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You respond to the river for a medical call given as a "man
down". You arrive at the scene; a barge that has been beached
alongside the levy for months. Upon investigation, you find not
one but three men "down" inside the wing tank of the
double hull vessel; the original "victim" and two would
be "rescuers", including your caller. The 18"
diameter opening won't allow entry of your rescuers while wearing
self-contained breathing apparatus.
This is not a fixed facility and there are no shipping papers,
bills-of-lading, MSDS information or witnesses available. Are
you familiar enough with confined space hazards and rescue techniques
to protect yourself and your fellow team members as well as to
rescue the original victims?
Safety Standards
A recent study1 released by the National Institute for Occupational
Safety and Health (NIOSH) indicates that asphyxiation was the
cause of death in 45% of 670 fatalities in confined spaces in
a recent ten year period. 41% were due to poisonings (CO, H2S,
etc.) and 14% were the result of drownings. An atmosphere that
is oxygen deficient, flammable or toxic often displays no outward
signs of a potential impending tragedy. One rule must always
hold true when dealing with confined space rescue; the safety
of the rescuer must come first.
Because of the many documented fatalities and injuries in
confined spaces the Occupational Safety and Health Administration
(OSHA) instituted regulations to protect workers in General Industry
and the Maritime Industry. Municipal emergency responders fall
under the general industry regulation in OSHA states which includes
approximately half of the fifty states in the U.S.
The general industry standard is 29 CFR 1910.146; Permit-Required
Confined Spaces and the new maritime standard is 29 CFR 1915
Subparts A and B; Confined and Enclosed Spaces and Other Dangerous
Atmospheres. Both standards are pretty similar in nature. If
you read either standard you will quickly notice a great lack
of information about rescue operations. This is because OSHA
does not intend for workers to get hurt and require rescue. Both
standards outline safe working practices in confined spaces;
the needed rescue skills are up to you.
Definitions
Some of the important definitions that need to be understood
by emergency rescuers are:
Attendant: means an individual stationed outside one
or more permit spaces who monitors the authorized entrants and
who performs all attendant's duties assigned in the employer's
permit space program.
Authorized entrant: means an employee who is authorized
by the employer to enter a permit space.
Confined space: means a space that: (1) Is large enough
and so configured that an employee can bodily enter and perform
assigned work; and (2) Has limited or restricted means for entry
or exit (for example, tanks, vessels, silos, storage bins, hoppers,
vaults, and pits are spaces that may have limited means of entry.);
and (3) Is not designed for continuous employee occupancy.
Engulfment: means the surrounding and effective capture
of a person by a liquid or finely divided (flowable) solid substance
that can be aspirated to cause death by filling or plugging the
respiratory system or that can exert enough force on the body
to cause death by strangulation, constriction, or crushing.
Entry: means the action by which a person passes through
an opening into a permit-required confined space. Entry includes
ensuing work activities in that space and is considered to have
occurred as soon as any part of the entrant's body breaks the
plane of an opening into the space.
Hazardous atmosphere: means an atmosphere that may
expose employees to the risk of death, incapacitation, impairment
of ability to self-rescue (that is, escape unaided from a permit
space), injury, or acute illness from one or more of the following
causes: (1) Flammable gas, vapor, or mist in excess of 10 percent
of its lower flammable limit (LFL); (2) Airborne combustible
dust at a concentration that meets or exceeds its LFL; (3) Atmospheric
oxygen concentration below 19.5 percent or above 23.5 percent;
(4) Atmospheric concentration of any substance for which a dose
or a permissible exposure limit is published in Subpart G, Occupational
Health and Environmental Control, or in Subpart Z, Toxic and
Hazardous Substances, of this part and which could result in
employee exposure in excess of its dose or permissible exposure
limit; (5) Any other atmospheric condition that is immediately
dangerous to life or health.
Immediately dangerous to life or health (IDLH): means
any condition that poses an immediate or delayed threat to life
or that would cause irreversible adverse health effects or that
would interfere with an individual's ability to escape unaided
from a permit space.
Permit-required confined space (permit space): means
a confined space that has one or more of the following characteristics:
(1) Contains or has a potential to contain a hazardous atmosphere;
(2) Contains a material that has the potential for engulfing
an entrant; (3) Has an internal configuration such that an entrant
could be trapped or asphyxiated by inwardly converging walls
or by a floor which slopes downward and tapers to a smaller cross-
section; or (4) Contains any other recognized serious safety
or health hazard.
OSHA Required Training
OSHA requires workers in and around confined spaces to be
properly trained and equipped before entering the space.
Duties of authorized entrants. The employer shall ensure
that all authorized entrants are trained in: Hazard recognition
including information on the mode, signs or symptoms, and consequences
of the exposure; The use of tools and personal protective equipment;
Communications; and Self-rescue.
Duties of attendants. The employer shall ensure that
each attendant is trained in: Hazard recognition; Is aware of
possible behavioral effects of hazard exposure in authorized
entrants; Continuously maintains an accurate count (personnel
accountability system) of authorized entrants in the permit space;
Remains outside the permit space during entry operations until
relieved by another attendant; Communications; Monitors activities
inside and outside the space to determine if it is safe for entrants
to remain in the space; Performs non-entry rescues as specified
by the employer's rescue procedure; and Performs no duties that
might interfere with the attendant's primary duty to monitor
and protect the authorized entrants.
Rescue and emergency services. The following requirements
apply to employers who have employees enter permit spaces to
perform rescue services.
- (i) The employer shall ensure that each member of the rescue
service is provided with, and is trained to use properly, the
personal protective equipment and rescue equipment necessary
for making rescues from permit spaces.
- (ii) Each member of the rescue service shall be trained to
perform the assigned rescue duties. Each member of the rescue
service shall also receive the training required of authorized
entrants;
- (iii) Each member of the rescue service shall practice making
permit space rescues at least once every 12 months, by means
of simulated rescue operations in which they remove dummies,
manikins, or actual persons from the actual permit spaces or
from representative permit spaces. Representative permit spaces
shall, with respect to opening size, configuration, and accessibility,
simulate the types of permit spaces from which rescue is to be
performed.
- (iv) Each member of the rescue service shall be trained in
basic first-aid and in cardiopulmonary resuscitation (CPR).
When an employer (host employer) arranges to have persons
other than the host employer's employees perform permit space
rescue, the host employer shall:
- (i) The outside rescuer can effectively respond in a timely
manner to a rescue summons.
- (ii) The outside rescuer is equipped, trained and capable
of functioning appropriately to perform permit space rescues
at the host employer's facility;
- (iii) The outside rescuer is aware of the hazards they may
confront when called on to perform rescue at the host employer's
facility.
- (iv) The outside rescuer is provided with access to all permit
spaces from which rescue may be necessary so that the outside
rescuer can develop appropriate rescue plans and practice rescue
operations.
To facilitate non-entry rescue, retrieval systems or methods
shall be used whenever an authorized entrant enters a permit
space, unless the retrieval equipment would increase the overall
risk of entry or would not contribute to the rescue of the entrant.
Retrieval systems shall meet the following requirements.
- (i) Each authorized entrant shall use a chest or full body
harness, with a retrieval line attached at the center of the
entrant's back near shoulder level, above the entrants head or
other point which the employer can establish will ensure that
the entrant will present the smallest possible profile during
removal. Wristlets may be used in lieu of the chest or full body
harness if the employer can demonstrate that the use or full
body harness is infeasible or creates a greater hazard and that
the use of wristlets is the safest and most effective alternative.
- (ii) The other end of the retrieval line shall be attached
to a mechanical device or fixed point outside the permit space
in such a manner that rescue can begin as soon as the rescuer
becomes aware that rescue is necessary. A mechanical device shall
be available to retrieve personnel from vertical type permit
spaces more than 5 feet deep.
Realistic Rescue Training
Your emergency responders need to be properly trained and
equipped for the hazards of confined space rescue. Some of the
many subjects that you need to train in are: Medical training;
Hazardous materials; Rescue pre-planning; Lockout/tagout; Respirators;
Ventilation; Atmospheric monitoring; Specialized equipment; Rescue
hardware/software; Patient packaging; and Rescuer/victim lowering,
raising and belaying techniques.
Conclusion
The scenario proposed in the opening paragraph of this article
was taken from an actual rescue incident in south Louisiana.
In that incident, 2 of the 3 original victims died from asphyxiation
and 3 rescuers were injured after removing their self-contained
breathing apparatus inside the barge when they ran out of air
while performing the rescues.
Be sure that your rescuers can protect themselves and their
fellow team members while performing the tasks involved in confined
space rescue.
1 "Worker Deaths in Confined Spaces.
A Summary of Surveillance Findings and Investigative Case Reports."
CDC/NIOSH One copy of this free book can be obtained from Publications
Dissemination, DSDTT, National Institute for Occupational Safety
& Health, 4676 Columbia Parkway, Cincinnati, OH 45226-1998.
Michael Dunn is the President of Emergency
Response Training, Inc., a Baton Rouge, LA., based fire/rescue
training and consulting firm. He has been a member of the IADRS
since 1980 and is a DR-I and PSSI trainer. |
