1. Rescue referstooperationsthatusuallyinvolvethe savingof life,orpreventionof injury.
Toolsusedmightinclude searchdogs,searchandrescue horses,helicopters,andthe "Jawsof Life"andother
hydrauliccuttingandspreadingtoolsusedto extricate individualsfromwreckedvehicles.Rescue operationsare
sometimessupportedbyspecial vehiclessuchasfire department'sorEMS Heavy rescue vehicle.
Ropesand special devicescanreachand remove individualsandanimalsfromdifficultlocationsincluding:
• confinedspace rescue
Confinedspace rescue isasubsetof technical rescue operationsthatinvolvesthe rescue andrecoveryof victims
trappedina confinedspace orina place onlyaccessible throughconfinedspaces,suchasundergroundvaults,
storage silos,storage tanks,orsewers.
Confinedspace rescuescanbe technicallychallengingdue tothe environmentinwhichtheyoccur.Confinedspaces
are oftennarrowand constrictingpreventingeasyaccessbyrescuers.Theyare usuallyeither unlitorpoorlylitso
rescuersmustprovide theirownlightsource.Finally,confinedspacesoftencontainhazardousmaterialsinliquidor
gas formwhichcan be harmful orfatal tohumans.
These hazardscan be fatal as theycreate a limitedwindow inwhichtoperformarescue.The general rule isthat
afterfour minuteswithoutoxygen,apersonina confinedspace will likelysufferasphyxiaresultingineitherbrain
damage or death.[1] The urgentneedtorescue someone fromaconfinedspace oftenleadstoill-preparedrescue
attempts.Two-thirdsof all of deathsoccurringinconfinedspacesare attributedtopersonsattemptingtorescue
someone else.
• rope rescue
Rope rescue isa subsetof technical rescue thatinvolvesthe use of staticnylonkernmantle ropes,anchoringand
belayingdevices,frictionrappeldevices,variousdevicestoutilize mechanical advantageforhaulingsystems,and
otherspecializedequipmenttoreachvictimsandsafelyrecoverthem.
Three primarycategoriesof rope rescue exist: highangle urban/structural,wilderness/mountainrescue,andcave
rescue.There are significantdifferencesbetweeneachinbothtechnique andequipment.Asarule,urbanrope
rescue involvesheavierequipmentandisof relativelyshortduration.Cave and Wildernessrope rescue involves
lighterequipmentwithextendedrescue times.
Rescue shouldnotbe attemptedbyindividualswhohave notbeenformallytrained.Local rescue authoritiesmaybe
able to provide informationonrope rescue training,practice, andequipment.
NFPA regulation1006 and 1670 state that all "rescuers"musthave medical trainingtoperformanytechnical rescue
operation,includingcuttingthe vehicleitself duringanextrication.Therefore,inmostall rescue environments,
whetheritisan EMS DepartmentorFire Departmentthatrunsthe rescue,the actual rescuerswhocut the vehicle
and run the extricationscene orperformanyrescue suchas rope,low angle,etc,are Medical FirstResponders,
EmergencyMedical Technicians,orParamedics,asmosteveryrescue hasapatientinvolved
• cave rescue
Cave rescue isa highlyspecializedfieldof wildernessrescue inwhichinjured,trappedorlostcave explorersare
medicallytreatedandextractedfromvariouscave environments.

2. Cave rescue borrowselementsfromfirefighting,confinedspace rescue,rope rescueandmountaineeringtechniques
but hasalso developeditsownspecialtechniquesandskillsforperformingworkinconditionsthatare almost
alwaysdifficultanddemanding.Since cave accidents,onanabsolute scale,are averylimitedformof incident,and
cave rescue is a veryspecializedskill,normal emergencystaff are rarelyemployedinthe undergroundelementsof
the rescue.Instead,thisisusuallyundertakenbyotherexperiencedcaverswhoundergoregulartrainingthrough
theirorganizationsandare calledupat need.
Cave rescuesare slow,deliberate operationsthatrequire bothahighlevel of organizedteamworkandgood
communications.The extremesof the cave environment(airtemperature,water,vertical depth) dictate every
aspectof a cave rescue.Thereforethe rescuersmustadaptskillsandtechniquesthatare asdynamicas the
environmenttheymustoperate in.
• fastwater rescue
• ice rescue
• minesrescue
• searchand rescue
• urban searchand rescue
• wildernessrescue
• ski patrol
• Vehicle Rescue
Vehicle extricationisthe processof removingapersonfroma vehicle thathasbeeninvolvedinamotorvehicle
accidentwhenconventional meansof exitare impossibleorunadvisable.Thisistypicallyaccomplishedbyutilizing
hydraulictools,includingthe Jawsof Life.Standardsandregulationscanbe foundinNFPA 1670 and1006.
It isbetterknownas "removingthe vehicle fromaroundthe person"inreference tothe oftendelicate touchneeded
to avoiddisturbingthe victim(movingthe victimaslittleaspossible) asmuchas possible duringthe extrication.
The basic extricationprocessconsistsof,butnotlimitedto,six steps:
• the protectionof the accidentscene,toavoida riskof anothercollision(markingoutthe scene withcones
or flares,lighting) andof fire (e.g.switchingoff the ignition,disconnectingthe battery,placingabsorbingpowderon
oil and gasoline pools,fire extinguisherandfire hose readytouse) ;
• patienttriage andinitial medicalassessmentof the patientbyqualifiedmedical rescuer;
• the stabilisationof the vehicle (see cribbing),toavoidthe movementsof the vehicleitself (e.g.fallingina
ditch),andthe movementsof the suspension,eitherof whichmayexacerbate anunstable traumawoundorcause
injurytothe rescuers);
• the openingof the vehicle andthe deformationof the structure (suchasremovingawindow) toallowthe
intervention of afirstresponder,of aparamedicor of a physicianinside the vehicle tobetterassessthe patientand
begincare and alsoto release apossible pressure onthe casualty;
• removal of a sectionof the cabin (usuallyremoval of the roof ordoor) to allow forsafe removal of the
accidentvictim,especiallyrespectingthe head-neck-backaxis(rectitude of the spine).

3. • removal of the patientfromthe vehicle
In lesscomplicatedcases,itispossible toextricate the casualtywithoutactually"cutting" the car,such as removing
a patientfromthe side dooror anotherpart othervehicle.
As soonas possible,bestbeforebeginningthe mechanical operation,amedicallytrainedpersonentersthe cabinto
performthe firstaidto the casualty:mid-level assessment,stoppingthe bleeding,puttingacervical collaronthe
patient(extricationoperationsare likelytoprovoke vibrations),providingoxygenfirstaid.NFPA regulation1006 and
1670 state that all "rescuers"musthave medical trainingtoperformany technical rescue operation,including
cuttingthe vehicle itself.Therefore,inalmostall rescue environments,whetheritisan EMS DepartmentorFire
Departmentthatruns the rescue,the actual rescuerswhocut the vehicle andrunthe extricationscene are Medical
FirstResponders,EmergencyMedical Technicians,orParamedics,asamotor vehicle accidenthasapatientinvolved.
Afterthe vehicle hasbeenstabilizedandaccessgainedtothe patient,the EMS teamthenenterstoperformmore
detailedmedical care.
The deformationof the structure andthe sectionof the roof take several minutes;thispre-extricationtimecanbe
usedformedical or paramedical actssuchas intubationorplacingan intravenousdrip.Whenthe casualtyisin
cardiac arrest,cardiopulmonaryresuscitationcanbe performedduringthe freeing,the casualtybeingseated.The
use of thisincompressible durationissometimescalledplayandrun,as a compromise betweenscoopandrun(fast
evacuationtoa trauma center) andstay and play (maximummedical care onsite).
The last stepisusuallyperformedwithalongspine board:the casualtyispulleduponit.An extricationsplint(KED)
can helpimmobilisingthe spineduringthisoperation.
Extrication,asdefinedbyNFPA mustbe done bymedicallycertifiedindividuals,andassuch,many Rescue teamsare
run by standalone Emergencymedicalservicesdepartments.Inmajorcities,where firedepartmentshave
FF/Emergencymedical technicians,firedepartmentscanrunrescue.There are some departmentsthatare a
combinationof Fire/EMS,Police/EMSorRescue/EMS,butthe conceptis thatmost organizationsthatrunRescue
have some sort of EMS divisionorEMT training.Assuch,there are manydifferentwaysextricationsare handled.
Some are byrun completelybyone organization,suchasstrictlybyan EMS department.Some are arun by a
combinationdepartmentthatrunsambulancesandfire trucks.Some are run as an inter-agencyjointeffort.Some
are backupsto others.Andsome departmentsrunjustaheavyrescue truck.Some departmentsalsomightonly
handle lightrescue anddoorpops,leavingthe more complicatedrescue andheavyrescue dedicatedtoaheavy
rescue unit.
Extricationincludespatientassessment,treatmentandremoval of patientfromvehicle.Some departmentsonly
carry withthemminimal toolssuchasone set of jawsof life andare onlycapable of simply"popping"adooroff and
thenmuststepaway to allowthe medical rescuersinortoallow a more dedicatedheavyrescue teaminwhohas
more equipment.Extricationunitsare supposedtonotonlyhave manydifferentkindsof extricationtools,but
medical equipment,oxygen,andbackboardsaswell.Extricationisthe entireprocessfromfire protection,power
unitdisengagement,vehicle stabilation,patientstabilizationandtreatment,removal of vehicle frompatient,
removal of patient,andtransfertoambulance.Extricationisnotjustsimplypoppingadooroff.
Hydraulicrescue toolsare usedbyemergencyrescue personnel toassistvehicle extricationof crashvictims,aswell
as otherrescuesfromsmall spaces.These toolsincludecutters,spreadersandrams.
Hydraulicrescue toolsare poweredbya hydraulicpump,whichcanbe hand-,foot-,orengine-powered,oreven
builtintothe tool itself.Thesetoolsmaybe eithersingle-acting,where hydraulicpressure will onlymove the
cylinderinone direction,andthe returntostartingpositionisaccomplishedusingapressure-reliefvalve andspring
setup,or dual-acting,inwhichhydraulicpressureisusedtobothopenandclose the suzzette cylinder

4. Rescue operationsrequire ahighdegree of trainingandare performedbyRescue Squads,eitherindependentor
part of largerorganizationslikeafire,police,military,firstaidsquad
• On-the-jobtrainingtakesplace inanormal workingsituation,usingthe actual tools,equipment,documents
or materialsthattraineeswill use whenfullytrained.On-the-jobtraininghasa general reputationasmosteffective
for vocational work.
• Off-the-jobtrainingtakesplace awayfromnormal worksituations — implyingthatthe employeedoesnot
count as a directlyproductive workerwhile suchtrainingtakesplace.Off-the-jobtraininghasthe advantage thatit
allowspeopletogetawayfrom workand concentrate more thoroughlyonthe trainingitself.Thistype of training
has provenmore effective[citationneeded]ininculcatingconceptsandideas.
Trainingdiffersfromexercise inthatpeoplemaydabble inexercise asanoccasional activityforfun. Traininghas
specificgoalsof improvingone'scapability,capacity,andperformance.