Essential steps and tools for Confined Space Rescue (CSR) during earthquakes, including VOID space entry, survivor care, and safe extraction techniques.
CSR stands for “Confined Space Rescue,” which in Japanese is referred to as rescuing activities in confined spaces, such as during earthquakes when rescuing people from collapsed buildings. In these scenarios, small spaces created within the rubble are known as VOID spaces, where survivors may be trapped.
Equipment Preparation
- Personal Protective Equipment (PPE):
- Ensure the headlight is working.
- Prepare necessary materials (blue sheet, tape, Sked stretcher).
- Depending on the situation, destruction and cutting tools may be needed. However, in earthquake rescues, it’s common for resources to be limited due to the number of rescue and fire sites. At the very least, ensure PPE and a blue sheet are prepared.
Entry and Rescue Procedures
- Searching and Entry:
- Conduct a size-up to find a possible entry point.
- Use a gas detector to check for oxygen levels and the presence of flammable gases.
- Establish an emergency exit signal and set the entry duration for rescuers (10-20 minutes).
- Create a management sheet (entry times, survivor information, entry space description, hazards).
- Entering the Void Space:
- Enter with two team members carrying a blue sheet.
- Avoid entering in large groups to ensure a quicker and safer exit.
- The entering team should communicate internal conditions to those outside. For example, “Advance 3 meters east and 1 meter south to reach the survivor.”
- Report survivor information (location, condition, etc.).
- Packing the Survivor:
- Survivors may be suffering from hypothermia due to contact with concrete and possible exposure. Cover them with a blue sheet to prevent further heat loss.
Use of Sked Stretcher
- Sked Stretcher:
- In confined spaces filled with debris, transporting survivors is challenging. The Sked stretcher helps wrap and protect the survivor while pulling them over obstacles within the rubble.
Conclusion
Rescuing survivors from confined spaces in disaster scenarios requires careful planning, appropriate equipment, and efficient communication. By following these guidelines, rescuers can safely and effectively perform their duties, ensuring the safety of both themselves and the survivors.
Packing (Insulation & Protection)
In confined spaces, the concrete surroundings can cause the victim’s body temperature to drop, leading to hypothermia. Packing prevents the victim’s body from coming into direct contact with concrete, helping to retain body heat. Additionally, packing serves as a protective layer for the victim while being moved across rubble, making it a crucial technique. Moreover, insulation is a medical intervention that rescue teams can provide.
1. Preparing the Sheet
- Use a 180cm x 180cm sheet.
- Ensure readiness to work with various sheet sizes as needed.
2. Rolling the Sheet
- Roll both ends of the sheet towards the center.
3. Folding the Sheet
- Fold it into thirds or in half, ensuring it is as compact as possible to facilitate transport.
4. Securing with Tape
- Use duct tape to secure the sheet, either inside the sheet or on the rescuer’s wrist for easy access during transport.
5. One-Person Log Roll Packing Method
- Cross the far leg of the victim over the other leg.
6. Positioning the Sheet
- Lay out the sheet close to the victim.
- For larger individuals, prioritize positioning the sheet near the head.
7. Supporting the Victim
- Place your hand securely under the victim’s neck to maintain spinal protection.
8. Adjusting the Sheet
- Unroll the sheet on the far side of the victim.
- If possible, request the victim’s cooperation to facilitate the process.
9. Returning the Victim to the Sheet
- Carefully return the victim’s body onto the sheet.
10. Securing the Sheet
- Spread the sheet and secure it with duct tape.
- Utilize the space around the victim’s neck, waist, and knees to make it easier to secure the sheet.
11. Packing Completion
- Since the victim may need to be dragged on the sheet alone, ensure the duct tape is applied firmly and in long strips.
12. Placing Medical Equipment
- Consolidate observation equipment near the victim’s head to allow easy monitoring.
13. Adding an Aluminum Sheet
- Use an aluminum sheet to increase insulation, but note that it may tear easily.
14. Adding a Blanket
- Adding a blanket provides more insulation, but it also increases thickness, which can hinder transport and packing.
Note: After packing, check if the victim feels warm. If necessary, consider adding another blanket on top. If an evacuation order occurs during packing, cover the victim with a blue sheet to provide as much protection as possible. Avoid excessive heating.
Sked Stretcher Use
In confined spaces, obstacles make it difficult to transport victims. The sked stretcher wraps around the victim, offering protection while dragging them over rubble or other obstacles.
1. Full Sked Stretcher
- Roll it vertically for easy transport in confined spaces.
2. Half Sked Stretcher
- Method 1: One-Person Log Roll
- Place the stretcher as close to the victim as possible.
- Return the victim’s body onto the stretcher.
- Method 2: Rescuer-Assisted Loading
- The rescuer positions the victim on top of the stretcher.
- Method 3: Dragging Method
- Slide the victim onto the stretcher by dragging them.
Important Points
- Victims may slide on the sked stretcher, reducing traction, so an assistant should hold the victim’s legs.
- When alone, use rubble as leverage to assist.
Foot Belt Techniques
- Basic Method
- Advanced Method (Leg Alignment)
- Overlapping Feet Method
- Packing + Full Sked Stretcher
Note: Methods 2 and 3 may cause pain in the victim’s feet, so proceed with caution.
Half Sked Stretcher
- Packing + Half Sked Stretcher
- Preparing in advance allows smoother operations. Practice and review techniques in a “safety zone” before entering confined spaces.
Rescue Techniques
Two-Rescuer Methods
- Front and Rear Rescuers
- The rear rescuer may face difficulty exiting the space.
- Front Rescuer Only
- Both rescuers can exit together, but it’s difficult to monitor the victim’s feet or respond to obstacles.
- Leg-Hold Method
- Similar to method 2 but usable in low-clearance spaces.
Clearing Obstacles
- Use the knees or shoulders of the lower rescuer to help the victim over obstacles.
- Balance and slide the victim up.
- The lower rescuer pushes from below, while the upper rescuer presses down on the head end.
- Monitor for any changes in the victim’s condition.
Rescue Using a Sheet
1. Advanced Techniques
- Place rocks, carabiners, or duct tape at the head end of the sheet.
2. Create Folded Handles
- Create folded handles on the sheet for better grip.
3. Use Tying Techniques
- Secure the sheet with tying techniques for better control.
4. Rescue Operation
- Use the guide ropes or equipment used during entry to assist in the rescue.
Note: The sked stretcher may not fit in confined spaces, as it can get stuck. Be prepared to remove the sked stretcher and rely solely on a blue sheet for rescue. Placing blankets or padding on rubble can make the extraction process easier.
Multi-Purpose Use of Sked Stretcher
- The sked stretcher isn’t just for rescue. It can be laid over rubble or small steps to create a smoother surface.
- It can also serve as a pelvic binder to stabilize pelvic fractures in emergencies.
Reference page: “Key fire characteristics: combustion elements, smoke risks, toxic gases, and safe firefighting techniques.”
References National Fire Protection Association (NFPA)