A solo rescuer assists at the top. Note that he is using a ladder lock with his right leg. Photo Andy Speier
Consider this scenario: You’re dispatched to an explosion. Upon arrival, you find a two-story commercial building that’s been reduced to a pile of rubble. There’s three feet of snow on the ground and debris from the building is everywhere. Injured people are in the debris. It’s also a daytime response for a mainly volunteer fire department, so staffing will be limited. Are you able to quickly move the injured to safety? Can you move your own rescue equipment over the uneven terrain with your limited number of personnel?
Ladder rescue systems are one of the many tried-and-true tools we can implement in such a scenario as a means to transport patients; they also return us to the basics. When I took my Rescue Systems I class, I was led to believe that the techniques discussed were discovered in California, because of the many earthquake responses, and because the class was a component of ladder rescue systems in the Rescue Systems I program. Upon further investigation, I discovered that many of the techniques were actually deployed in London after evening bombings during WWII. In fact, many of the techniques that we continue to use today were discovered by necessity when the London Fire Brigades and civilian rescuers attempted to locate and rescue people trapped in debris.
What I like about the ladder rescue systems that we use today is that they use fire service ladders, rope and carabiners, and little else. Pulleys and Prusiks can make the work a bit smoother, but it can also be done with just the basic equipment on a rig and a bit of ingenuity. In this article, I’ll discuss the Moving Ladder and the Ladder Slide (aka Sliding Ladder) rescue techniques, which can be employed when working with victims trapped and injured in debris.
The Moving Ladder
The Moving Ladder transforms a Stokes basket into a 12–14-foot-long tool for the movement of an injured person or equipment. A standard Stokes basket measures approximately 7 feet in length. When working in uneven terrain (a rubble pile), we try not to move across the terrain while carrying a litter but rather pass the litter through a line of other, waiting rescuers. This technique requires several personnel, but often, there aren’t enough rescuers on scene to adequately do the job if there are other rescues being performed. But by attaching the Stokes litter to the lower third portion of a roof ladder, we’re able to pass a patient in a litter over the same terrain with much fewer personnel, because the addition of the ladder increases the overall length of the litter to 12–14 feet, which allows personnel to spread out.
In addition to enabling the movement of an injured victim over uneven terrain, a moving ladder can be used to move a patient from a basement or second floor without using the stairs. This is a good technique to deploy when rescuing injured workers at construction sites where the stairs are not yet accessible. It can also be used to move an injured firefighter from a basement or cellar where the stairs have been damaged. With the litter lashed to the lower third of the ladder, rescuers positioned above can grab the ladder rungs and haul the ladder up. Likewise, from an upper floor they can pass the bottom of the ladder to rescuers below.
To attach the litter to the ladder, all you need are two 12' lengths of 1" tubular webbing (8-mm accessory cord could be used as well). Placing a piece of 4 x 4 cribbing under the ladder at each end will make it easier to lash the litter to the ladder because it will leave a space for the rigger’s hands to pass under the rungs. Lash the first side down tight enough so that the other end of the litter starts to lift off the ladder. But don’t lash it too tight or you won’t be able to get the other end back onto the ladder.
There are many effective ways to start and finish the lashing. Similar to the rigging you use for patient packaging, a round-turn and two half hitches will work fine; it’s simple and you can instruct another rescuer as you finish securing your side. Once the webbing is secured to the ladder rung or litter, continue to wrap the top rail of the litter and the ladder rung. When you reach the end, secure the end of the webbing in a similar manner. Remember: Ensure that the litter is secured to the ladder and will not move around. The patient can be secured to the litter using an internal and external lashing system.
The Ladder Slide
A Ladder Slide uses a roof or extension ladder to support the litter as it’s raised or lowered. The ladder is positioned at less than a 70-degree angle to place more of the weight on the ladder and to simplify the transition into a window. If the landing area is at ground level (for instance, when raising a litter up from a hole in a floor or cellar access), then the angle of the ladder is not as critical.
For raising the litter, a 2:1 haul system (known as a Ladder Rig) is used. A progress-capture Prusik (PCD) is placed at the anchor on top, and a change-of-direction pulley (COD) is used so that more than one set of hands can easily pull on the rope. A rescuer follows the litter up the ladder to prevent it from getting hung up on the fly ladder or pulley assembly on an extension ladder. The same rescuer is also critical at the start of a lower or the end of a raise. On a lower, the litter can be controlled by a Munter hitch, Rescue 8 plate or multiple wraps around a carabiner. The shallower the angle of the ladder, the less weight there will be will on the rope system.
The use of the ladder eliminates the need for a belay line, since most of the litter’s weight is on the ladder, and the rope system serves as a means of moving the litter up and down the ladder. The ladder also facilitates the difficult transition from horizontal to vertical without the use of an overhead anchor.
On the question of the ladder fly being in or out, my answer is: It depends on whether the loaded litter will be raised or lowered; the location of the transition that the litter will make as it drops or raises over the fly/bed transition; the location of the ladder pulley in relation to the window sill; and the rescuers working at the top. In the end, either way—in or out—will work because either way, there are items that can potentially get hung up.
Tip: When the pulley and anchor webbing arrive at the tip of the ladder, a rescuer needs to be there to “pop” them over the top rung. Therefore, rigging the webbing anchor short rather than long on the litter will allow the litter to be raised to its highest point prior to the pulley getting hung up at the top. So if the tip of the ladder is no higher than the sill, the maneuver will be much easier.
So What Happened?
Back to my opening scenario: On March 6, 1990, Crested Butte, Colo., a town with a population of 1,000, received mutual aid from more than 30 miles away after a large gas explosion collapsed the Crested Butte State Bank, killing three bank employees and injuring 14 others who were pulled from the rubble. Twenty bystanders became rescuers. Cold weather, snow and lack of personnel were just some of the problems that rescuers encountered that day.
The bottom line: With knowledge of basic ladder rescue systems, firefighters can more quickly and safely move injured people over varying and sometimes dangerous terrain.