In the second phase, remove those casualties whoare trapped in more difficult circumstances but whocan be rescued by use of the equipment at hand and in aminimum amount of time.In the third phase, remove casualties whereextrication is extremely difficult and time consuming.This type of rescue may involve cutting through decks,breaching bulkheads, removing large amounts ofdebris, or cutting through an expanse of metal. Anexample would be rescuing a worker from beneath alarge, heavy piece of machinery.The last phase is the removal of dead bodies.Stages of ExtricationThe first stage of extrication within each of therescue phases outlined above is gaining access to thevictim. Much will depend on the location of theaccident, damage within the accident site, and theposition of the victim. The means of gaining accessmust also take into account the possibility of causingfurther injury to the victim since force may be needed.Further injury must be minimized.The second stage involves giving lifesavingemergency care. If necessary, establish and maintainan open airway, start artificial respiration, and controlhemorrhage.The third stage is disentanglement. The carefulremoval of debris and other impediments from the victimwill prevent further injury to both the victim and therescuer.The fourth stage is preparing the victim forremoval, with special emphasis on the protection ofpossible fractures.The final stage, removing the victim from thetrapped area and transporting to an ambulance orsickbay, may be as simple as helping the victim walkout of the area or as difficult as a blanket dragged out ofa burning space.Special Rescue SituationsLEARNING OBJECTIVE: Recognize theprocedural and precautionary steps that mustbe taken in various rescue situations.The procedures you follow in an emergencysituation will be determined by the nature of thedisaster or emergency you encounter. Some of themore common rescue situations and the appropriateprocedures for each are outlined below.RESCUE FROM FIRE.—If you must go to theaid of a person whose clothing is on fire, try to smotherthe flames by wrapping the victim in a coat, blanket, orrug. Leave the head UNCOVERED. If you have nomaterial with which to smother the fire, roll the victimover—SLOWLY—and beat out the flames with yourhands. Beat out the flames around the head andshoulders, then work downward toward the feet. If thevictim tries to run, throw him down. Remember thatthe victim MUST lie down while you are trying toextinguish the fire. Running will cause the clothing toburn rapidly. Sitting or standing may cause the victimto be killed instantly by inhaling flames or hot air.CAUTION: Inhaling flames or hot air can killYOU, too. Do not get your face directly over theflames. Turn your face away from the flame whenyou inhale.If your own clothing catches fire, roll yourself upin a blanket, coat, or rug.KEEP YOUR HEADUNCOVERED. If material to smother the fire is notavailable, lie down, roll over slowly, and beat at theflames with your hands.If you are trying to escape from an upper floor of aburning building, be very cautious about openingdoors into hallways or stairways. Always feel a doorbefore you open it. If the door feels hot, do not open itif there is any other possible way out. Remember, also,that opening doors or windows will create a draft andmake the fire worse. So do not open any door orwindow until you are actually ready to get out.If you are faced with the problem of removing aninjured person from an upper story of a burningbuilding, you may be able to improvise a lifeline bytying sheets, blankets, curtains, or other materialstogether. Use square knots to connect the materials toeach other. Secure one end of the line around someheavy object inside the building, and fasten the otherend around the casualty under the arms. You can lowerthe victim to safety and then let yourself down the line.Do not jump from an upper floor of a burning buildingexcept as a last resort.It is often said that the “best” air in a burning roomor compartment is near the floor, but this is true only toa limited extent. There is less smoke and flame downlow, near the floor, and the air may be cooler. But it isalso true that carbon monoxide and other deadly gasesare just as likely to be present near the floor as near the3-15
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