Old School Trench Rescue

Back in the late 1970s, the wonderful world of trench rescue training with its shoring work and special equipment was in its infancy.  In my area, it hadn’t even yet been conceived.  Hell, Johnny and Roy were the cutting edge of fire rescue as far as we were concerned.   

We were dispatched for a man injured in an excavation behind the local junior high school.  When we arrived in the old Chevy Suburban ambulance, we found a male laying at the bottom of about a six foot deep trench.  Part of the wall had come in on him and he complained of hip/pelvis pain. 

Not knowing any better, we jumped right in with him and started to clear some of the dirt away by hand and with some shovels that the other workers had.  We were smart enough to request fire department assistance, and the arriving engine company, no smarter than us, helped with an attic ladder for access and more hand tools.  It was like being an archeologist, as the land where they were digging was an old landfill, and we were working on a couple of layers of antique trash. 

Once we had the dirt off him, the real fun started.  We had to get him immobilized to lift from the trench.  We had nothing to work with but the basics we carried on the ambulance; no stokes basket, and certainly no modern strap system.  We had a full backboard and cravats.  For the uninitiated, i.e. younger than 45 years of age, cravats are folded triangular bandages.  Part of the EMT curriculum at the time was to be able to completely immobilize a victim to a long board so that when the board was stood up vertically, the victim did not move using nothing more than these big handkerchiefs.  It was something we practiced for hours at a time.  Now we had to do it for real. 

As you can imagine, it’s not a speedy method, but we got to work, square knot after square knot.  Finally done, it was the moment of truth.  We stood the backboard up with the ladder behind it to slide him up.  He didn’t move a bit.  With the assistance of the engine company, up the ladder he went and onto terra firma for transport. 

Luckily nothing bad had happened—to any of us.  The walls of this trench, made up of landfill material, were far from stable, but we were protected in our ignorance.   The old days were not always better…

A Great Concept Doesn't Equal Success

Some equipment looks great in the catalog, has an awesome concept behind it, and works like shit in the real world.  A piece of equipment I worked with that met this definition was the build-a-board.  A take off on the scoop stretcher, it was a four piece replacement for the short board.  In theory, each of the four pieces would slip under or behind the victim, snap together and lock in place, and provide a quick and safe method for immobilizing possible back and neck injury patients in auto accidents.  

After we received ours, we practiced and trained and trained and practiced with it.  The literature made it sound like it should be as easy as, well, any analogy you could think of.   It wasn’t.  Oh, we got rather proficient with it in our personal vehicles in the parking lot and chairs in the squad room, but it was never as simple as the brochure made it look.   

Finally a few days after putting it in service, we responded on a wreck with a victim in the passenger seat needing immobilization.   With the old fashioned short board and long board combo, we’d have gotten her out in less than ten minutes.  With our marvelous new build-a-board, we finally got everything lined up,  connected, and snapped together after forty minutes; not an auspicious beginning.   

I had seen all I needed, and after that forgot about it’s presence in the drivers side compartment.  The short board wasn’t broken; no need to fix it.  It was a great lesson.  A terrific concept did not necessarily guarantee real world success. 

The Demise of "Hearse" Ambulances and Other Good Things

Anyone who ever watched Emergency when originally on network television or later in syndication understands how far EMS, among other things, has come in the fire service.  With few exceptions, medical responses have long ago taken the lead over fire calls.  Some contend the name fire department is no longer accurate.  While I understand these arguments, I’m not prepared to go that far—yet. However, if you’re a firefighter today, particularly a young one, you better learn to “like” EMS, or consider another profession, because it isn’t going away. 

The development of ALS while the most prominent and recognized improvement is far from the only change.  Ambulance services run by funeral directors with a red light tossed onto the roof of a hearse have, thankfully, gone the way of the horses.    Overall availability has improved as well. 

How much?  A lot.  When I was six or seven years old, some buddies and I were playing in the woods, jumping in piles of leaves and generally doing the things young boys did back then when no one had to be worried about us being kidnapped if we went ten minutes from the house.  One boy jumped into a pile over a bank and hit something hidden beneath the leaves, breaking his femur.  His screams of pain frightened the living hell out of the rest of us.  There was no thought of moving him, not because we knew not to, but because of fear.  Practically as one, we all started running for our respective homes for one thing; to get our mothers—it was the 60s, they were home. 

The group of mothers followed us back, and mine, being a nurse, promptly recognized the fracture for what it was.  An ambulance was called, but it wasn’t quite as simple as today.  The first due fire department where Dad was a member had no ambulance or any medical capabilities at all.  No help there.  The neighboring department had an ambulance, but they only responded outside of their first due area on nights and weekends.  Monday through Friday, eight to four, they didn’t leave the district.  In the next village over, the police department ran the ambulance.  They didn’t leave their town at all, regardless of time or day.  The only unit available was operated by the county Sheriff’s department.  The road patrol deputy had to respond to get the ambulance from wherever he happened to be, and then across half the county to where we were waiting.    This wasn’t a rural area either; the suburban town had a population in the tens of thousands. 

Almost an hour later, it arrived to transport the boy.  Luckily the break hadn’t hit the artery or he’d have been dead long before the unit arrived.  After an extended convalescence; most of a school year, he recovered. 

Good?  No, but normal back then, so yes, things other than just ALS have changed a lot.  As much as almost no one wants to be on the ambulance every shift,  I think everyone would agree things are better now.