ROPE SYSTEMS

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ROPE SYSTEMS
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PATIENT PACKAGING Objectives To identify,
describe and define the advantages and
disadvantages of each type of litter. To
demonstrate securing patient to a littler
properly. Equipment needed
Litter basket Tarp Patient harness Patient
PPE Litter shield Head protection
Eye protection Padding/pads Blanket for
warmth Medical supplies as needed Backboard
Cervical collar, etc.
2- yellow webbing (internal lashing) 1- black
webbing (external lashing, if needed)
Medical and environmental considerations and the
type of litters available dictate patient
packaging. Careful packaging protects the
patient while allowing access to monitor vitals.
The patient should not move or shift in the
litter during transport. SAFETY Patient(s) must
be internally lashed to protect them from
ejection out of the ends of the litter. They
must also be externally lashed to prevent them
from movement within the litter. All carabiners
should have gates opening down and toward the
inside of the litter basket. Ensure carabiners
are properly loaded and will not torque or side
load. Never tie patient lashing around top rail
of the litter Always weave webbing between
uprights of the stokes or to internal areas of
plastic stretchers. STEPS TO PATIENT
PACKAGING Stabilize the patient before
loading --Head/eye/face protection --Sit
harness (for steep high angle, maybe considered
during medium) --C-collar, backboard, bandaging,
splinting Prepare the litter to receive the
patient Load the patient Lash the patient into
the litter securely --Internal lashing (utilize
only the amount needed for the type of
rescue) --External lashing
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INTERNAL LASHING
NOTE webbing is tied off to an upright stay,
not the railing.
2. Secure torso webbing with round turn and 2
half-hitches on either side.
1. Connect yellow webbing to harness with an
interlocked girth hitch.
3. Secure legs in same manner as torso. Ensure
leg webbing is pulled taut against torso webbing.
This may or may not be needed in low load angle
environment.
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EXTERNAL LASHING
NOTE External lashing is required when
performing high angle rescue.
3. Finish with a round turn and 2 half-hitches on
one end, then pull slack back through entire
black webbing. Finish other end in same manner.
2. Weave webbing around upright stays, not over
the railing.
1. Start with middle of black webbing here.
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LOW ANGLE RESCUE
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LOW ANGLE RESCUE During this session well
discuss the various degrees or classifications of
Low Angle Rescue, and Patient extrication. OBJECT
IVES Identify, describe define when and how to
perform a Low Angle vs. a Steep Angle
rescue. The goal of the low angle evacuation is
to keep the patient moving and get them out as
safely and comfortably as possible. In order to
achieve this goal follow these steps Locate and
stabilize the patient -- The first responder may
have to rappel down to the patient to recon the
area and initiate first aid/triage -- Load the
patient into the litter Talk to the patient,
whether they are conscious or not -- Make the as
comfortable as possible -- The patient is afraid
and uncomfortable, being lashed to a litter
completely helpless, exposed to the weather,
relying on other hands not to cause them any
further discomfort or harm -- Establish a
rapport Plan and flag the best
extrication/evacuation route while the patient is
being packaged -- Best route on medical terrain
considerations, and resources available Start
the carry-out and keep the patient
moving -- Arrange litter handlers by
height -- Keep the patients head level or higher
than the feet unless medical considerations requi
re something different Only one attendant calls
signals. Rotate attendants, if appropriate, to
avoid rest stops and prevent rescuer
fatigue. Have handlers use webbing loops as
across-the-shoulders straps to distribute the
weight of the patient and facilitate ease of the
carryout. Tag obstacles along the route for
quick belays before you need them, keeping ahead
of the patient. If not actually handling the
litter, rescuers should be out in front where
they are needed most.
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PATIENT EXTRICATION / EVACUATION
Keep your systems as simple as
possible! In reality, most backcountry
evacuations are low angle, not high angle
rescues. This involves moving the patient in a
litter over low angle rugged terrain. The number
of ropes, the rigging used depends on the slope
and terrain characteristics. When evaluating the
conditions, and you come to the point when you
need to make the decision weather to use a
mainline and a belay, or just a main line, or
just a belay, ask yourself this question, What
are the consequences if you have a failure in a
single rope system? Lets call this The
consequence based decision process In General
Low Angle Rescue Considerations Use of belay
line only -- If the slope is of a low enough
angle where it allows rescuers to carry the load
up the hillside. -- Hillside has stable footing
and attendants can safely carry the litter and
patient up the hill without the use of a
mechanical advantage system. -- Consequences of
failure of the single rope system are not
exposing rescuers and patient to potential death
or injury. Use of a 21 mechanical advantage
system, by itself, is allowed in low angle rescue
situations when -- You only need a slight bit
of mechanical advantage to assist the litter and
patient up the hillside past minor obstacles.
(Attendants should not be hooked to the litter,
if you lose your footing while handling the
litter, let go of the litter). -- Once again, if
the single rope system fails, rescuers and
patient will not be exposed to death or injury.
If litter is dropped to the ground and haul line
is unattended the litter will not slide or fall
down the hillside. Use of both a main line and a
belay line -- When consequences of a failure of
a single rope system place rescuers and patient
at risk. -- If the decision is made to in any
way shape or form attach attendants to the liter
or system, a mainline and a belay line should be
used. Other important considerations for low
angle rescue -- If you need more than a 21
mechanical advantage system to overcome weight
or slope angle, revise your system to a steep
angle rescue system using a main line and a
belay line with three litter attendants. -- Also
consider upgrading to a steep angle system using
a mainline and a belay if slope angle, poor
footing or potential for death or injury dictate.
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CARRY OUT The carry out should be performed when
lashing is complete and webbing loops are
established for each rescuer/handler. And most
important, everyone should know what the Action
Plan is. EQUIPMENT NEEDED FOR THE CARRY
OUT ½ static rope for belay line 2 locking
steel carabiners Litter with patient lashing Red
or yellow webbing for every tender to construct
webbing loop RESOURCES NEEDED The angle and
terrain stability will determine number of
attendants. Low angle, low hazard terrain with
stable footing -- 6 personnel, not tied to
litter or main line. -- Rope 0-1 -- Rigging
tandem Prusik belay Low angle, moderate to high
risk terrain, poor footing -- 3-6 personnel -
if the angle and quality of the slope or terrain
dictates use of a main line to haul up the load,
only 3 rescuers will be used. For information on
steep angle rescue, reference the next section
in this manual. -- Ropes 1 or 2 -- Rigging
tandem Prusik belay, main line lower (if needed)
and main line raise (if needed). SAFETY The
overall safety tip we can offer is that you
always consider the environment you are working
in, such as, terrain, angle and weather
conditions. Also consider the resources you have
available, call for help when in doubt. In
making a good scene size up, most of these
concerns will be answered. The first step to
safety is to ensure that everyone is on the same
page. Is this a Rescue? Body Recovery? Whos in
charge? And what is the over all Plan of
Action? What are the hazards we face? These
are some of the questions that should be answered
in your briefing.
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Belay line attachment is with Long Tail Bowline
with tail going to patient
Webbing bridle needs to go around rail for
strength...DO NOT rely on plastic alone
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Note the single yellow webbing attachment on the
harness. Considering this is a low angle
setting, the only risk to the patient is whether
or not they will slide out the foot end of the
litter.
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In low angle rescue, the burden of carrying the
patient falls upon the rescuers. The single line
shown is a belay line to prevent the load from
sliding down the slope.
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STEEP ANGLE RESCUE
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SAFETY CONSIDERATIONS 2 rope system - main line
and belay (rope dependent). 3 attendants shall
be used. 2 attendants are tied into the main
line and belay via Purcell Prusik and a secondary
Prusik. The strongest of the 3 attendants shall
be located at the foot of the litter and tied
into the system with a Prusik wrapped around the
foot of the litter and hard tied using the long
tail of the belay line. The patient should be
lashed to the litter and also tied into the main
line. The 2 side attendants weight must hang
from the Purcell Prusik, not from the main/belay
line. One person calls the commands.
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Third attendant primary and secondary attachment
points
One of front attendants primary and secondary
attachment points
End of other long tail to patient
Other front attendant primary and
secondary attachment points
Interlocking long tail bowlines to connect
the main line and belay line to the litter bridle
Clove hitch around litter rail constructed from
portion of bowlines long tail
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Interlocking long tail bowlines to connect the
main line and belay line to the litter bridle
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