Andy Williams, Training Manager at Reax Ltd in Blackpool considers an often overlooked aspect of emergency planning for rope rescue operations. Andy works in an industrial context trainingspecialist access and rescue to a range of industries and has a background in instructing mountaineering and climbing.

Many emergency response plans focus solely on getting a casualty down safely from a tall structure. Quite rightly attention is paid to the technical side of rope based rescue. Staff need to be competent. The correct equipment needs to be selected. Rescue kits need to be easily available. Anchor points can sometimes be pre-identified. The possibility of the need for a stretcher, spine board or pain killing drugs may be recognised… more training needed!

These are all essential considerations during the planning phase of any task or rescue at height.

However, what is rarely considered is the need to protect the casualty from the elements. A casualty with an injury from a fall or other accident can quickly become very cold unless action is taken. Even on a relatively warm day an exposed casualty can be quickly cooled by a combination of windchill, rain and cold surfaces. The weather can also be massively changeable in some climates: in the North West of England, UK, where Reax Ltd is based, it can seemingly cycle through each season in the space of 24 hours!

This means that while planning and preparing to rescue a casualty is highly important, consideration also needs to be given to preventing hypothermia (core body temperature going too low). While in hot climates hypothermia can be an issue (written by someone who hung for far too long on the side of a radio tower in Liberia…), for many of us is our primary context hypothermia is the main hazard. While many people are aware of hypothermia, few seem to do anything about it. While training groups at Reax Ltd, we regularly hear of teams of workers getting into situations in which a lengthy rescue could ensue, or where response times for the emergency services might be long. Only a few plan for this.

Hypothermia is when the core body temperature drops below 35 degrees C. There are a number of kinds of hypothermia but for our purposes, in a rope rescue context, “exposure hypothermia” is the most likely. There is not space within this brief article to detail the symptoms or treatment of hypothermia. However there is space to consider how casualties can be best protected when shelter is not easily available.

Open up many rescue or first aid kits and you will probably find a foil “Space Blanket” packed in there alongside bandages and latex gloves. Sometimes this is the extent of peoples planning with regards to a casualties thermal requirements! Unfortunately, Space Blankets are often seen as sufficient to protect a casualty. They’re good enough for marathon runners, aren’t they?! In fact, a Space Blanket usually offers little protection as they wrap around the user, allowing heat to escape through many gaps. In addition, if a casualty is not producing much heat themselves a thin foil blanket will do very little, as there is not much heat to retain! While being cheap and very lightweight, foil “space Blankets” are not as effective as many people would hope.

Next in terms of protection is the Survival Bag. Essentially a large, heavy-weight orange bin bag, the Survival Bag is able to entirely enclose the casualty, shielding them from wind and rain very effectively. If a small opening for air is maintained and the casualty is still giving off sufficient body heat the environment inside can become quite warm. They can be entered feet first or head first, leaving the opening by the users feet. Double bags capable of fitting two people are available. Being able to fit two people in is a massive advantage as it allows for a relatively cosy environment to be created in otherwise miserable conditions. It should be noted that it is not always easy to get a casualty into a Survival Bag, as it is essentially shaped as a sleeping bag which does not open. In addition if a casualty may need to be protected for a significant amount of time a lot of condensation can accumulate, reducing its protective value. However, in a scenario which has been planned and prepared for we shouldn’t be stuck there too long, should we…!? At under 5 pounds and still relatively small these simple bags should be seen as an absolute minimum for any rescue kit.

Blizzard Bags are very useful pieces of kit. Ranging from a straight forward bag which the use crawls into through to those adapted for use during medical care, with Velcro opening, they offer an extra level of protection which Space Blankets and Survival bags do not. They come vacuum packed in a very small packet and can be repacked using a domestic vacuum cleaner if necessary. There are lots of options available but for now let’s just say this is the kind of product the author would like to pull out a rescue kit on a cold day! The versions which use Velcro fastenings along the side could be used to protect a suspended casualty if necessary. They cost roughly £30, although lots of different variations are available. (NB, the author has no links to this manufacturer, it’s just good kit!).

Much more heavy weight options are available and used by various rescue teams in the UK. “Cas Bags” offer a highly insulated, weather proof method of protecting the casualty. Carrying handles on either side and a full length zip are useful for casualty management.

The last piece of kit to consider is a group shelter. These are variously named as Bothy Bags, Group Survival Shelters or KISU’s (Karrimor Instructor Survival Unit). They are usually made of lightweight fabric and are able to enclose a number of people all at once. Sitting on the edges to keep the bag in place, rescuers are able to treat the casualty in a much more protected setting. They warm up very quickly if a few rescuers are available. It should be noted however that to operate to the best of their ability they require a number of people to be available to hold the shelter in place. In a remote setting on a crag or industrial structure this may be difficult to achieve. In addition if it is likely that only one rescuer will be dealing with the casualty the benefits of a Group Shelter begin to diminish. In this case other solutions such as the Blizzard Bag might be considered

Hats, gloves and mats

Hats and gloves can make a huge difference to a casualties comfort and also to the ability of a rescuer to concentrate and maintain dexterity. Roll mats are also very important in insulating the casualty from the surface they are lying in. For example a casualty may be lying on a cold chequer plate floor in a wind turbine nacelle or sitting on open grating as found on many pylons or comms towers. In the absence of roll mats other equipment could be used to improvise; bags or ropes could be placed under the casualty.

Further tech

There’s lots of more advanced options out there, including warm air systems that aim to help casualties as they breath, bags with warming pads in them, the list goes on. For now that’s a brief introduction to the possibilities.

So, have you thought through all the hazards you might face in an emergency? Has the threat from hypothermia been dealt with? Is it likely that a casualty could be left waiting either for rescue, while up at height, or waiting for the emergency services, down at ground level? What have you done to make sure your casualties are protected?