BY JOE AMIGLIORE
Every day in the United States, firefighters are faced with challenging rescues that go beyond their equipment and personnel resources. Nevertheless, only one thing is paramountgetting to the victim, treating the victim, and getting the victim to the hospital expeditiously. Our job is to save lives!
A typical response scenario for Marion County Fire Rescue Engine Company 16, located in Ocala, Florida, is described below.
Scenario
It’s a hot June day. The temperature is near 100°F. We are trying to stay in the station out of the sun. The alarm sounds: “Engine 16, respond to Santos Trailhead reference a fall.”
We already have an idea of what we have to do. On arrival, a mountain bicycle rider tells us his buddy fell off his bike and might have broken his leg. We grab our medical and immobilization equipment and start hiking. The rider then tells us it’s only a mile back. When we hike to the accident scene, we find a victim with an angulated leg fracture, who is experiencing back pain. We fully immobilize the victim. Then, the fun begins.
All four members of my crew grab a corner of the backboard and start walking. It’s hot, the terrain is rocky and hilly, and we have a mile to go. After about half an hour, we transfer the patient to the medic unit and take a well-deserved drink.
TERRAIN CREATES NEED FOR SPECIAL RESPONSE EQUIPMENT
This scenario involving the Santos Trailhead has been played out time and time again. The 70 miles of mountain bike, hiking, and equestrian trails are nationally renowned. The equestrian trails extend throughout Marion County and pass over Interstate 75 on the only land bridge in the United States.
 Photo 1. |
The mountain bike trails, developed by the Ocala Mountain Bike Association, are divided into three color-coded trails. The yellow trail, for family bicycle riding, offers flat, even trails that even the smallest youth can ride comfortably. The rocky terrain of the blue trail requires more riding experience. The infamous red trail requires expertise in mountain bike riding because it was built in and around abandoned limerock pits, and in some areas a fall can mean a drop of 30 to 40 feet.
It was one of these falls, in which the victim died, that made apparent the need for equipment that would accelerate access to the victim, victim stabilization, and transport of the victim to a waiting medic unit. In a perfect world, we would just have to call up the chief and tell him we needed $20,000 for two new all-terrain vehicles and the related ancillary equipment. However, at that time, only four months were left in the current fiscal year and the budget for the next year was already set.
EQUIPMENT OBJECTIVES REALIZED
When we realized the fiscal realities, we developed a plan that included the following goals: (1) to find community financial backing, (2) to find a local dealer that might build a specialized victim transport system for us, and (3) to find unique equipment that suited our needs.
As we began talking to people about the plan, we were referred to the Marion County Horsemen’s Association. We were invited to speak at one of its meetings; by the end of the night, we had raised more than $3,000.
 Photo 2. |
We then contacted a local dealer of all-terrain vehicles in Gainesville, Florida, and explained to its representatives how much equipment we had to carry when responding in the Santos Trailhead area, the small trails we had to traverse, the steep inclines and declines in the area, and our need for equipment that would expedite transporting a victim out of the area. Within weeks, a dealer, with the cooperation of a motorcycle manufacturer, offered us two 500-cc four-wheel-drive vehicles on a loan plan that would enable us to use the motorcycles for one year, at which time we could trade them in for the next year’s model. The vehicles have four-wheel drive, a high-low range, the ability to carry 60 pounds on the front rack and 130 pounds on the back, and two secondary 12-volt power supplies. These vehicles appeared to be specifically designed for our needs (they were red, too!). (See Photos 1 and 2.)
We now needed some type of victim transport trailer. The equipment we had looked at was way out of our price range. We once again looked to our community for assistance. After discussing our needs with an accessories retail outlet, the company’s employees proposed building a victim transport trailer for us on their own time after work hours. The vehicle ultimately was presented to us along with tie-downs for the bikes, 12-volt victim lights, and a 16-foot ramp-down trailer at cost.
Additionally, we ordered two portable systems with handlebar mounts and 12-volt accessory plugs, three helmets (two large, 1 2 l ), two radio chest harnesses, and two 12-volt 1.5 million candlepower handheld lights. We ordered the lights because we already had been called to a rescue at 9 p.m.; the riders were using helmet lights with battery power packs.
We were able to equip these units with full advanced life support and basic life support equipment. The only equipment we needed from the engine was a cardiac monitor.
 Photo 3. |
TRAINING
With all the equipment in place, we began to train. Since there was no formal four-wheeler rescue training program in the Florida area, we put together a program and developed standard operating guidelines using our own knowledge of four-wheeler riding, our EMS skills, and our knowledge of the topography of the land.
The majority of the training consisted of creating scenarios in which we took the roles of victims with various types of injuries. We practiced using full immobilization techniques and transporting victims out of a remote area and then critiqued the operation, including projecting how the victim would feel during transport. This was very helpful because we had to determine the speed at which a victim could be transported safely and quickly without being subjected to further injury.
STANDARD RESCUE RESPONSE
The units are now online. Our response to a standard rescue is as follows: Once an all-terrain vehicle rescue is identified by communications, Engine 16 and Support 16 are dispatched to the closest entry point along the trail. On arrival, Engine 16 assumes incident command, and a paramedic and EMT power up the units along with the global positioning, satellite (GPS) systems at which time the entry point is listed as home on the GPS.
 Photo 4. |
The medic unit is dispatched to the entry point and stands by. Once the units enter the trail, they maintain communication with Command, referencing any hazards located and contact with the victim. After the victim is evaluated, stabilized, and packaged for transport, Command is notified that victim transport has begun.
During transport, communication is maintained with the victim as well, to make sure that the rate of speed of transport is not harming him (see Photo 3). In the case of extremity fractures, if the victim’s condition is stable and if it is necessary, we will stop and reposition the fractures using egg-crate mattress pieces.
Once the victim is transferred to the waiting medic unit, both units are loaded back on the trailer (see Photo 4), the transport trailer is decontaminated, and the units are refueled and prepared for service.
Simply making our community aware of our needs and identifying areas typically not defined by fire rescue guidelines, we have created a rescue system that will increase the survivability percentage of hikers and bicycle and horse riders who work and play in Marion County.
JOE AMIGLIORE, a 15-year veteran of the fire service, is a paramedic/firefighter with Marion County (FL) Fire Rescue in Ocala, a member of the hazardous materials team, and the chairperson for health and safety for the Professional Firefighters of Marion County Local #3169.
(Photos by author.)
