By Quintin Pavel
The vast majority of fire departments have light commercial structures in their coverage area. Though not frequently present in more rural areas, multi-tiered flat roofs are sometimes present on certain structures. Why are these structures more important than a typical 1,500-square-foot ranch, you might ask? Although commercial industry buildings may present more hazards in terms of fire spread, fire attack, and search and rescue, those are not the only reasons we need particular tactics to mitigate emergencies in this type of building. The ladder hinge rescue method is not a new, groundbreaking method that is flashy and fancy. In fact, it uses basic skills we all learned in fire academy: safely lifting and lowering a ground ladder and basic knot tying knowledge.
- Primary Tools for Primary Search
- Pressler: Portable Ladders
- Civilian Rescue: Removing the Occupant
- Smells and Bells: HVAC Rooftop Units and Belts
Let’s Look at Policies
Consider your department’s existing above-grade rescue tactics. Are they as simple as: “Go find your victim and bring them back down the stairs”? Maybe it is a blend of tactics involving an aerial apparatus, stokes basket, and webbing. In any case, removing a victim from a non-IDLH environment (when time is on our side) is not necessarily a one-size-fits-all situation. As we progress further into our fire service careers, we begin to realize that we have more time to perform our tasks than we initially thought when we signed up. Recall the first time you responded to a call for service, how quickly you moved and how fast you drove, only to realize the haste you exhibited was not nearly as beneficial to you as you initially thought it would be. The same applies to situations where we have a stable victim who simply needs removal from a precarious position that is not easily accessible by our standard tactics. The ladder hinge is an outstanding option to safely remove a victim from an elevated area with minimal access when we as firefighters have time to set the method up. As long as you have the space to raise and lower a ladder completely to the ground, you can perform the ladder hinge.
Let’s examine the following call for service. You are dispatched to a large commercial supermarket for a report of a heating and ventilation worker who has sustained a broken leg while working on the roof of the building. Your truck company responds to this and arrives on scene to find that the trades worker has sustained his injury on the roof of a heating unit in the middle of the supermarket roof. This heating unit is well out of the range of your aerial ladder and not accessible from the ground immediately around the building.
Had the worker become injured and immobile on the main roof surface of the supermarket, it’s would be a simple above-grade rescue via the aerial ladder. Crews can simply make the roof, package the victim into a stokes basket, manually move the person to the edge of the building, and bring him or her down the aerial ladder. However, the victim being immobilized on the roof of an HVAC unit makes the situation more challenging. The ladder hinge method can be used to bring the worker down to the main roof deck, and then moved to the edge of the building via stokes basket for extrication down an aerial ladder.
Setting up the ladder hinge is not complicated, nor is it something requiring specialized knowledge of ropes and ladders. Remember our fire academie days, where we rehearsed figure eight knots and bowline knots ad nauseum, and recall the reps and sets of lowering and raising ladders. In addition to the simplicity of skills, the ladder hinge method does not require an abundance of manpower or specialized equipment and can be completed with a standard, four firefighter truck crew.
The following is a list of equipment needed to effectively perform the ladder hinge tactic:
- One appropriately sized ground ladder
- Two sections of webbing
- One 100-foot section of rope
- Two load-rated locking carabiners
- One stokes basket
- Four firefighters
Examining the Equipment Needed
For any above-grade rescue, whether inside or outside of an IDLH environment, a ladder is obviously needed. A straight ladder or extension ladder can be used to implement the ladder hinge method of rescue. The limiting factor here is selecting a ladder that allows for one or two (preferably two) rungs to be above the leading edge of your rescue “floor.” This can mean a windowsill, parapet wall top, the edge of roof, or even the edge of a mezzanine. As long as the ladder you will be using extends past that surface by at minimum of one ladder rung, you will be able to use that ladder to perform the rescue. As with extending any ladder, ensure that the ladder dogs are locked in place, and that the halyard is secured via clove hitch so as to prevent the ladder fly from coming unsecured and crashing back to its bedded position.
In addition to the appropriately sized ladder, the appropriate webbing, rope, and carabiners must be employed as well. For training purposes, using utility rope is acceptable. However, during actual above-grade rescues using the ladder hinge method, rated life safety rope must be used. The correctly sized and rated webbing and carabiners also must be used. Take some time to examine the equipment your fire department uses and determine the feasibility of employing it should you choose to implement the ladder hinge method into your tactics. In addition to this, examine your department’s standard operating procedures (SOPs) when it comes to above-grade rescues, and review your department’s rules of engagement.
Every ladder truck in my department and the vast majority of truck companies in my area are outfitted with a stokes basket. Due to the infrequency of above- and below-grade, rescues they are mostly used for rapid intervention team operations. However, they are necessary for successful removal of a victim from an above-grade position using the ladder hinge method. Stokes baskets are all relatively built the same way and are essentially an off-road stretcher that gets carried by hand by rescuers. Although generally the same, you will see differences in the structural portion of the stokes basket. Some are entirely plastic whereas others have metal structural components with plastic patient areas. Others are entirely made of metal, with a metal mesh area for the patient to lay in. Regardless of your stokes basket construction, any of them can be used with this method. In this tactic, the ladder and rope will be doing all the heavy lifting and hoisting.
Lastly, and as always when a tactic is being employed, we need competent firefighters to complete the task. For the ladder hinge method to be successful, you will need at least three firefighters, however four firefighters are recommended for ease of use, safety, and communication. With three firefighters, the tactic requires one ladder firefighter, one rope control firefighter, and one stokes basket firefighter. When four firefighters are available, the above three positions are filled while the fourth firefighter assists the ladder firefighter with lowering the ground ladder back down.
Setting up for Success
Let’s return to the aforementioned rescue scenario. To begin setting up the ladder hinge rescue method, move all your equipment to the work area. The most efficient way to do this is to package all your rope, webbing, carabiners, and hand tools into the stokes basket while two firefighters carry that to the scene. This process frees the other two firefighters involved with the rescue to move the ladder to the rescue area and begin setting that up.
To begin, quantify the length of the ladder throw you will need to successfully gain access to the victim. Remember, having one or two rungs above the surface the victim is positioned on is ideal. Understand as well that the distance to the deck will factor into the length of the webbing you need to secure the stokes basket to the ladder. Anything more than two or three feet should be examined for feasibility and safety. The length of the webbing in the above photo is approximately 18 inches once the webbing has been looped (36 inches of webbing tied with a water knot for an 18-inch loop). Once the ladder’s raise length has been determined and before lowering the ladder to the ground, have the rope control firefighter (carrying the rope) make their way to the victim, if they haven’t been able to gain access to them via another way. Now the ladder can be lowered to prepare it for connection of the stokes basket and associated rope and webbing connections.
While this is taking place, the rope control firefighter can do a patient assessment (recall our scenario is using an injured trades worker with a broken leg) and provide any immediate interventions to stabilize the patient before packaging into the stokes basket for lowering. Having this firefighter make contact with the victim while other portions of the rescue is being set up allows the firefighter to provide patient assessment and any immediate lifesaving interventions prior to moving the victim. Once the member has made it to the area of the victim, the rope control firefighter can lower the working end of the rope to the ground firefighters who have prepared and secured the stokes basket to the ladder (below).
Once the setup has been completed on the ground, the ladder firefighters can set up to lift the ladder into position while the rope control firefighter begins to pull the rope towards them, bringing the stokes basket with it. This is the first half of the ladder hinge, as it begins to get the stokes basket to the victim for packageing and removal. In this portion, you are essentially transporting the stokes basket from the ground, to the patient area. The ladder raise is no different than any other raise of a ladder into position. The only minor adjustment to be made is the timing of the raise as the rope control firefighter is raising the stokes basket while the ladder is being raised (below). During this portion of the rescue, since there is no patient in the stokes basket, the maneuver is simply based upon speed and safety to get the stokes to the patient. In contrast, when the patient is being lowered in the stokes basket, care needs to be taken to maintain the patient’s head above their feet as the stokes basket is lowered. Once the ladder has been raised and the stokes basket pulled up to the victim area, adjustments may need to be made to the stokes: you may need to move the webbing, securing the stokes to the ladder up or down rungs, depending on the building height and positioning on the building.
Once the ladder is fully raised and the stokes basket is in place, the victim can be packaged and placed into the stokes basket to prepare for lowering from the elevated surface. When the victim has been secured to the stokes basket, the second firefighter in the above grade area can begin to communicate to the ground ladder firefighter that members are ready to lower the stokes basket. When securing the patient to the stokes basket, take extra care with any injuries that need to attended to prior to moving the patient. Injuries such as broken limbs or penetrating trauma will need to be secured and stabilized prior to moving the victim. In addition to stabalizing any injuries to the patient, take care to keep the victim secured to the stokes basket during the rescue. This can be accomplished using diamond lashing with rope, the manufacturers straps that are included and secured to the stokes basket, or aftermarket “spider” straps that secure the patient to the stokes basket’s structural members. The end goal of securing the patient into the stokes basket is to maintain stability of the stokes (by preventing the patient from moving around) as well as maintain care for the patient’s existing injuries (such as a broken limb or penetrating wound)
The ground ladder firefighter remains the primary pace setter for the lowering portion of the tactic. As the ground ladder firefighter lowers the ladder, pay special attention to keeping the victim’s head higher than his or her feet during the descent. Through communication with the rope control firefighter and the ground ladder firefighter, the second elevated firefighter can safely control the speed of decent to match the ground ladder firefighter’s pace.
Simple friction control devices can be used to aid the rope control firefighter’s ability to lower the stokes basket. A very common method is to use a standard ladder belt, with two round turns of rope to create a friction device that furthers the rope control firefighter’s ability to maintain smooth decent of the stokes basket. Commercially available products can be purchased to replace a ladder belt for this method. If no ladder belt is available, a standard body/hip belay can be used to safely lower the rope. Be sure to examine and understand your department’s SOPs and guidelines before training on our using the ladder hinge method at your next rescue.
Simply an Extension of Established Tactics
The ladder hinge method is something that can be put in a truck company’s toolbox for consideration during unique rescue sitations. Although not overally complicated, like anything else in the fire service this technique requires communication, a clear leader, and execution of each part to successfully be used. Admittedly, the ladder hinge method is a tactic that is beginning to creep into technical rescue team territory. However, the equipment being used to perform the tactic is not specialized or limited to technical rescue operstions, and is widely used and available at departments nationwide. The ropes, webbing, carabiners, and stokes baskets are in the cabinets of countless truck companies’ aerial apparatus even now.
Understand your departmental SOPs and recognize when a rescue is beyond of the capabilities of your truck company. Be ready to get more specialized resources involved before attempting to employ the ladder hinge tactic. Having a firm understanding of your equipment capabilities is doubly important. If you know your truck company only carries utility rope, this method is not practical until a more suitable rope is obtained (life safety rope). As mentioned above, particular incidents require an outside-the-box approach to successful mitigation. Know when proven tactics are the best option and when to dig into your toolbox of knowledge and training. Adding more training and more tactics like the ladder hinge into your toolbox simply increasese your chances for a successful rescue mitigation. Balancing your toolbox knowledge with adherence to your department’s SOPs and limitations requires constant evaluation and refining of your skills. Consider the ladder hinge rescue the next time someone is fishing for training ideas or wants to get some sets and reps in with ropes, knots, and ladders.
Quintin Pavel is a six-year veteran of the fire service and currently serves as a firefighter in the suburban metro Detroit area. He holds a Michigan residential builders license and has a degree in mechanical engineering from Central Michigan University.
