By JIM BONELLI
On March 8, 2008, the Passaic (NJ) Fire Department was in the process of handling a severe storm with periods of high winds and heavy rain. At approximately 1900 hours, the 911 dispatch center lit up, reporting everything from downed utility lines to roofs blown off buildings. Nearly 40 911 calls were received in an hour and a half; one of those calls was from the local hospital.
At 2039 hours, the 911 dispatch center received a call for persons stuck in the elevator. Ladder 2 and Engine 3 were dispatched. While en route, the units were asked to expedite because hospital staff was reporting a coded patient in full cardiac arrest in the elevator.
On arrival, fire department members were met by hospital staff and directed to the third-floor intensive care unit (ICU). The area’s only access was through the emergency room (ER) to a rear stairwell. Once units arrived on the third floor, hospital staff informed crews that four hospital staff (two nurses, one doctor, and one security guard) and one critical care patient were in the elevator.
THE SCENE
The ER elevator is a dedicated car, running from the first-floor ER to the third-floor ICU with no second-floor stop. There are no adjoining cars or shafts.
The elevator car is three-sided with only one operating door. The car is cable driven; the motor room was in the basement.
The patient entered the ER and was being treated for a cardiac problem. Once the patient was stabilized, the decision was made to relocate to the ICU using the elevator, which stalled between the first and third floors. While trapped in the stalled elevator car, the patient went into cardiac arrest. Hospital staff stabilized the patient with CPR.
A maintenance supervisor was assigned to support fire department personnel, and an elevator repair company was requested to expedite response to the scene.
THE RESCUE
On arrival on the third floor, members used an elevator door key to open the third-floor shaft door to determine the car’s position; the elevator’s top was visible between the second and third floors. A team was sent to the basement and unsuccessfully tried to reset the car’s motor. At this point, the elevator was locked out and tagged out. Power was disconnected, and a firefighter was assigned to guard the switch. Members climbed on top of the car and removed the emergency access hatch. They made visual contact with the trapped occupants. The original plan was to remove the occupants through the escape hatch, but the patient weighed more than 300 pounds and was in no condition to be moved in this manner. Medical supplies were lowered into the car to sustain the patient. A smoke ejector was placed into the shaft to help relieve some built-up heat and supply fresh air.
Rescuers briefly discussed options; breaching the shaft seemed like the only viable option. The Passaic Fire Department units needed additional breaching tools for this operation and requested a USAR team from the Paterson (NJ) Fire Department (a fully staffed unit serving as a rescue/USAR). While the USAR team responded, ladder company members were sent to the second floor, just below the third-floor lobby. Members reported a small bathroom approximately 8 × 16 feet. An exploratory hole was made into the shaft just above the second-floor ceiling (photo 1). The hole could be seen from the third floor; it was perfectly lined up with the elevator door. The order was given to continue opening up.
 1. Photos courtesy of the Passaic (NJ) Fire Department. |
When the Paterson Fire Department’s USAR team arrived, all necessary equipment was brought to the second floor. Bathroom dividers were removed to enlarge the working area. Tiled wall and gypsum board were removed. Metal studs were cut with a battery-operated hydraulic tool. Once removed, this exposed the protective sheet metal in the shaft (photo 2). This metal was cut with a nonspark electric circular saw.
 2. |
Once the area was secured, the mechanical safety door lock on the elevator car was released, and the elevator doors were opened (photo 3). A portable folding ladder was used to access the car, which was still about four feet off the floor level. Four hospital staff members were removed to allow for patient access. The patient was removed from the bed, placed onto a backboard, and secured. Members lowered the patient by sliding the backboard down the ladder to awaiting crews. The patient was immediately removed from the area and handed over to awaiting medical staff.
 3. |
Special considerations
- The patient’s location and condition were our greatest concerns. Time was of the utmost importance.
- Because of the oxygen use inside the car, any ignition source was closely monitored.
- Motor room power was secured early as part of the lock out/tag out procedure. The motor room location below the car was a concern. Open grating was the only separation from the shaft. Any smoke generated from the motor or electrical components released into the shaft would have endangered the occupants.
- All equipment brought into the hospital was kept to a minimum so as not to disrupt the operations inside the ER.
- Working in the hospital environment adds to the concerns because of patient care, the gases being used, and sanitary conditions.
- Family members were nearby. Security and police kept family at a safe distance so they would not disrupt the rescue operation. Interior crowd control was critical because of the open shaft.
- Hospital staff was kept close to the operation. Moving about the building could not have been done as quickly without their knowledge.
The time from the decision to breach the shaft to the patient’s removal was 45 minutes. Although the operation was successful, the patient died the following day.
Lessons Learned
- Identify exactly where the elevator is stuck.
- Properly position personnel (above and below the car and in the elevator control room) using communication.
- Be familiar with the components and operation of the specific elevators.
- Establish a proper equipment pool (flashlights, large flathead screwdriver, hydraulic forcible entry tool, collapsible ladder, pipe wrench, halligan).
- Always start rescue operations by shutting off power and then reenergizing to “reset” the elevator. If that doesn’t work, you may have to move the elevator.
- Moving a hydraulic elevator is quite easy; electric cable elevators take considerably more elevator knowledge.
- When breaching walls to gain access (as done in this rescue), be extremely careful of electrical wires running through the walls of the chase.
- Control and communicate all elevator movement.
- When removing victims from elevators between floors, always have victims climb out of the elevator, as opposed to dropping down out of it, because of the potential for falling down the exposed shaft.
JIM BONELLI, a 30-year fire service veteran, has spent 17 years with the Passaic (NJ) Fire Department, where he is a captain of a ladder company. He has taught at FDIC.
