Exercise 32.4. Evacuation of the victim from the gassed area

Starting position: the intelligence unit found the victim. The atmosphere is not breathable. The personnel of the squad are included in breathing apparatus and have minimal equipment for reconnaissance and an apparatus or rescue device for the victim.

By order of the head of gas rescue operations, a base was organized near the border of the gassed zone to receive the victims and provide them with first aid.

At the command (signal) of the squad leader:

include the victim in the breathing apparatus available at the department in accordance with complex 20 or in the rescue device complex 21 (Figures 41-45).

Figure 41 Figure 42

Figure 43

Rescuers No. 2 and No. 3 prepare a stretcher;

The squad leader, rescuers No. 1 and No. 3 kneel on the right knee on one side of the victim (where there is more damage) and put their hands: the squad leader – under the neck and shoulder blades of the victim, rescuer No. 1 – under the lower back and pelvis, rescuer No. 3 – under the hips and shins; at the command of the commander of the “Raise the victim” section, raise the victim;

To the rescuer No. 2 , bring a stretcher under the victim, holding, if necessary, his dangling arm; rescuers carefully place the victim on a stretcher in a stable position on their side;

Figure 44

For rescuer No. 1 , fix the victim with the chest and waist belts of the stretcher, stand at the stretcher from the side of the victim’s head;

To the rescuer No. 2 , fix the victim with the stretcher’s foot strap (when using the reserve apparatus, place it on the stretcher and fix it with the straps together with the victim), stand at the stretcher from the side of the victim’s legs;

Rescuer No. 3 to collect the equipment of the department;

To the commander of the department, take an air sample, make sure that the victim is properly secured (tied up) on the stretcher, give the command “Lift the stretcher. Forward”;

Figure 45

Rescuer No. 3 transmit the necessary information to the GSS, go ahead, maintain the necessary pace of movement, illuminate the path, warn of possible obstacles, provide assistance in difficult places of movement;

The squad leader should go to the side of the stretcher from the side of the victim’s face and monitor his condition.

Squad leader to take an air sample.

Note: When evacuating a casualty in conditions of poor visibility, rescuer no. For rescuer No. 2, place the cable on the handle of the stretcher in such a way that during movement it passes freely between the arm and the body of the rescuer. For the rescuer walking in front, control the direction of the exit along the guide cable and constantly use the probe.

Exercise 32.5. Evacuation of the victim with a leg injury on sanitary
stretcher for steep ascents and descents

Starting position: the victim, included in the breathing apparatus, lies on a stretcher; On examination, a fracture of the leg bones was found. The atmosphere is not breathable. The personnel of the department is included in breathing apparatus, has a reserve breathing apparatus and a rescue kit with high-altitude equipment.

32.5.1. At the command of the commander of the department “Prepare the victim for evacuation”:

Rescuers put the victim on a stretcher, place the apparatus, secure the victim and the apparatus with stretcher belts (hose above the belts); position, relative to the stretcher, as follows:

To the squad leader – at the head of the victim,

Rescuer No. 1 – from the side of the injured leg,

Rescuer No. 2 – from the side of a healthy leg;

Rescuer No. 3 to organize the points of attachment of the ropes and insurance;

For rescuer No. 2 , unwind the rescue rope, place it at the head of the victim, measure approximately 7 m from the end of the rope and tie it with a double loop (the “stirrup” knot – Figure 21) to the handle of the stretcher, from the side of the victim’s healthy leg, at a distance of 25-30 cm from the opposite handle of the stretcher, make a double loop on the long end of the rope and pass the foot of the healthy leg into it, pass the long end of the rope to the squad leader, and the short end to rescuer No. 1;

To the squad leader, pull the long end of the rope along the stretcher string to the handle (at the head of the victim) and fasten it with a double loop;

For Rescuer No. 1, pull the short end of the rope, fasten it with a double loop on the handle of the stretcher at the injured leg of the victim, circle the rope stretched along the bowstring of the stretcher opposite the knees of the victim, stretch the end of the rope to the victim’s belt and, holding it with one hand, pass the end of the rope under the stretcher with the other hand;

The squad leader , if necessary, lift the stretcher with the victim from the side of his head;

To the rescuer No. 2 , take the end of the rope from the rescuer No. 1 under the stretcher, pass it under the rope held by the rescuer No. 1 at the waist, pull it, hold it against the chest of the victim with one hand, and pass it under the stretcher to the rescuer No. 1;

Rescuer No. 1 to accept the rope, pass it under the rope held on the chest of the victim, pull it, hand it over to the squad leader and, together with rescuer No. 2, tuck the victim’s hands under the belt harness;

Squad commander , pulling the rope, fasten it with a double loop on the handle of the stretcher, 1-1.5 m from the head of the victim, tie both ends of the rope with a bowline knot (Figure 15), which should be located on the longitudinal axis of the stretcher;

Rescuer No. 3 organize the insurance of the victim with one of the methods (exercise 29.7);

For rescuer No. 1 , fasten the safety rope to the safety belt of the victim or directly to the victim, tying it around the chest with a bowline knot (Figure 15). If necessary, secure the device with the same rope.

The department then proceeds as follows.

32.5.2. When climbing a steep staircase:

Rescuers No. 1 and No. 2 bring the stretcher and place it vertically near the stairs; the squad leader to hold the stretcher;

Rescuers No. 1 and No. 2 put on gloves, climb with a rope to the first landing, throw the rope over the railing and pull it;

Rescuer No. 3 to provide insurance to the victim;

Give the squad leader a signal to rise;

Rescuers No. 1 and No. 2 lift the stretcher with a rope, rescuer No. 3 insures from above, and the squad leader – from below to support and guide the stretcher;

The squad leader and rescuers, when lifting the stretcher to the site, move the stretcher with the injured to the site.

Further evacuation of the victim is carried out in the order described above.

32.5.3. When descending a steep staircase:

Rescuer No. 2 put on gloves, take a stable position and, at the command of the squad leader, gradually lower the stretcher down, using one of the methods of exercise. 29.7.;

Rescuer No. 3 to provide insurance to the victim;

Squad leader and rescuer No. 1 to support and guide the stretcher.

Exercise 32.6. Placing the victim on a stretcher
various injuries

32.6.1. In the absence of consciousness:

All injuries To prevent retraction of the tongue and entry into the respiratory tract of saliva, mucus, blood, gastric contents: in the position on the side; the lower leg is extended, the upper leg is bent and rests with the knee on the bearing beam (string) of the stretcher; the head is thrown back, the face is turned to one side and downwards. To prevent tilting, it is recommended to bend the upper limb closest to the flooring at the elbow joint and push back 1/3 – 1/2 of the forearm. Transportation in the prone position is allowed; at the same time, the head is laid on its side on crossed arms or a roller from a blanket (clothes) and tilts back somewhat.
Carrying out mechanical ventilation during evacuation on a stretcher Lying on your back: ensure maximum extension of the head, lay the victim with his neck on the upper edge of the stretcher or half-string (transverse bar) of the stretcher.

32.6.2. In the presence of consciousness:

Significant blood loss or low blood pressure On the back with the head end of the stretcher lowered; limbs are higher than the body, or tightly bandaged, or tourniquets are applied.
Fracture (suspected fracture) of the spine On the back – on a rigid stretcher or on a shield. To do this, prepare a sufficiently wide board (door) or knock down a shield from the boards (slab). Stand on the sides of the victim in 4-5 people, take his clothes with both hands and slightly pull it up until it stops; one lifeguard to support the head. At the command of everyone, simultaneously gently lift the victim, avoiding the slightest bend of the spine; bring a shield (or rigid stretcher); gently lower the victim onto the shield; put the shield on a regular stretcher and fix the victim.
On the stomach – on a soft stretcher. To do this: for rescuer No. 2, position the open stretcher close to the victim at an angle of 60-80ºС to his body; the squad leader, rescuers No. 1 and No. 3 from the opposite side, bring their hands under the victim and carefully roll him onto the stretcher from the position on the back to the position on the stomach; lower the upper edge of the stretcher together with the victim.
Cervical spine fracture On the back; with a Chance collar or a roll under the neck. In the position on the side.
In case of damage to the occipital region or urge to vomit In the position on the side, the head is thrown back, the face is turned down or lying on the stomach with rollers from the blanket (clothing) under the head and chest; if possible, turn your head to the side.

Fracture of the lower jaw In a sitting position, with the head tilted forward; or on the stomach with rolls of clothing (blanket) placed under the head and chest; or on the side.
Injury to the front of the neck Semi-sitting position, the head is bent forward, the chin touches the chest.
Chest injury and acute respiratory failure In a sitting position or in a semi-sitting position; support the back with blankets or clothes, or hold the squad leader and rescuer No. 3 with hands on both sides.
Unilateral chest injury Lying on the affected side.
Back or buttock injuries On the side, on the healthy side or on the stomach.
Bruising or injury to the abdomen On the back. To relieve muscle tension in the abdominal muscles – bend the lower limbs at the hip and knee joints, put a roller of clothing (blanket) under the knees; tie your knees and ensure their immobility during transportation.
Fractures or bruises of the pelvic bones On the back: legs slightly bent at the knees; knees apart, feet together (“frog position”); under the knees put a tight roller of clothes or a blanket 25-30 cm high. It is preferable to transport on a rigid stretcher or on a shield in the same position.
Fracture of the upper limb After immobilization – on the back with a slight inclination to the healthy side; put a blanket (clothes) under the limb.
Fracture of the lower limb After immobilization – on the back, without pressure on the injured limb; provide a somewhat elevated position by placing clothing or a blanket under it.
Gas poisoning, incl. causing profuse salivation or vomiting Regardless of well-being – lying on a stretcher; on the side or on the stomach with rollers under the forehead and chest.
Skin burns Burn surface up; with extensive burns – under the frame of sheets or blankets.

Thermal lesions Lying on your back or on your side; packages (bubbles) with a cooling mixture on the head, on the sides of the neck, on the heart area, on the inner thighs; with reddening of the face – with a raised head, with pallor – with the head end of the stretcher lowered.
electrical injury Victims who lost consciousness even for a short time, regardless of how they feel, should only be transported while lying on a stretcher.
Long-term (more than two days) stay without light, under or behind the collapse Lying on a stretcher; before transportation, put a cotton ball on each eye and fix it with a light circular bandage or put on canned glasses with black lenses.
Oxygen inhalation during evacuation Lying on your side or on your stomach; do not fasten the mask, but hold it with your hand.

IndicationIn the absence of a pulse and breathing , it is permissible to place the victim on a stretcher in a supine position.

COMPLEX 33.
EMERGENCY START IN BREATHING APPARATUS

For the maximum possible reduction in the time of preparation of rescuers to follow to assist people, the department, after receiving the first operational task, makes an emergency inclusion in breathing apparatus before entering the gas-polluted zone.

Emergency inclusion in the breathing apparatus is only permissible if it has been checked when the rescuer entered duty in accordance with the “Checking the breathing apparatus when entering on duty” complex and checked before receiving the task in accordance with the “Use of breathing apparatus” complex.

When re-introduced into breathing apparatuses, their serviceability is checked in accordance with the requirements of the “Application of breathing apparatuses” complex.

Starting position: the personnel of the department, moving into the gas-polluted zone, with breathing apparatus on and with service equipment, is lined up near the operational vehicle. The head of the liquidation of the accident, who met the rescuers, informed the commander of the department of the situation and issued a task for conducting gas rescue operations. The squad leader issued a task to each rescuer.

Exercise 33.1. Inclusion in breathing apparatus
AVKh-324 (324 M, 324 NT, AVKh-U)

At the command “Emergency turn on the device”:

§ remove the helmet and hold it between your knees;

§ put on a mask; by tensioning the straps of the headband, ensure its tight fit along the entire obturation band;

§ take a breath, if at the same time there is a large resistance to inhalation, which does not decrease within 2-3 seconds and does not allow continuing to inhale, the airway system is considered tight;

§ open the valve (s) of the cylinder (cylinders) to the stop;

§ determine the air pressure on the manometer;

§ turn on excess pressure by pressing the rod (button) of the lung machine;

§ make 2 – 3 deep breaths; the absence of breathing resistance confirms the serviceability of the lung machine, exhalation valve and gas reducer;

§ put on a helmet.

If necessary, check the serviceability of the suit inflation device in accordance with exercise 1.1 of complex 1.

No more than 20 seconds are allotted for the exercise.

Exercise 33.2. Inclusion in breathing apparatus
ASV-2 with helmet-mask and reserve switch

At the command “Emergency turn on the device”:

§ set the handle of the reserve switch to position “P”;

§ remove the helmet and hold it between your knees;

§ put on a helmet-mask;

§ take a breath, if at the same time there is a large resistance to inhalation, which does not decrease within 2-3 seconds and does not allow continuing to inhale, the airway system is considered tight;

§ open the valve to the stop, half a turn back and “drown” its handwheel;

§ determine the air pressure on the manometer;

§ make 2 – 3 deep breaths; the absence of breathing resistance confirms the serviceability of the lung machine, exhalation valve and gas reducer;

§ put on a helmet.

No more than 20 seconds are allotted for the exercise.

Exercise 33.3. Inclusion in breathing apparatus
ASV-2 with panoramic mask and sound signal

At the command “Emergency turn on the device”:

§ remove the helmet and hold it between your knees;

§ put on a mask; by tensioning the straps of the headband, ensure its tight fit along the entire obturation band;

§ take a breath, if at the same time there is a large resistance to inhalation, which does not decrease within 2-3 seconds and does not allow continuing to inhale, the airway system is considered tight;

§ open the valve to the stop, half a turn back and “drown” its handwheel, determine the air pressure on the pressure gauge;

§ make 2 – 3 deep breaths; the absence of breathing resistance confirms the serviceability of the lung machine, exhalation valve and gas reducer;

§ put on a helmet.

No more than 20 seconds are allotted for the exercise.

Exercise 33.4. Inclusion in breathing apparatus
ASV-2 with type III lung governed demand valve and sound signal

At the command “Emergency turn on the device”:

§ remove the helmet and hold it between your knees;

§ turn off excess pressure;

§ put on the mask, tighten the straps of the headband to ensure its snug fit along the entire obturation band;

§ take a breath, if at the same time there is a large resistance to inhalation, which does not decrease within 2-3 seconds and does not allow continuing to inhale, the airway system is considered tight;

§ open the valve to the stop, half a turn back and “drown” its handwheel;

§ determine the air pressure on the manometer;

§ turn on excess pressure;

§ make 2 – 3 deep breaths; the absence of breathing resistance confirms the serviceability of the lung machine, exhalation valve and gas reducer;

§ put on a helmet.

No more than 20 seconds are allotted for the exercise.

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