Emergency preparedness, rescue and resuscitation
This domain tests emergency preparedness and rescue. The exam rewards the principle that rescue should be performed from outside the space, and it penalises the "hold your breath and run in" answer.
Plan and equipment
A site-specific rescue plan is prepared before entry. It identifies the rescue team, access and egress, communication, first aid and the equipment: tripod, winch, retrieval line, SCBA with spare cylinders, stretcher, oxygen, AED and extinguisher. Drills should be run. The plan must match the space, the entry method and the likely emergency.
Emergency sequence
On collapse, gas alarm, communication loss, fire or flooding: raise the alarm, call 999, isolate and ventilate if it is safe to do so, and retrieve the worker from outside using the harness and winch. Only trained and equipped rescuers enter, with breathing apparatus, a backup and a written plan. Most confined space fatalities include would-be rescuers. After retrieval, move to fresh air, check airway, breathing and circulation, give CPR and oxygen, use an AED and hand over to the ambulance crew.
Worked example
An entrant collapses in a pit. The standby should not climb down. The standby calls 999, alerts the person in charge and operates the tripod and winch if the harness and line are rigged. If the worker cannot be retrieved, the standby waits for the rescue team rather than entering with a filter mask. The reasoning is that an unprotected rescuer becomes a second casualty and delays the professional rescue.
Traps that cost marks
- Entering with an air-purifying respirator to rescue a collapsed worker.
- No retrieval line or winch, making outside rescue impossible.
- Delaying the 999 call while trying to "fix" the situation.
- Forgetting to account for all entrants.
- No drill, so the equipment does not fit or the winch jams.
- Moving a casualty without considering spinal injury or secondary contamination.