Contents

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While the greatest care has been given to the content, it is possible that the information in this newsletter is incorrect or incomplete. N.V. Holmatro and its affiliated companies (hereafter: Holmatro) cannot be held liable in any way for the consequences of activities undertaken on the basis of this newsletter. If you have any doubts about the correctness or completeness of the information, you shall contact Holmatro (phone number: +31 (0) 162 589200). Nothing from this newsletter can be copied and/or made public in any way without the explicit authorisation of Holmatro.

Newsletter 1 | 2011                                                                              

Introducing Holmatro’s new Rescue Consultant

Full Name:

Ian Michael Dunbar

Age:

36

Place of Birth:

Liverpool UK

Position:

Rescue Consultant Holmatro

“Before becoming Rescue Consultant at Holmatro, I spent 18 years working for the UK fire and rescue service. I worked at several fire and rescue stations until 2005, when I became a training officer responsible for training fire fighters in Road Traffic Collision Extrication and Trauma Care. I subsequently became an instructor for height safety, tactical fire fighting, breathing apparatus as well as an incident command and control officer. I was also privileged to join the UK Rescue Organisation (UKRO) as an assessor. This work allowed me to assess extrication teams from all over the UK in competition and give them constructive feedback with a view to improving performance and promoting the ‘Gold Standard’ approach to technical and medical extrication.

Technical & medical rescue

I believe that technical and medical rescue are inexplicably linked. One cannot be performed without an intimate knowledge of the other. For this reason in 2006, I completed the anaesthesia, trauma and critical care (ATACC) course and was asked to join the faculty as a specialist instructor. I have maintained this position, which allows me to train doctors and other health care / rescue professionals in dealing with road traffic collisions and other specialist rescues in the pre hospital environment. My other work in the field of trauma care includes e.g.:

• Working with ATACC DRT (Disaster Response Team) in 2007, I organised a training expedition to Greek Macedonia where we delivered trauma training to the Hellenic Rescue Team and staged an earthquake exercise.

• Presenting at the Fourth Mediterranean Emergency Medical Congress 2007 (MEMC IV) Subjects - Rescue 1 Concept, Emox Oxygen.
• Training UK fire fighters and Police Armed Response officers in trauma care.

Tactical Fire Arms Trauma Training

In 2010 I qualified as a world assessor when I attended the World Rescue Challenge in Cork, Republic of Ireland. This was a privilege for me, as I worked with teams from countries such as South Africa, Sakhalin (Russia), USA and Ireland. This allowed me to see varying rescue techniques from all over the world. In the same year, I was asked to manage an International Development Program for the World Rescue Organisation (WRO). This project identifies countries that require assistance with their capabilities to plan for and react to road traffic collisions. I went to Kiev in Ukraine and spent time analysing their infrastructure, training methods and requirements. This is a 3-5 year development program and is currently ongoing.

World Rescue Organisation Assessor 2010

My hopes for the future

In the 18 years I spent as an operational fire officer and my work with UKRO / WRO, I have gained a lot of knowledge and experience in the area of technical and medical rescue. I hope this will allow me to give value to the people I meet in my new role. I hope the experience I have will assist rescuers to perform their role more effectively, and more safely. I also hope that the people I meet, can enhance my skills. As I believe you can never have enough knowledge and experience.”

Ian Dunbar

If you any questions regarding technical and medical rescue, please contact Ian by email: Este endereço de e-mail está protegido de spam bots, pelo que necessita do Javascript activado para o visualizar or at telephone number +31 (0) 162 58 92 00.

If you have any further questions, please contact your local dealer.

Newsletter 1 | 2011                                                                              

The Golden Hour: Still realistic?

By Ian Dunbar

"There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later -- but something has happened in your body that is irreparable." R Adams Cowley, University of Maryland Medical Centre

The concept of ‘The Golden Hour” is well established in the minds of rescuers across the world. But how often is this actually achieved? And is it realistic in 2011?

There are many factors that affect the time it takes for a casualty with life threatening injuries, to receive definitive medical care. It should be made clear that definitive care does not mean arrival at a trauma centre, but actual medical intervention (usually surgery). So just how realistic is it to actually get a casualty from the roadside to the operating theatre within 60 minutes? In reality, we as technical rescuers have only 20 minutes to stabilize and disentangle our casualty. Is this achievable?

Challenging developments

It may be argued that with new car technology and improvements in vehicle construction that 20 minutes is now not realistic and the concept of the golden hour has become out-dated. 15 or 20 years ago we did not have to deal with boron steel construction nor did we have to neutralise the threat from airbags.

Construction of a Volvo S40

B-post construction was far simpler, and hybrid or LPG powered vehicles were still some years off. While vehicle construction may have changed considerably over the last 20 years, the human body has not developed quite so quickly and still reacts the same to rapid deceleration and blunt force trauma resulting from collision with the vehicle interior (albeit that airbags have helped). So the reality is, that as rescuers, we have to work smarter to achieve the same extrication times and give the best possible chance of survival to our victim(s).

Saab B-post construction

Smart working

At the scene of an extrication, there is now more to do than ever before to ensure a safe and satisfactory outcome for casualties and rescuers alike. There must be great emphasis on simultaneous activity (performing multiple tasks at the same time), team dynamics (how, as rescuers, do we work together?) and multi-agency working (do you know what to expect from the other emergency services involved?).

To give yourself (and the casualty) the best chance you must:

• Prepare – As rescuers we owe it to the public we serve to be aware of the issues surrounding technical/medical rescue. We must keep our knowledge up to date and be aware of the latest developments and techniques.
• Perform – Ensure we have the correct equipment, skills and safe systems in place
• Evaluate – Learn from the extrication. Look at the extrication you have performed. Could you have done it differently? Quicker, safer, better? Only by evaluating your performance can you improve.

Figure 1

Prepare

With the exception of specialists who only attend road traffic collisions, rescuers have a wide variety of disciplines to learn in order to fulfil their operational duties. Fire-fighting, water rescues and rescues from height for example.

-         But, is your training proportional to your operational workload? I.e. does preparing for road traffic collisions only make up 20% of your training but is 40% of your operational workload spent at the roadside extricating?

-         Are you training enough?

-         Is the training you are doing of sufficient quality?

-         Are you consulting experts?

-         Are you training with other agencies, such as paramedics and local police?

-         Do you know where to find the information you require?

These are questions only you, as rescuers, can answer.

Perform

You cannot perform well at an incident without adequate preparation. Along with education, preparation of your equipment and techniques is the key. The tools you choose are vital. They must be reliable and rapidly available, in all weathers and all times of the day and night. They should be quiet in operation, as this does not compromise safety of crews or casualty care. With new vehicle technology, they must also operate quickly and be designed with the construction of the vehicle in mind. At each stage of the extrication you need to find ways of saving time, and keeping to your 20 minute window.

Modern vehicles ask for specially designed tools. The picture shows our  New Car Technology cutter CU 4055 C NCT II

Evaluate

Each and every rescuer should learn something from all extrications. Whether it is something about the performance and capabilities of the tools, the construction of the vehicle(s) involved or how the extrication could be improved next time. Evaluating your and your team’s performance is a critical part of maintaining skills and ensuring that rescue techniques progress. Input from other agencies should also form part of your evaluation, as this is the only way that technical and medical rescue personnel can be more effective in the future.

Conclusion 

Vehicle technology develops rapidly, but the Golden Hour principle remains unchanged. There is no doubt that some of the extrications you face are complex. However, what reduces the complexity of any incident is being prepared for it and having the knowledge to deal with any eventuality (see figure 2). This ensures you can still keep to your 20 minute window. In the coming years, removal of persons from the passenger cell following an impact will become even more challenging. So the question is, how will you make sure you are up to it?

Figure 2

If you have any further questions, please contact your local dealer.

Newsletter 1 | 2011                                                                             

Urban Search and Rescue: Equipment Developments

By Ian Dunbar

March 11^th 2011 saw appalling devastation inflicted on Japan and the wider pacific area as a result of an 9.0 earth quake and resulting tsunami. This is by far the strongest of 8 major earthquakes so far seen in 2011.

Battery powered combitool BCT 4120: mobile and versatile

New Zealand suffered its own devastation on February 21^st where a reported 166 people lost their lives, with the international Urban Search and Rescue Response (USAR) to Christchurch totalling over 400 personnel from 7 different countries including USA, UK and Japan. This was in addition to the 150 operatives from New Zealand, a huge humanitarian response.

This series of high profile natural disasters coupled with the very real and on-going threat from terrorism is a stark reminder, if it were needed, that USAR personnel need to be well prepared and have the latest equipment to perform with maximum safety and success, in these areas of devastation. It also serves to remind us that urban search and rescue is not just confined to rescue from collapsed structures, but also vehicles and public transport. Indeed, in any location where people live and work when the disaster strikes.

Holmatro rescue equipment was heavily used in the initial rescue efforts at the Canterbury TV and Pine Gould Corporation building sites as well as the numerous other entrapment areas within Christchurch.

A mix of hydraulic spreaders, cutters, airbags in conjunction with shoring, concrete cutters, hand tools and of course the manpower of many fire fighters on site resulted in the rescue of 21 live entrapped victims from a pile of rubble which was once a building.

All USAR operations require specialist tools and manufacturers of hydraulic rescue equipment have made great advances in recent years allowing teams to operate safely and more effectively, improving the chances of survival for trapped casualties.

Equipment developments

There have been many advances in all types of rescue equipment designed for USAR operations. These changes have come in the form of specifically designed cutters, for the cutting of chain, padlocks and rebar (reinforced steel found in masonry and concrete as a tensioning device). These are small and powered by compact, mobile pumps, light enough to be taken over challenging terrain.

Rebar cutting with special materials cutter SMC 4006 C

Tools designed specifically for crushing and removing concrete are silent in operation, thus improving communications, and expose rescuer and casualty to less dust during operations.

Hydraulic wedges allow the rescuer to commence lifting operations in narrow openings (from an initial height of 6mm) and can be followed up by the use of high pressure lifting bags and hydraulic jacks.

The continued success of CORE^TM couplings for hydraulic rescue equipment means that the rescuer can change under flow,  has one hose extended to the scene of operations and can change tools independently. This increases the capability of the rescuer in terms of speed and flexibility.

Concrete crusher CC 20 C

Battery- and hand-operated tools now have an important place in USAR operations. Not only are they versatile enough to deal with a wide variety of materials, they are also self-contained and can be carried in the most inaccessible of environments thanks to specifically designed body harnesses.

Hydraulic wedge available in hand-operated version, HPW4624

Complexity requires versatility

Building construction varies greatly all over the world, both in the design and the materials used. It therefore follows that next to specialist equipment one also needs recue tools versatile enough to deal with the many types of materials. It should also be remembered that rescue from a collapsed structure means not only penetrating the building materials but also the contents of the structure, whether that is furniture, fittings, fabrics or indeed vehicles.

Advances in casualty detection (seismic/acoustic listening devices, canines) mean that casualties are being located at greater depths than ever before, both horizontally and vertically. This presents problems in terms of maintaining safe access and egress. Because of this, emergency shoring is now becoming more complex and intelligent systems are invaluable. They must be light, readily deployable and provide structural support in a whole host of situations. Shoring systems with integrated hydraulics offer the added advantage of lifting capability.

Shoring systems should be readily deployable: PowerShore^TM

Conclusion

USAR operations are becoming technically more difficult. The physical and emotional burden on rescue personnel is enormous. The challenge is to constantly maintain and increase skills and knowledge, whilst all the time ensuring they have the latest tools and techniques to deal with the catastrophic scenes like those already witnessed this year.

If you have any further questions, please contact your local dealer.

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