hazards may worsen, especially in dynamic situations.
One crew member should be disconnected from patient care, continuously evaluating the environment.

33. Victim Access (1 of 3)
Complexity varies depending on the entrapment type.
Type of technical rescue determines difficulty.
Victim location precipitated during the search phase.
Requires control or reduction of hazards that may affect rescuer

34. Victim Access (2 of 3)
Procedures, access equipment, and access techniques vary widely.
Rescuers should continuously look for new hazards.
Major goal to secure, stabilize victim and protect from further harm
Rescuers must identify escape route prior to entry.

35. Victim Access (3 of 3)
Courtesy of Robert Rhea

36. Victim Assessment (1 of 2)
First priority following assessment
Identifies patient injuries and adverse medical conditions
Determines resources to extricate, package, transport patients

37. Victim Assessment (2 of 2)
Based on medical protocols established by AHJ and applicable local, state, federal laws:
Ensure protection from bloodborne via PPE
Adherence to written protocols related to BSI

38. Victim Stabilization per BLS
Establishing and maintaining adequate airway
Providing respiratory ventilation to maintain air flow
Controlling severe bleeding
Maintaining circulatory system
Spinal immobilization or shock treatment, if necessary

39. Triage (1 of 2)
Sorts patients based on severity of injuries or medical conditions
Essential in mass-casualty incidents where increased number of patients strains resources
Review mass-casualty triage process.
Follow local medical protocols to determine patients with highest priority.

40. Triage (2 of 2)
© Scott Downs/Dreamstime.com

41. Common Injury Patterns
Rescuers should be familiar with common injury patterns related to specific rescue scenarios.
Review injury patterns for:
Vehicle accident entrapment
Confined-space
Trench and structural collapse
Wilderness
Water

42. Victim Packaging, Movement, and Transfer (1 of 4)
Performed after victim access, assessment, initial treatment
Often uses long spine board or similar device
Rescuers choose the appropriate packaging device for the environment.
Goal is completing process safely, efficiently, limiting further injury

43. Victim Packaging, Movement, and Transfer (2 of 4)
Special equipment may be necessary.
Ends with patient transfer, or handing-off patient to EMS responders for transport to medical facility

44. Victim Packaging, Movement, and Transfer (3 of 4)

45. Victim Packaging, Movement, and Transfer (4 of 4)
Courtesy of Ferno Washington, Inc.
Courtesy of Junkin Safety b.
c. Courtesy of Ferno Washington, Inc.
d. Courtesy of Ferno Washington, Inc.
Courtesy of Ferno Washington, Inc.
Courtesy of Ferno Washington, Inc.

46. Resource Requirements
Emergency medical services resources:
Can be significant, depending on situation and environment
Specialized victim packaging and transfer equipment:
May need to fit in small, space-limited areas
Must allow for proper victim management, stabilization, movement
Multiple patients requires multiple patient packaging devices

47. Transport Vehicle Options (1 of 3)
Ambulances
Mass-care vehicle, like a medical bus used for numerous patients
Commercial or school buses
Aircraft for serious injuries

48. Transport Vehicle Options (2 of 3)

49. Transport Vehicle Options (3 of 3)
Courtesy of the Prince George’s County Fire/EMS Department

50. Helicopter Usage (1 of 2)
Initial reconnaissance and large-area search operations
Transport rescue teams over long distances and in isolated areas that are difficult to access by ground
Flood and swiftwater rescue
Serious medical emergencies

51. Helicopter Usage (2 of 2)
© Fred L. Isom/ShutterStock, Inc.

52. Helicopter Resources
Agency supplying helicopter determines helicopter needed for particular rescue
Identify locations and response times of helicopter resources during response planning.
Rescue response agencies should have SOGs related to helicopter assistance.

53. Helicopter Safety and Landing Zone Management (1 of 2)
Be aware of hazards directly related to approach, landing, and takeoff.
Be aware of procedures for identifying, procuring, and securing landing zones.
Be aware of safety guidelines for working around a helicopter.

54. Helicopter Safety and Landing Zone Management (2 of 2)

55. Incident Management Requirements
Use ICS to achieve strategic objectives.
ICS staffing and positions are determined by scope of event.
ICS management personnel are responsible for strategic and tactical management.

56. Response Planning (1 of 2)
Perform regular needs assessments to determine vulnerability to various technical rescue events.
Identify capability of agency personnel in advance, including level of performance at which agency personnel are trained.

57. Response Planning (2 of 2)
Understand location, capabilities, and response times for regional, state, federal search and rescue teams and medical teams.

58. Summary (1 of 2)
Victim management includes identifying hazards, accessing victims, performing triage, assessing patient injuries, stabilizing victim injuries, interacting with victims, and moving and transferring victims.
Resource requirements vary, depending on entrapment problem and number of victims.

59. Summary (2 of 2)
Effective planning incorporates risk assessment, resource assessment, and development of written procedures.
Rescuers must understand types of common injury patterns.
ICS may be necessary to control the emergency.