Man in machine goes way beyond the V.M.R. course content. The main focus of the class is specialized machinery and equipment. This also covers everyday commercial kitchen equipment and small shops with machinery and presses, so even a small town will have the potential for this type of rescue call.
The other aspect of this class is on impalements. Impalements can come in many forms — such as wood sign poles, trees from car accidents into the woods, steel sign posts, fence posts, rebar from construction sites — the list for both is almost truly endless.
Many times these types of calls can only have a good outcome, if the first responder is well trained and keeps up with their training and new theories and concepts. These types of calls are truly gory and very traumatic to all parties involved to say the least.
Other special skills for these types of calls require a specially trained paramedic, usually termed as a “crush medic.” To say the least, crush injury/crush syndrome is an extremely life threatening issue, and in some cases even the very best “crush medic” crew and rescue company can, and do with regret, have a morbid outcome.
Types of Calls
We will discuss a few different classification types of calls. The types of tools will be discussed later, this way you will have a better understanding of some specialized tools needed for the task at hand. The types of calls are broken down into, simple, manmade and complex.
These are incidents that usually do not require technical tools. The victim (often children) are not hurt or in pain, they just became part of an object (no blood or broken bones). It is best to have EMS respond and make the final call, but if needed it may only be a BLS call. Simple incidents rarely transport their patient to the ER.
Man Made Incidents
These types of incidents are not like the accidental Man in Machine calls. These types of calls are generally geared towards protests. These are intentionally manmade to prolong a protest or to hold up projects of many types. The items used to construct these obstructions range from crude construction to extremely complex construction. These calls are generally a law enforcement incident, but in most cases the police call in the area fire department rescue company or specialized teams to assist in the removal of the individual(s), as these can become a very complex rescue that also will have a large media spotlight due to the type of protest and the unique and extreme liability that comes with these types of calls.
In this x-ray photo, the construction worker fell and was impaled by rebar. The rebar was stabilized “in” the patient, and then the patient was transported to the hospital to have it removed.
The large liability comes into play as the process of extrication begins. We must not do any additional harm when removing the individual(s) during the operation by the fire department. If we do, even by accident, you can rest assured that a legal lawsuit for malice and malpractice towards the members of the fire department will be brought forth. With that said, along with a true accidental Man in the Machine incident, if we do more harm than good, it makes the fire service as a whole look very unprofessional. All firefighters, rescue personnel and fire departments should possess some sort of game plan to mitigate a Man in a Machine incident in the safest and most professional manner as possible. These types of calls will most likely require specialized training and equipment. Are you and your department up to this task?
The Sleeping Dragon is a maneuver used by protesters to cause disruption. It involves handcuffs and PVC pipe as a series of protesters are handcuffed together through the PVC pipe, which precludes police from simply using bolt cutters to break the handcuffs. Advanced variations include covering the PVC pipe with elements which will make it more difficult to break. Examples include chicken wire, tar and duct tape. Another variation is filling the PVC pipe with concrete. Often the protesters will chain, lock, or otherwise secure themselves to immovable objects, resulting in a difficult-to-remove human obstacle. This tactic will prolong the time of the demonstration or protest.
These are incidents that will require specialized tools and take time to remove victims from different types of machinery that range from any type of tool or machine that can “grab or pull in “the operator.” This type of call usually requires taking apart the machinery — disentanglement. The victim is often in pain, going into shock or deceased. They most likely have broken bones and this is usually a bloody and gory scene. Complex incidents require a systematic approach, team work and a true understanding of the pros and cons to every basic tool along with specialized tools. This is where the true saying of “the right tool for the right job” may have come from.
The EMS response for this type of call needs a very well versed team of paramedics, and even the “crush medic,” and in some areas even the local doctor from the area hospital may respond to the scene. The victim is often transported with part of the machinery or with limbs in the machinery or tool; they may even be impaled by some type of object.
The Wizzer saw, used for fine, controlled cuts, is powered by air.
This type of class is much too hard to explain with an article. The classification of calls can be broken down into three basic categories: Manipulative Extrications, disassembling the machine, and forcing the machine. The tool list for each is almost endless.
Air regulators, hoses and air cylinder to get the job started.
The basic tools start with all types of hand tools, open end wrenches and boxed end wrenches both in standard and metric. Pliers of all shapes and sizes, including vise grips, open and closed split ring pliers. Some of the technical tools for these calls will be the Wizzer Saw; this saw is the back bone to these types of calls. The Wizzer is used for fine and controlled cuts and is powered by air. For precision cuts, a Dremel tool is used. For large cuts torches are used and in some cases an electric die grinder is also used. The tool of choice is? Well, again this is the million dollar question; again picking “the right tool for right job” will come by taking a course with a well versed tool lab included in the class, along with continual training.
The “palm sized” airbag is used for confined operations.
Other tools used that have a great benefit at these calls include the portable band saw. The control and safety of this tool is unparalleled for these rescues. The downfall to this tool is that you need a lot of room to use it.
An electric portable band saw gives control and safety but needs a lot of room to be used.
Gear pullers are another type of tool used to remove the machine from the victim, as is the case with these calls. Palm sized air bags are used to help move or release pressure on the victim. Sterile water should be used when open or crushing wounds are present, basic vegetable oils will help to slide out the entrapped limb. The sterile water and oil is used with hopes of not breaking the machine. A Porta Power Unit with many attachments for special use as these tools can have up to 10 tons of pushing or pulling power depending how they are rigged. A Hydra Ram Tool may even be used if the operator is skilled in the pros and cons of its operation.
Rescue Operations: Size Up Questions
- Is this a rescue or recovery operation?
- What type of machine are we dealing with?
- How and what part of the victim is stuck in the machine? (Degree of Entrapment)
- What powers the machine? (Lock Out/Tag Out)
- Is there adequate victim access?
- Have someone who is experienced on how the machine operates.
- Medical treatment — ALS or BLS.
- What tools will be needed (Special Call Additional Rescue)?
- Bagel Making Machine — Trapped with forearm caught
- Meat Grinder — forearm caught
- Man Caught In Printing Machine
- 15 year old youth crushed while cleaning a Dough Mixing Machine
- Escalator Traps Child’s Hand
- Teenager Gets Caught On Top of Elevator Car
This list is endless.
Remember: How everyone performs as a team will affect the outcome for the victim.
Ed Henry has been with Charleston FD since 2004. He is an instructor for both the South Carolina Fire Academy and Connecticut Fire Academy. He is a H.O.T. instructor at F.D.I.C. and Firehouse Expo teaching engine and truck operations. He also instructs at the Charleston F.D. Recruit School and has taught H.O.T. class at the S.C. Firefighters Conference in Myrtle Beach on Forcible Entry. Henry has a B.S. in fire service administration and is certified as a Fire Officer IV. He has been awarded the nation’s high honor, The Presidential Medal of Valor by President G.W. Bush, along with several other state accommodations.