How to Safely Rescue Someone from a Confined Space
You need a trained and properly equipped rescue team on site whenever confined space work is taking place.
Emergency situations that take place in confined spaces are some of the most dangerous ones a worker can face. Hazards accumulate and synergize so that entry and rescue scenarios are uniquely risky activities, requiring diligent preparation and forethought. At their worst, a confined space rescue situation can result in multiple fatalities – one rescuer and one casualty quickly become two casualties if any steps have been overlooked.
But that doesn't mean confined space work is doomed to disaster. Confined space entries are performed safely all the time, and if we have the wisdom to learn from mistakes and the vigilance to stick to best practices, this can be a safe and inconsequential part of the workday in most cases. However, incidents occur. When they do, you have to be prepared.
Your Confined Space Program
Your organization must have a confined space hazard assessment and control program in place and it must be reviewed regularly. The specific paperwork required will vary from one jurisdiction to the next, but for the sake of completeness, a confined space program should at the very least include the following:
- An inventory of confined spaces on the job site
- A rescue plan for each confined space
- Confined space permit requirements
- Atmospheric monitoring logs
- Training certificates (confined space, rescue/emergency medical training, Self-Contained Breathing Apparatus training, hot work, WHMIS)
- Confined space monitor/attendant/standby person training
- Confined space entry procedure
- Bump test and equipment calibration logs
- Field level hazard assessment (or confined space hazard assessment)
- Drill and tabletop activity records
That is a lot of paperwork! Because of that, it can be challenging for safety managers to overcome the optics that all this is excessive and a waste of time. On the contrary, a thorough record of successful entries (including those listed above) demonstrates conformity to procedures, creates a paper trail for audits, identifies opportunities for improvement, allows you to perform trend analyses, and provides peace of mind for management by showing them that best practices are being adhered to.
Confined Space Entry Permit
One of the objectives of the permit process is to have workers step back from the situation, consider the hazards that could contribute to an unexpected situation, and verify that the proper controls are in place. The conditions that trigger a permit requirement vary depending on the jurisdiction, but spaces that require a permit are generally those with the highest hazard levels or multiple interacting hazards.
OSHA considers a permit-required confined space to have the following characteristics:
- Contains (or may contain) a hazardous atmosphere
- Contains (or may contain) material that could engulf those within the confined space
- Has walls that converge or floors that slope down and taper to an area that could trap or asphyxiate an entrant
- Contains other hazards, such as live wires or extreme heat
Other jurisdictions have grading criteria for confined spaces based on their hazard levels. However, to avoid getting in the weeds with all the details, it's important to note that they typically require permits for all of them. The trend is towards requiring a permit for all entries because the practical resolution between level 1, 2, and 3 spaces, restricted vs. confined, permit-required vs. not, just led to confusion and disagreement.
The permit process facilitates communication and hazard assessment related to an entry activity so that all involved parties know what they’re dealing with. Knowing is half the battle, after all. If an attendant knows it’s possible for an isolation to fail and oxygen to be displaced, they are less likely to charge in to attempt a rescue unprepared and risk their life.
According to NIOSH, more than 60% of those who suffer fatalities in confined spaces are the ones attempting to rescue others without being fully trained and adequately equipped. That's a staggering statistic. A grim figure like that should be enough to underscore just how important training and preparation are when performing confined space work. Permits provide an opportunity to confirm those details.
A proper permit program is therefore critical to facilitating a rescue, because much of the preparation has been done before the entry even started.
Preparing Your Confined Space Rescue Team
If there were a motto for confined rescues, it would be: expect the best and plan for the worst.
Properly trained rescue personnel must be available during any confined space work. These could be external experts or fully trained internal employees, but they must be available for immediate deployment and must have all the necessary gear available, inspected, and ready.
Nobody who hasn't been properly trained in confined space rescue should attempt any rescue activities. Period. This should be written into policy and reiterated to all workers. While it runs contrary to our better impulses, trying to "help" is often the worst course of action. Training and practice can help make sure everyone knows the appropriate actions to take.
The safe rescue of a person from a confined space starts long before an emergency occurs. Emergency teams perform walkthroughs, visualizations, and painstakingly review lessons from previous experiences seeking opportunities to improve. Experienced rescuers should be integrated into training activities to contribute the value of their experience and shed light on things unseen.
Internal rescue teams must take part in practicing confined space rescues, using mannequins and representative physical situations. They must also be trained in first aid and cardiopulmonary resuscitation (CPR), and at least one team member must be certified in CPR.
(Learn about CPR Certification: Why You Need It and How to Get It)
The rigorous preparation necessary for confined space work can feel onerous and heavy-handed at times and workers are often not shy about sharing their thoughts on it. But the cost of complacency is tremendous! Everyone on the rescue team must know their roles and responsibilities, and have enough practice under their belt to execute without hesitation.
Rules vary from one jurisdiction to another, but many now specify that an attendant, monitor, or standby person be designated who cannot also be part of the rescue operation. Their role is to maintain communication with an entrant, keep track of everyone inside, and initiate an emergency response if one should be needed.
Depending on the other characteristics of the confined spaces in a site’s inventory, rescuers may need additional training such as fall protection, WHMIS, high-angle rescue, explosive atmosphere training, donning and doffing SCBAs, and training on specific equipment. Consider a situation where a worker falls unconscious on a bosun seat in the top third of a smokestack while performing repairs – the rescue team needs to know how to access them, how to retrieve an unresponsive casualty, and how to protect themselves. is the air breathable? Is it flammable? There’s no time to figure it out on the spot!
For that reason, a rescue plan is needed for any entry activities. The rescue team must be apprised of all facilities in which confined space work will be conducted, and must have access to and knowledge of physical plans and emergency communication procedures.
A static site should have an inventory of their confined spaces and an associated rescue plan for each. This needs to be shared with anyone involved in the work so that they understand their responsibilities in the event of an emergency and in the course of normal activity. Each of these spaces should be drilled and practiced to make sure the personnel, equipment, and rescue methods are sufficient.
Rescue drill activities should include a way to introduce improvements. When rescue activities are practiced, any deficiencies should be noted and corrective actions assigned so that it improves each time it is drilled. An employer can’t afford to assume they got it right without putting it to the test.
Types of Confined Space Rescue
There are three types of confined space rescue: self-rescue, non-entry rescue, and entry rescue.
Self-rescue involves an entrant leaving the space under their own power, either because they have identified a hazard or are feeling ill. The worker may also have a gas monitor alarm indicating a potentially dangerous condition. Sites such as gas plants may require continuous monitoring of the internal atmosphere for lower explosive limit (LEL), or the lowest flammable concentration of a particular gas with air. Monitors also detect the presence of hazardous gases inside the space beyond the permissible exposure limit (PEL).
(Learn more about The Dangers of Gas in a Confined Space)
Self-rescue removes the need for other people to enter the space, but also requires that the individual has been fully briefed or trained on safe self-exit procedures. This might include safely disengaging or powering down equipment, as well as procedures for a correct exit, following a checklist, and moving slowly and deliberately to identify and avoid additional hazards.
Non-Entry (External) Rescue
Non-entry rescue uses assistive tools to eliminate the need for additional people to enter the space. These tools might include a harness that the entrant dons and is then lifted by pulleys and ropes.
Careful planning must ensure that retrieval systems won't get snagged or caught on obstacles in either emergency or non-emergency situations. This is doubly critical when the entrant is using an air supply line, since entanglement is a constant threat.
It can’t be assumed that a non-entry rescue is therefore non-technical. It requires careful consideration and practice to make equipment functions and rescue technicians know how to use it. Even in situations where non-entry rescue techniques are deemed primary, an entry rescue team or specialist must be immediately available.
Entry rescue involves additional people entering the confined space to perform the rescue. This method poses the greatest risk - there is a casualty inside the space and the hazards that contributed to the situation may not be fully known. Planning should account for the hazards that may not be apparent. Entry teams must be fully briefed on the space, including any new information that might have changed its safety and integrity. This might include factors such as:
- Failure of structural support elements that may have caused entrapment or immobilization. Rescue teams would have to take steps to mitigate further collapse.
- Engulfment or entrapment in materials (either dry material like grain or fluid like water). Unstable materials may be untraversable without extra equipment or would require a different approach to retrieve any casualties.
- Ingress of toxic substances or failure of isolation. When an unconscious or delirious casualty is stuck in a confined space, it may be due to an isolation or lockout strategy that has failed and allowed a substance (e.g., carbon monoxide) to enter the space.
- High or low oxygen content in the atmosphere. There are a number of mechanisms by which this can occur. Hot work or natural oxidation processes can consume oxygen and leave a space deficient (less than 19.5% oxygen in the atmosphere). The use of organic peroxides can introduce oxygen into an enclosed space and cause an “enriched” condition (greater than 23% oxygen in the atmosphere). While this is breathable, it may cause oxygen intoxication, making a casualty confused and communication difficult. More dangerous is the fact that combustion can happen readily in an oxygen-enriched atmosphere. Rescuers must be prepared to enter without creating sources of ignition, using non-sparking tools, intrinsically safe electronics, and supplied air.
Quick but careful planning and communication must be used to ensure all rescue personnel plus the necessary equipment can safely be used in the extrication process. Of particular importance is the decision for spinal immobilization of the injured party. This will depend on whether there is enough room to move as well as additional life-threatening situations such as a toxic atmosphere. In these rescue operations, the principle of “life over limb” applies – priority is given to retrieving a casualty alive, even if it means they suffer a substantial injury in the process.
Time-Sensitive and Non-Time-Sensitive Rescues
Time sensitivity is a vital identifying factor in all confined space rescues.
A time-sensitive rescue usually involves atmospheric hazards (specifically, air supply or toxic vapors) and points to a maximum rescue time of six minutes. A fire-related issue might make that time window even smaller.
A non-time sensitive rescue might include a non-life-threatening injury like a broken ankle, which requires careful rescue but does not pose an imminent, life-threatening danger. On the other end of the spectrum (it's grim, but it bears mentioning), if it can be determined that the casualty is obviously deceased, the rescue will not be considered time-sensitive.
It’s important to remember that the perceived severity doesn’t necessarily define the preparation necessary. Just because a person has twisted an ankle does not mean we can forego the hazard assessment and personal protective equipment, and cast the rescue plan aside. A pre-determined minimum preparation must take place for anyone entering the space.
Other Complications Rescue Teams Should Consider
Moving People and Objects
Ladders may be easy to use to climb down into a tank, but a winch or tripod system for lifting a stretcher or harnessed patient must remain safely balanced both during the lift out of the tank as well as the descent externally to the medical team.
Air tanks and other bulky gear will likely need to be removed and manually passed from hand to hand when entering small apertures. Doing this efficiently and safely takes practice.
People are very hard to lift – it’s not like in the movies. It takes more than brute strength to transport someone, and an unconscious person is a uniquely uncooperative load. The rescue plan may provide for the assistance of a winch, a multi-person lift, a dragging technique, or a different strategy altogether.
Corrosive atmospheres might cause unseen structural damage to nylon harnesses, and metal objects can be a source of spark or static discharge.
Equipment used in potentially flammable atmospheres has to be “intrinsically safe,” meaning their electrical components are shielded from the atmosphere and can’t ignite gases or vapors.
“Bombproof anchors” is a term that describes rigging that can withstand the demands of moving and lifting people and obstacles without failure. A secondary anchor is always advisable. Rigging must also take into consideration friction, contact with bends and edges, and overuse of connectors like carabiners.
Rigging and pulley systems require a thorough knowledge of weight and pulley ratios. There is a specific parlance – words, tugs, and signals - that must be learned thoroughly by all team members if such a system is going to be relied upon for communication.
Loss of Focus
It is easy for rescuers to lose track of time and develop tunnel vision when working in a rescue situation. Tunnel vision can affect hearing, with rescuers no longer able to pay attention to instructions from their superiors. In addition, lives can be lost when pursuing the rescue of a victim who has already died. These are difficult prioritizations to make in the best of times and are many times more dangerous in situations of confined space and time.
Confined spaces are risky to begin with. Emergency rescue situations only add to the risks. That's why it's important to plan ahead, train adequately, and have all the equipment needed for a successful rescue. Because the last thing you want is a rescue that results in even more casualties.