7.2 Victim Drags, Carries & Removal

7.2 Victim Drags, Carries & Removal

Fundamentals of Victim Removal

Once a victim is located, the immediate priority is to remove them from the IDLH (Immediately Dangerous to Life or Health) atmosphere. The choice of removal technique depends on the victim’s condition, the size of the victim, the number of rescuers available, the visibility and heat conditions, and the presence of debris or structural obstacles.

Firefighters must distinguish between emergency and non-emergency moves:

• Emergency Moves: Conducted when there is an immediate threat to the life of the victim or the rescuers (e.g., advancing fire, structural collapse, toxic gas release). Spinal immobilization is bypassed in favor of rapid extraction. Speed and safety are the primary concerns.
• Non-Emergency Moves: Conducted when the scene is stable, the victim is not in immediate danger, and resources are available to properly package and immobilize the victim (e.g., using a backboard or cervical collar) before movement.

Safety and Body Mechanics

Lifting and moving victims is a major source of firefighter injuries. Rescuers must use proper lifting techniques:

• Keep the back straight; do not bend at the waist.
• Lift with the legs, using the large muscles of the thighs.
• Keep the victim close to the body.
• Coordinate lifts and movements, using clear, standardized commands (e.g., 'Ready to lift, lift').

Lifting and Carrying Techniques

Lifts and carries are generally used for conscious or semi-conscious victims who cannot walk, and are typically performed in low-heat, smoke-free environments or after the fire has been controlled.

Two-Rescuer Seat Carry

The two-rescuer seat carry is an effective method for moving a conscious or semi-conscious victim who cannot support their own weight but is able to sit up.

• Procedure:
  1. The two rescuers kneel on opposite sides of the victim near the victim’s hips.
  2. Each rescuer passes one arm under the victim’s thighs and locks hands with the other rescuer, forming a secure seat.
  3. The rescuers pass their other arms behind the victim’s back and lock hands or grasp shoulders to support the victim’s torso.
  4. On a coordinated command, both rescuers stand in unison, lifting the victim.
• Limitations: This carry requires two rescuers and cannot be used for unconscious victims or those with suspected spinal injuries. It also raises the profile of the rescuers, making it unsuitable for high-smoke or high-heat environments.

Extremity Carry

The extremity carry (also known as the fore-and-aft carry) is a common method for moving a victim through narrow hallways, doorways, or down stairs.

• Procedure:
  1. The first rescuer kneels at the victim’s head, slides their hands under the victim’s armpits, and grasps the victim’s opposite wrists (left hand to right wrist, right hand to left wrist) across the chest. This crosses the victim's arms and locks them.
  2. The second rescuer kneels between the victim’s legs, facing away from the first rescuer, and grasps the victim’s legs behind the knees.
  3. On a coordinated signal, both rescuers lift together using their legs, keeping their backs straight.
• Limitations: This carry exposes the victim’s spine to bending and twisting, so it must never be used if spinal trauma is suspected. It also requires a high vertical profile, which is dangerous in active thermal layers.

Drag Techniques

Drags are the preferred method for removing unconscious or heavy victims, particularly in low-visibility, high-heat environments where rescuers must remain low to the floor. Drags reduce physical strain on the rescuers and help protect the victim's head and neck.

Clothing Drag

The clothing drag is a rapid, single-rescuer emergency move.

• Procedure:
  1. Extend the victim's arms along their sides or cross them over their chest.
  2. Grasp the collar of the victim’s shirt or jacket behind their neck. If the clothing is durable (e.g., a heavy jacket), it provides a secure handle.
  3. Support the victim's head with the rescuer’s forearms to prevent it from striking the floor.
  4. Backward crawl or walk, dragging the victim along the long axis of their body.
• Advantages: It is very fast, requires only one rescuer, and provides some support for the head and neck.

Webbing Drag (Improvised Harness)

The webbing drag utilizes a loop of tubular webbing (typically 15 to 20 feet long) to create a secure harness around the victim's upper body. This allows the rescuer to pull with more leverage.

• Procedure:
  1. Form a loop of webbing using a water knot.
  2. Place the loop over the victim’s head and position it chest-high.
  3. Feed the webbing under both armpits and back up over the shoulders, or wrap it under the chest to form a harness.
  4. Pull the remaining loop over the victim’s head to create a handle.
  5. The rescuer grasps the loop handle and crawls backward, dragging the victim.
• Advantages: The webbing distributes the pulling force across the victim’s chest rather than pulling on their neck or clothing. It allows the firefighter to maintain a lower profile while using large muscle groups to pull.

Downed Firefighter Rescue Operations (RIC/RIT)

Rescuing a downed firefighter presents unique challenges due to the weight of their personal protective equipment (PPE) and self-contained breathing apparatus (SCBA), which can add 50 to 70 pounds to the rescuer's load. Additionally, the SCBA harness and straps can become snagged on debris.

SCBA Harness Conversion

Before dragging a downed firefighter, their SCBA harness must be secured to prevent it from slipping off the firefighter’s body during transport.

• Procedure:
  1. Locate the Waist Strap: Undo the SCBA waist strap buckle.
  2. Convert to a Crotch Harness: Route the waist strap between the firefighter’s legs and buckle it back together. This creates a secure harness (crotch strap) that prevents the SCBA air cylinder and harness from sliding up over the firefighter’s head when pulled.
  3. Tighten Shoulder Straps: Fully tighten the shoulder straps to ensure the unit is snug.
  4. Use as Drag Handle: The shoulder straps or the SCBA frame handle can now be used as a heavy-duty drag handle.

Rapid Intervention Crew (RIC) Air Management

A downed firefighter’s air supply is the most time-critical factor in a rescue. The Rapid Intervention Crew (RIC) must bring a RIC pack (containing a spare SCBA cylinder, hose, regulators, and masks).

• Air Assessment: The RIC team immediately checks the downed firefighter’s remaining air pressure.
• Universal Air Connection (UAC): If the downed firefighter’s SCBA cylinder is low but their mask and regulator are intact, the RIC team can perform a rapid transfill using the UAC. The UAC is a high-pressure connection that equalizes pressure between the rescue cylinder and the victim’s cylinder in seconds.
• Low-Pressure Regulator Swap: If the regulator is damaged, the RIC team can swap the regulator or connect a buddy-breathing line to the firefighter's SCBA.
• Mask Replacement: If the facepiece is cracked or compromised, the RIC team must replace the entire facepiece with the rescue mask.

Comparison of Lift, Carry, and Drag Techniques