Rescue and Transportation
If you are faced with the problem of rescuing a person threatened by fire, explosive or
poisonous gases, or some other emergency, do not take action until you have had time to
determine the extent of the danger and your ability to cope with it. In a large number of
accidents the rescuer rushes in and becomes the second casualty. Do not take
unnecessary chances! Do not attempt any rescue that needlessly endangers your own life!
The Navy uses a wide variety of special protective equipment. It includes the oxygen
breathing apparatus; air-line masks; emergency escape breathing devices; protective (gas)
masks; proximity suit; tending lines; and detection devices.
Figure 11-1 - A-4 Oxygen Breathing Apparatus.
Oxygen Breathing Apparatus
The type A-4 Oxygen Breathing Apparatus (OBA) is a self-contained breathing apparatus
(Fig. 11-1) used throughout the Navy. It is particularly valuable for rescue purposes
because it enables the wearer to breathe independently of the outside atmosphere. It
produces its own oxygen and allows the wearer to enter compartments, voids, or tanks that
have a low oxygen content or that contain smoke, dust, or fire. The face-piece contains
the eyepiece, the speaking diaphragm, and the head straps. The breathing bag contains the
oxygen that is generated by the canister. One breathing tube transports the oxygen from
the breathing bag to the face-piece; the other transports the exhaled air back to the
canister. Both tubes are made of corrugated rubber. They control the flow and help cool
the air. The timer is located so that you can check the amount of time remaining. To set
the timer, turn the knob clockwise to 60 minutes, and then turn it counterclockwise to 30
minutes. By setting the timer to 60 first, you fully wind the alarm bell spring. When 30
minutes have expired, the warning bell will sound continuously for 10 or more seconds. All
OBA equipment and canisters must be stored in a cool, dry place. The life of an OBA will
be lengthened if it is stored under these conditions.
Figure 11-2 - Air-line Hose Mask Components.
The air-line mask (Fig. 11-2) is part of all ship's repair party locker allowance. Never
use the air-line mask to fight fires. It may be used to enter smoke-filled spaces to
rescue personnel. The air-line mask is a demand-flow, air-line respirator with a speaking
diaphragm, monocular lens with adjustable head harness, breathing tube, and belt-mounted
demand regulator with male and female (buddy) quick-disconnect fittings. A 25-foot length
of hose with male and female quick-disconnect fittings is provided for use with the
air-line mask. This hose can be used to connect to the demand regulator fitting and a
low-pressure air supply, or to a compressed air cylinder with an intervening air regulator
and air filter. The maximum length of hose that may be used with the air-line mask is 250
Tending lines (Fig. 11-3) are used as a precautionary measure to help rescue an
individual who is wearing an oxygen breathing apparatus, air-line mask, or similar
equipment. A 50-foot nylon covered, steel wire tending line is used aboard ship. The
tending line has a stout hook on each end that is closed with a snap catch. The line is
pliable and can slide freely around obstructions.
Figure 11-3 - Tending Lines.
If necessary, the rescue should be accomplished by having another person equipped with
a breathing apparatus follow the tending line to the person to be rescued. Do not drag
the casualty out by the tending line. If the rescue is to take place promptly, someone
must be equipped with an OBA that is ready for immediate use and must be standing by ready
for immediate entry. The tender should wear rubber gloves and shoes when handling steel
tending lines and cables. The OBA wearer and the line tender should both know and use the
following system of line signals.
The OATH code is as follows:
Take Up Slack
Atmosphere Testing Devices
All closed or poorly ventilated compartments, particularly those in which a fire has
just occurred, are potentially dangerous. The atmosphere may lack oxygen, contain
poisonous gases, or present fire and explosion hazards.
Aboard naval ships, no person may enter any closed compartment or poorly ventilated
space unless the ship's gas-free engineer, or his or her authorized representative, has
tested the space and declared that it is safe to enter.
If you are faced with the problem of rescuing an individual threatened by fire,
explosive or poisonous gases, or some other emergency, do not take any action until you
have had time to determine the extent of the danger and your ability to cope with it. In a
large number of cases, the rescuer rushes in and becomes the second casualty.
Do not take any unnecessary chances! Do not attempt any rescue that needlessly
endangers your own life!
Phases of Rescue Operations
When there are multiple casualties (explosions or ship collisions), rescue operations
should be performed in phases. These phases apply only to extrication operations. The
first phase is to remove lightly pinned casualties, such as those who can be freed by
lifting boxes or removing a small amount of debris. In the second phase, remove those
casualties who are trapped in more difficult circumstances but who can be rescued by the
use of the equipment at hand and in a minimum amount of time. In the third phase, remove
casualties where extrication is extremely difficult and time consuming. This type may
possibly involve cutting through decks, or removing large amounts of debris. An example
would be rescuing a worker from beneath a large, heavy piece of machinery. The last phase
is the removal of the dead.
Stages of Extrication
The first stage of extrication within the rescue phases outlined above is gaining
access to the casualty. Much will depend on the location of the accident, damage at the
accident site, and the position of the casualty.
The second stage involves giving lifesaving (emergency care) first aid.
The third stage is disentanglement. The careful removal of debris from the casualty.
The fourth stage is preparing the casualty for removal.
The final stage is removing the casualty from the trapped area and transporting to an
ambulance or medical facility.
Rescue from Fire
If you must go to the aid of a casualty whose clothing is on fire, try to smother the
flames by wrapping the casualty in a coat, or blanket. Leave the head uncovered.
Beat out the flames around the head and shoulders, then work downward toward the feet. If
you have no material with which to smother the fire, roll the casualty over slowly
and beat out the flames with your hands. If the casualty sits or stands, they may be
killed instantly by inhaling flames or hot air. Inhaling flames or hot air can kill
you! Do not place your face directly over the flames. Turn your face away from the flames
when you inhale!
Always use an oxygen breathing apparatus or other protective breathing equipment when
you enter a burning compartment.
Rescue from Steam-filled Spaces
It is sometimes possible to rescue a casualty from a space in which there is a steam
line. Since steam rises, escape upward may not be possible. If the normal exit is blocked
by escaping steam, move the casualty to the escape trunk, or to the lowest level in the
compartment. Equipment that offers protection against fire does not protect against
Rescue from Electrical Contact
Rescuing a casualty who has received an electrical shock can be difficult and
dangerous.You must not touch the casualty's body, the wire, or any object that may be
Look for the switch and turn the power off immediately. Do not waste time hunting for
the switch, every second is important. If you cannot find the switch, try to remove the
wire from the casualty or the casualty from the wire. Use a dry broom handle, branch,
pole, oar, board, or similar non-conducting object. An old favorite is to remove the
casualty from an electrical contact using the uniform belt. Be careful, the belt was made
of cotton, but is now made of nylon and other conductive material. When you are trying to
break an electrical contact, always stand on some non-conducting material. The old drop
kick method is extremely dangerous and not recommended.
Rescue from Unventilated Compartments
Rescuing a casualty from a void, double bottom, gasoline or oil tank, or any closed
compartment or unventilated space is a hazardous procedure. Aboard naval vessels and at
naval shore activities, no person is permitted to enter any such space or compartment
until a gas-free engineer, or his or her authorized representative, has tested the space
and declared it safe to enter.
Rescue from Water
Never attempt to swim to the casualty unless you have been trained in water rescue
techniques, and then only if there is no safer way of reaching the casualty. If you do not
have the skills, or if the conditions do not warrant rescue by swimming, you should note
the exact location (time and any landmarks), and seek help immediately. Many double
drownings occur when individuals untrained in water rescue techniques attempt swimming
The casualty may panic and fight you so violently that you will be unable either to
rescue the casualty or to save yourself. Even if you are not trained in water rescue
techniques, you can rescue the casualty by holding out a pole, oar, or branch for the
casualty to grab hold of, throwing a lifeline, or a buoyant object such as a life
preserver. Various methods are used aboard ship to pick up survivors in the water. The
method used will depend upon the weather conditions, the type of equipment available
aboard the rescue vessel, the number of personnel available for the rescue operation, and
the physical condition of the casualty. Most rescue operations aboard ship use motor
whaleboats (life boats) or helicopters.
In an emergency, there are many ways to move a casualty to safety, ranging from
one-person carries to stretchers. The casualty's condition and the immediacy of danger
will dictate the appropriate method, but remember to give all necessary first aid before
moving the casualty. At times it will be necessary to move the casualty immediately,
without regard to the severity of the injuries. Remember, when you move a casualty, you
are taking a calculated risk. You may cause further injury or even death!
You are justified in taking such a risk only when it is evident that the casualty will
die if not moved.
1. Whenever possible, render first aid before transporting the casualty. Reduce
the casualty's pain and make them as comfortable as possible.
2. Use a regular stretcher, with enough people to carry it, so that you will not drop
3. Whenever possible, take the stretcher to the casualty, instead of carrying the
casualty to the stretcher.
4. Fasten the casualty to the stretcher so that they don't slip, slide, or fall off.
5. Use blankets, clothing, or other material to pad the stretcher and protect the
casualty from exposure.
6. Casualties should be lying on their back while being moved. However, in some case,
the type or location of the injury will necessitate the use of another position. In all
cases, it is important to place the casualty in a position that will best protect them
from further injury.
7. Always move the casualty feet first so the rear bearer can watch for signs of
8. Always give a complete account of the situation before giving the casualty to other
personnel. Include what caused the injury and what first aid procedures have been
completed. Also, get the name of the casualty and the person whom you are turning them
over to. This is one way of protecting yourself and at the same time ensuring that the
patient will be in good hands.
Figure 11-4 - Neil Robertson Stretcher.
Neil Robertson Stretcher
The Neil Robertson stretcher (Fig. 11-4) is specially designed to remove a casualty
from engineering spaces, holds, vertical trunks, and other compartments where hatches or
ladders are too small to use other stretchers. It is made of semi-rigid canvas with wooden
slats sewn the length of the stretcher. When firmly wrapped around the casualty in a mummy
fashion, it provides sufficient support for the casualty to be lifted vertically. A
12-foot length of handling line is spliced on the O-ring at each end to prevent the
casualty from swaying against bulkheads while being lifted. Figures 11-5 through 11-10
provide instructions on its proper application. Secure the outer chest straps over the
victim's chest and under his arms. Secure the arms to the side by placing the middle chest
strap over the upper arms and chest.
Figure 11-5 - Neil Robertson Stretcher. Arrange the stretcher as depicted.
Figure 11-6 - Neil Robertson Stretcher. Remove the hood.
Figure 11-7 - Neil-Robertson Stretcher. Place the hood on the victim. This is easier
than trying to place the victim in the hood while it is still attached to the stretcher.
Figure 11-8 - Neil-Robertson Stretcher. Three persons should pick up the victim as
depicted. A fourth person should be available to slide the stretcher under the victim. In
placing the victim in the stretcher, ensure that the shoulders line up with the arm holes
and chest flaps.
Figure 11-9 - Neil-Robertson Stretcher. Place the victim on the stretcher. If the
victim is a short person, make sure that his or her armpits are even with the cut-out
section of the flap. This will place the casualty in the correct position in the stretcher
and prevent them from slipping out. Secure the hood to the stretcher. Place the chest
flaps over the patient's chest and under the arms.
Figure 11-10 - Neil Robertson Stretcher. Fold the leg flaps in place over the
victim's legs. If the victim is positioned correctly the hands will be under the leg flap
and against the thigh. Secure the leg straps.
Miller (Full Body) Board
The Miller Board is constructed of an outer plastic shell with an injected foam core of
polyurethane foam. It is impervious to chemicals and the elements and can be used in
virtually every confined space rescue and vertical extrication. The casualty can be turned
vertically and laterally with no movement, and the board's narrow design allows passage
through hatches and crowded passageways. It fits within a Stokes (basket) stretcher and
will float a 250-pound person. The Miller Board will eventually replace the Neil Robertson
Figure 11-11 - Stokes Stretcher
The most commonly used stretcher for transporting the sick and injured is called the
(Fig. 11-11) Stokes (basket) stretcher. It is essentially a wire basket supported by iron
rods. A new version is made of molded plastic. It is adaptable to a variety of uses, since
the casualty can be held securely in place even if the stretcher is tipped or turned. It
can be used with floatation devices to rescue casualties from the water. The Stokes should
be padded with three blankets: two should be placed lengthwise, so that one will be under
each of the casualty's legs, and the third should be folded in half and placed in the
upper part to protect the head and shoulders. The casualty should be lowered gently into
the stretcher and made as comfortable as possible. Cover the casualty with one or more
blankets. Fasten the casualty and blanket with the straps provided over the chest, hips,
thigh, and lower legs.
Do not place the straps over the knees or areas of suspected broken bones!
Army (Pole) Litter
The Army litter (Fig. 11-12) is collapsible, made of canvas, and supported by wooden or
aluminum poles. They are used aboard ship only for mass casualty situations and are not to
be used for transporting casualties throughout the ship.
Figure 11-12 - Army Litter
Standard stretchers should be used whenever possible to transport casualties. If none
are available, it may be necessary for you to improvise. Sometimes a blanket may be used
as a stretcher. The casualty is placed in the middle of the blanket on his or her back.
Four people kneel (Fig. 11-13) on each side and roll the edges of the blanket toward the
casualty. Stretchers may also be improvised (Fig. 11-14) by using two long poles (approx.
7 feet long) and a blanket. Most improvised stretchers do not give sufficient support
in cases where there are fractures or extensive wounds of the body!
Figure 11-13 - Blanket used as improvised transport stretcher.
Figure 11-14 - Stretcher made from poles and a blanket.
The Fireman's Carry (Fig. 11-15) is one of the easiest ways to carry an unconscious
1 .Place the casualty face down. Face the casualty, and kneel on one knee at the
casualty's head. Pass your hands under the armpits; then slide your hands down the sides
and grasp them across the back.
2. Raise the casualty to his knees. Take a better hold across the casualty's back.
3. Raise the casualty to a standing position and place your right leg between the
casualty's legs. Grasp the right wrist in your left hand and swing the arm around the back
of your neck and down your left shoulder.
4. Stoop quickly and pull the casualty across your shoulders and, at the same time, put
your right arm between the casualty's legs.
5. Grasp the casualty's right wrist with your right hand and straighten up. The
procedure for lowering the casualty to the deck is also illustrated. Do not attempt if
the casualty has an injured arm, leg, ribs, neck, or back!
Figure 11-15 - Fireman's Carry
Figure 11-16 - Tied Hands Crawl
The tied-hands crawl (Fig. 11-16), may be used to drag an unconscious casualty for a
short distance. It is particularly useful when you must crawl underneath a low structure,
but it is the least desirable because the casualty's head is not supported.
1. Place the casualty face up. Cross the casualty's wrists and tie them together.
2. Kneel astride the casualty and lift the arms over your head so that the casualty's
wrists are at the back of your neck.
3. When you crawl forward, raise your shoulders high enough so that the casualty's head
will not bump against the deck.
The blanket drag (Fig. 11-17), can be used to move a casualty who, due to the
seriousness of the injury, should not be lifted or carried by one person alone.
1. Place the casualty face up on a blanket, and pull the blanket along the deck.
2. Always pull the casualty head first, with the head and shoulders slightly raised, so
that the head will not bump against the deck.
Figure 11-17 - Blanket Drag
The pack-strap carry (Fig. 11-18), can be used to move a heavy casualty for some
1. Place the casualty face up.
2. Lie down on your side along the casualty's uninjured or less injured side. Your
shoulder should be next to the casualty's armpit.
3. Pull the casualty's far leg over your own, holding it there if necessary.
4. Grasp the casualty's far arm at the wrist and bring it over your upper shoulder as
you roll and pull the casualty onto your back.
5. Rise up on your knees, using your free arm for balance and support. Hold both of the
casualty's wrists close against your chest with your other hand.
6. Lean forward as you rise to your feet, and keep both of your shoulders under the
Do not attempt if the casualty has an injured arm, ribs, neck, or back!
Figure 11-18 - Pack-Strap Carry
The chair carry (Fig. 11-19), can be used to move a casualty away from a position of
danger. The casualty is seated on a chair and the chair is carried by two people. This is
a good method to use when you must carry a casualty up or down steps or through narrow,
Do not attempt if the casualty has an injured neck, back, or pelvis!
Figure 11-19 - Chair Carry
Figure 11-20 - One-Person Arm Carry
There are several kinds of arm carries that can be used in emergency situations to move
a casualty to safety. The one-person arm carry (Fig. 11-20), should not be used to carry a
casualty who is seriously injured. Unless the casualty is considerably smaller than you,
you will not be able to carry the casualty very far. The two-person carry (Fig. 11-21),
unless absolutely necessary, should not be used to carry a casualty who is seriously
injured. An alternate two-person carry (Fig. 11-22) also can be used.
1. Two rescuers kneel beside the casualty at the level of the hips, and carefully raise
them to a sitting position.
2. Each rescuer puts one arm under the casualty's thighs; hands are clasped and arms
3. Both rescuers rise slowly to a standing position.
Do not attempt if the casualty is seriously injured!
Figure 11-21 - Two-Person Carry by Arms and Legs
Figure 11-22 - Two-Person Arm Carry
1. NAVEDTRA 10669-C, Hospital Corpsman 3 & 2
2. NAVEDTRA 10572, Damage Controlman 3 & 2
Department of the Navy
Bureau of Medicine and Surgery
2300 E Street, NW
Washington, DC 20372-5300
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Operational Medicine 2001
Health Care in Military Settings
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Health Care in Military Settings
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January 1, 2001
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