Casualty extrication from a fire risk area

[Lorick Fox, PA-C]

Never heard of any such, and my tendency would be to say that you 
will need both hands to move the patient, and your safety plus the 
patient's safety require you move the patient to where you can work.

If you find a cardiac arrest in a bathtub, you presumably immediately 
move them to a place you can work (airway, IV, etc) and where you can 
shock without water hazard.
I would think this situation is analogous to removing a patient from 
a smoke filled, hot environment with acutely toxic gases present.

I doubt there would be any data to even suggest that the delay of 1-2 
minutes will change outcomes when the alternative to increase risk to 
yourself and the patient and attempting to treat the patient in a 
toxic environment.
Also consider the risk to other fire fighters of you needing 
protection in the middle of a fully involved room trying to 
resuscitate.  You can't "tie-up" a crew on a line(hose) to shelter 
you while you use a demand valve or such.
In my brief tenure as a volunteer fire-fighter (before I figured out 
that running a building that everyone else was running out of was BAD 
idea, and moved to strictly the EMS side of the house), in most cases 
you could have a victim out to safety in < 1 minute and they had 
already been "down" for 5-15 minutes depending on how the call 
originated and distance to fire station.

I guess you COULD strap a demand valve, attached to a small capacity 
oxygen cylinder on the face of a spontaneously breathing patient, but 
those masks are rarely airtight and 100% oxygen+fire is usually a 
really bad combination.

Lorick

At 07:05 PM 8/4/2007, tuganddawn at talktalk.net wrote:
>Dear all,
>
>     I am a firefighter and paramedic working in Oxford UK.  I am 
> currently researching the extrication of casualties from smoke 
> logged and fire risk buildings by Breathing Apparatus (BA) 
> crews.  I am currently undertaking my BA training and am acutely 
> aware of the dificulties encountered when working in this type of 
> environment but, as a dual professional, feel that there must be a 
> better way of dealing with casualties. Current practice is still 
> quite archaic and simply follows the "just get them out" mantra.
>   Does anyone on the list know of any programs or ideas that allow 
> a BA crew to secure a basic airway, administer clean air and 
> manually handle the casualty in an ergonomic and practical way 
> without sacrificing the safety and efficacy of the crew?
>    In any event, thanks for your time and trouble ladies and 
> gentlemen and I look forward to hearing your ideas.
>
>  yours with Kindest Regards
>
>   Tristan "Tug" Crumpton
>-


LFFox, MPAS, PA-C
Fellow, AAPA
CCA, American College of Cardiology
Associate, Society for Critical Care Medicine
Associate, Underwater and Hyperbaric Medical Society

Lorick Fox, MPAS, PA-C
SEAVIN/Peace Vector IV
Unit 64903, Box 1201
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