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Permalink Reply by Ben Waller on November 11, 2008 at 6:40pm

I've run a few of these when I worked in the mountains.

If you can do the extrication with manually-powered tools, you'll need less manpower.
A set of lightweight struts will usually work for stabilization.
Rescue 42's composite Telecribbing struts are the lightest weight on the market for this.

A supply of good machinist's hacksaws with several spare blades and a battery-powered recip saw or two are good items to take, but the recip saw batteries won't last long. Two flat-head axes make a good sheet-metal cutter. Use the blade of one axe as the cutting edge and drive it with the other axe. A halligan is a good idea, too.

Rescue air bags can be a good choice but plan on at least 4 rescuers carrying the stokes litter with that gear if you take it. Carrying hydraulic rescue tools and power units is almost impossible to do. It will exhaust the people carrying them, and they'll be of limited use in the off-road setting.

Of course, if you have off-road rescue vehicles that can get your extrication gear to the scene, take whatever gear you wish.

In my experience, if you have a 4WD rescue truck plus one or two more 4WD vehicles to transport manpower, you'll need twice as much manpower as for an on-road extrication. If you have to hike in, plan on using up four to six times as much manpower. You'll need over 50% of the manpower just to carry the gear in and the patient out, assuming that you can't land a medical helicopter nearby and that no rescue-capable helicopter is available.

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Permalink Reply by T.J. on November 12, 2008 at 9:08am

Well we live in the outer area of anyways and we all have 4X4 so we'd just switch out the equipment at the road and into our POV's, we also have rescue sled's ans in the summer time their hooked up to a four wheeler, so we'd be all set.

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Permalink Reply by Joe Stoltz on November 12, 2008 at 1:04pm

While en route I would request help from two adjoining departments for manpower and their off-road vehicles. Also I think I would put the local medevac on stand-by just in case it's needed for recon or patient evacuation. It would most likely be in state forest land so the Forest Ranger needs to be contacted as well. The county high-angle rope team would be considered depending on the circumstances.

Once on scene I would set up a command post at the closest point of access, start a dual accountability system (tags and written) and start forming teams of 4 to 6 members each. First team in would ideally have a senior line officer and EMT for scene assessment and initial patient care. If vehicle stabilization is immediately required it may be possible to use rocks, logs, or other materials or objects at hand until the proper tools arrive. The first team leader would take command of the extrication.

From past experience there is usually someone with a 4 wheeler or other vehicle nearby who could take the first team in. The trail needs to be flagged with bright tape for others to follow. Members showing up in civvies or structure gear are advised to go back home to change into more appropriate attire. A staging area needs to be set up in preparation for the manpower and equipment en route.

Next-in teams (hopefully in wildland gear rather than structure gear) would carry the Stokes with spinal immobilization equipment. They would be on foot until the mutual aid off-road equipment arrives. Hopefully by then, we would have a better idea from the first-in team as to patient condition, extent of entrapment, and any equipment needed for extrication and stabilization. These would be taken in via the Mule and ASV vehicles. Bottled water (our beverage of choice) needs to go in on one of the trips for fluid replenishment at the incident scene.

By this point I would have consulted the topo maps we carry in the brush truck to determine if there is an alternate means of access to the incident. It's not unusual to shift the center of operation from one site to another as the patient's location is determined by our troops, and the exact position plotted on the map. (Next year we plan to buy a laptop computer with air card for wireless web access so we can bring up the "birds' eye" view and examine the area for possible routes of egress.)

It then becomes a waiting game as the teams do their thing. Each team has to have a good working portable radio with them. Communications as to the progress of the teams is essential. The pool of manpower that has built up in the road will come in handy if the patient has to be carried any distance by hand; several 6-person teams will be necessary to carry one average sized person one mile. They will be exhausted and thirsty, too so rehab has to be waiting for them when they get out of the woods.

Once the patient is evacuated and on the way to the hospital, keep track of all members leaving the woods and check them off on the accountability sheet. No one goes anywhere until everyone and everything is accounted for. Dismiss the mutual aid crews with many thanks, and head back to the fire house.

Then it's time to kick back and down a few brewskis... I mean Gatorades.

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