First Aid

Search and Rescue

In disasters involving collapsed buildings or crashed vehicles, it may be necessary to localize and begin to extricate live victims before first aid can be practiced. Search and rescue (SAR) applications can be divided between mass-casualty sites, and the hunt for dispersed individuals in ocean or open terrestrial landscape environments. The first kind is often carried out in urban environments, using urban search and rescue (USAR), also known as urban heavy rescue. In the immediate aftermath of earthquakes, people are trapped under fallen buildings, or floods have marooned them in homes surrounded by water.

In modern disasters, a typical urban heavy rescue unit may consist of two groups of up to 28 people. These will include dog handlers, rescue personnel, engineers, heavy plant operators, communications experts, logistics specialists, documentation officers, and hazardous-materials operatives. In each group there will be a doctor and two other medical workers, who will usually be nurses or paramedics. They will be trained in rescue techniques so that they can, if necessary, accompany the other first responders into the rubble or among the wreckage and be at the scene when an injured victim is located.

In the worst cases, in-situ amputation of limbs trapped under concrete beams or in heavy wreckage [Page 213]may be necessary, but this is fortunately very rare. In most instances, clearance of the airways and checks on the patient's vital signs are the first acts of medical rescuers, and possibly the application of measures to stop external bleeding or to attach a splint to a broken limb. The patient will be strapped to a spinal board, or a stretcher in the form of a sledge, possibly with the addition of a cervical collar to prevent torsion of an injured spine or neck. The patient will be handled out of the site in the gentlest manner possible. On occasion, this has to be done using a winch attached to a helicopter. When a patient is trapped among wreckage, a Kendrick extrication device can be used, which is a form of sling that immobilizes the neck and spine and protects the patient against further damage during movement.

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