Among the different situations where it simply may not be safe to enter an active scene as an EMS provider 鈥� structure fire, hazardous material spill/leak, a scene with down wires 鈥� building collapse certainly should be considered toward the top of your 鈥渄o not enter鈥� list ... not without proper training, PPE and equipment, at least.
Those who serve a dual-role and work as a firefighter and EMT/paramedic have an advantage here, often having more insight into building construction, technical rescue training, and better access to both the structural stability and extrication equipment necessary to begin making the scene 鈥渟afe,鈥� not to mention more appropriate PPE. While I support every EMS provider wearing protective glasses 100% of the time, having access to some sort of protective helmet, and even carrying a set of step chocks in the external compartments of 911-response ambulance, this nowhere compares to the expansive needs a structural collapse situation can present.
Having said that, here鈥檚 a quick, crash course of considerations that EMS crews should keep in mind if they鈥檙e either the first arriving unit at the scene of a building collapse, or are serving as a part of the response arsenal that will likely comprise this complex incident鈥檚 logistical and operational needs.
1. Collapse zone
While not a scientific value, 1.5 times the building height (or hole depth, if a trench) is the minimum distance that you want to distance your apparatus from the site. Falling or crumbling debris can travel quite a distance, so keep your ambulance a safe distance away to prevent it from becoming a part of a potential rubble pile. Think of the collapse zone as the hot zone, like with hazardous materials situations. Only trained and prepared responders should be in this space.
2. Start with ICS
Arrive on scene, provide a building and incident description, request more resources and then start with safely moving individuals away from the immediate hazard zone (including yourself, if need be). Collapse incidents are going to be both labor and resource intensive, so work with incident command, and concisely notify your dispatch center of what you see and what you need to get your response off to its best start (this may also include structural engineers 鈥� if your community has them on staff).
3. Active utilities
Buildings don鈥檛 just automatically cut power, gas line flow or water from running when something bad happens. Everything stays active until it is either manually turned off or it is tripped by some sort of safety mechanism (assuming it, too, is intact). Dangerous gas levels can rise, water can flood low spaces and the spaghetti lines of power within any structure can remain energized immediately following a collapse, so it鈥檚 important to treat this structure as very volatile, unpredictable and simply unsafe until further preventative and mitigating actions can be taken.
4. Structural integrity
Of course, whatever portion of the building that collapsed didn鈥檛 have the best of integrity, but just because there鈥檚 a pile of rubble on the ground where a structure once stood, doesn鈥檛 mean that the rubble pile (itself) is stable, either. Weakened walls and trusses can still fail. Movement, vibrations or even the removal of pieces of debris can cause the remainder of the structure or pile to lose its integrity. Once again, structural collapse scenes are very volatile. One wrong move, literally, can have profound negative effects.
5. Don鈥檛 rush in
Stop, take a deep breath, formulate a plan, and then act! Rushing into a partially- or fully-collapsed building is ill-advised at the start. Yes, there are times where we take calculated risks to save a life, but that same level of calculation should also be taken to keep you out of a hazardous situation when there鈥檚 a lower (or no) likelihood of any lives to save, too.
A structure collapse response is going to be bigger than just your crew, so requesting ample resources early can go a long way as technical rescue teams assemble, added resources are arranged and the calvary of hands needed to overcome this large hurdle becomes prepared. Keep yourself safe, your crew safe and your patients safe ... and in the case of building collapses, sometimes this simply means not making the first move to enter the scene until it鈥檚 鈥渞eady鈥� for you to rapidly respond.
Rescuers need to anticipate specific medical problems and patient needs as they prepare to encounter patients in a collapsed structure or debris pile
