By George Healy
Forty years ago, FDNY’s Rescue Company 3 was summoned to the emergency room of Lincoln Hospital in the Bronx to assist doctors with a problem. A young man had showed up with his hand enmeshed in a commercial meat grinder. The doctors felt that their only medical alternative would be amputation of the hand. At the time, Rescue 3 had a new tool at its disposal – the Partner Saw, equipped with a metal cutting blade. After an on-scene size up of the situation, Rescue 3 members decided to use this tool to perform the very delicate and critical cutting operation, freed the boy’s hand, and avoided any amputation.
On July 1, 2005 at 1300 hours, Rescue 3 was dispatched to an almost identical situation, this time for a “man in machine” call at a butcher shop. While en route members of Rescue 3 began their size up and discussed possible scenarios they might face at the scene. Members assembled the tools and equipment the rescue company officer ordered them to utilize for this sort of entrapment.
Upon arrival, firefighters found a middle-aged male with his arm in the hopper of a commercial meat grinder. The patient’s fingers were protruding from the discharge side of the grinder. The first-arriving truck and engine companies secured power to the unit and began a physical assessment of the patient. Rescue 3 members verified that there was no power to the unit and conducted a quick on-scene size up of the situation. Emergency medical personnel conducted a medical triage of the patient. For this type of “man in machine” situation, paramedics are recommended if available. They can administer drugs for pain management and, if appropriate, begin to treat for crush injury syndrome. EMS personnel determined the patient was medically stable and the extrication should be accomplished at the scene.
Ensuring the patient is relaxed and calm is imperative before commencing this type of extrication. Rescue 3 personnel explained the steps of this operation so as to reassure the patient. EMS personnel also conducted a second physical assessment. The grinder was L-shaped, approximately 12 inches long, and there was a metal pan surrounding it. Removing the pan first allowed members to access the barrel of the grinder. This also allowed the patient to move into a more comfortable position for the duration of the incident.
Personnel used a stainless steel table located at the site the cutting platform and positioned it in an area with ample lighting. This area allowed enough room to conduct a safe operation. The necessary tools were staged in close proximity to the area of operation. With the help of Squad 61, another special operations unit assigned on the box, members assembled an identical backup for each of the tools they’d be using. If available, backup tools allow for immediate replacement if a tool breaks. Back p tools are also important for needed maintenance during operations. In these situations, if a tool needs a new blade or battery change during the operation, the tool operator can call for a replacement tool and complete the operation while the other tool is serviced. This is also critical when air tools are used since delays in operation are necessary to replace air cylinders.
At this incident, Rescue 3 members decided to initially use a deep cut band saw for the extrication. This tool has proven to be reliable for impalements and “man in machine” applications. It operates at variable speeds with very minimal vibration or heat generation. It allows for very precise and well-controlled cuts. The depth of cut is 4 3/4 inches, which might not be deep enough for all jobs. However, the necessary cuts for this operation were along the barrel of the grinder, essentially cutting the machine in two halves lengthwise. Limitations in the depth of cut with the band saw caused members to make four cuts, two on each side of the grinder, both at the hopper end and at the discharge end. These cuts measured approximately three inches long each.
To finalize the cuts, rescuers used a “Whizzer Saw.” The Whizzer Saw is a tool adopted from the automotive repair industry. The tool’s portability as well as its ability to make difficult and intricate cuts made it suitable for this application. The abrasive disk spins at more than 20,000 rpm, causing considerable friction heat. Whenever the material being cut is in contact with the victim’s skin a means of cooling the material must be provided such as a water extinguisher or a garden hose. The saw was connected to the tool side of the air source cart, ensuring an uninterrupted air supply to the tool through the entire cutting operation.
Rescue 3 members consulted EMS personnel prior to disassembling the grinder. EMS personnel prepared for any heavy bleeding or other medical issues that may have occurred once the patient was extricated from the grinder. Once the two halves of the machine were separated, it was easy to remove the shaft of the grinder by hand, thereby freeing the patient.
During the entire removal operation personnel took many steps to protect the patient. For example, EMS personnel monitored the victim’s vital signs and rescuers used wet sheets to protect the patient from the sparks the Whizzer Saw generated. The patient also had to be protected from the blades of the saw for his safety during cutting. Rescue 3’s “Man in Machine” kit contains various hand tools., but also improvised metal shims that, when placed between the patient and the machinery being cut, protect the patient from the blade of the tool and further injury when the blade completely cuts through the work.
When encountering a “man in machine” rescue, responders must realize this will be a labor and time intensive operation. If there are personnel at the establishment who are familiar with a particular piece of equipment, they may be able to assist with technical advice if necessary. A call can also be placed to the manufacturer for technical assistance if the machine is particularly complex. If an identical piece of machinery is available, one or two members can inspect it for possible solutions to potential problems. During any removal operation, talent, skill, ingenuity, and proficiency with your equipment will bring these very challenging operations to successful and safe conclusions.
George K. Healy is a 14-year veteran of the Fire Department of New York (FDNY), currently serving as a captain in Special Operations Command. He is a Fire Service Instructor 1. He has also served in ladder companies and Rescue 1.
