A Stokes basket is a metal wire (or plastic) litter used by First Responders in difficult terrain.
Originally designed by Charles Francis Stokes, a Navy Surgeon General in the early 20th century, these baskets have been updated to keep pace with our changing requirements. Once used primarily in mountainous areas with transport occurring on the backs of donkeys and horses, the appearance of helicopters on the historical scene expanded the ways in which rescues could be conducted.
After the person’s immediate first aid needs are tended to, he/she is fastened into the litter, and then the litter can be moved. In my own case, I had a ski accident that included a deeply lacerated arm. I was dripping blood onto the snow, but since I didn’t ordinarily need poles to ski, I thought I could ski down the rest of the mountain to the First Aid Station on my own, holding the injured arm in front of me.
Wiser heads than mine prevailed. The mountain rescue team wrapped my arm, lowered me into a Stokes basket, and strapped me in. I was towed about a half mile across a mogul field by a pair of guys from the Ski Patrol. It was a bumpy ride over that mogul field, but there was no other way to get me down to the waiting ambulance.
I was towed behind skis, but snowmobiles, horses, and ATVs have all been employed to get the injured through the woods or hill country.
With specially attached ropes and in limited situations, people can be also be lifted to safety by helicopter. Natural disasters sometimes cut people off from ground transportation, so people have been airlifted out of wildfires or flooded areas without the helicopter ever having to set down. Somebody on the ground helps the injured person get into the basket, attaches it to the pulley system, and then the helicopter takes them to safety. The photo shows the same Stokes basket (with demo dummy) and the single rope leading to the tie-down spot.
The view of the underside of the six-foot Stokes basket reveals the mesh insert that keeps the patient’s limbs from falling through the open steel frame. In addition, the dark blue insert provides some comfort and support to the upper body.
Stokes baskets are also used to rescue victims from confined spaces, like caves or collapsed buildings. I recently discovered that some baskets used in surface water rescue have floats attached. If used in mountain rescue, the litters might come with a lid/cover to either protect the person from falling rocks or keep the patient from falling out, should it tip.
Design improvements have included using multiple attachment points, separate hold-down cables, and powered extension hoists. The multiple attachment points can prevent the basket from spinning while being transported by helicopter. Powered hoists can be valuable during steep terrain rescues and/or if there is not enough manpower onsite to do the heavy lifting. The U.S. Navy has used the Stokes basket to transport patients through narrow corridors and doorways.
The close-up shot of the ‘bear claw’ shows the holes at the bottom through which the carabiners and ropes are attached; the other ends secured at the Stokes basket. The ropes attached to the vehicle that supplies the lifting power are secured at the top of the ‘bear claw.’
On the right: the rope is wound through the brake bar rack to more securely anchor the rope to the vehicle. Less slippage occurs with its use.
Ropes come in different strengths for different needs, so the ropes are different colors to keep it simple for the rescuers. Because of the incredible demands placed on the ropes (weight, tension, water, scorching heat, and freezing cold) the ropes need to be tested for soundness on a regular basis. Too much weight at any given time can compromise the integrity of the rope, but even with normal wear and tear, they are replaced every few years.
Life expectancy of the ropes seen in the photos is about seven years. Somebody’s life depends on that rope not snapping, but even at a cost of about $15.00 per foot, fire departments try to budget for replacement at about the five year point.
The type of rescue involving a Stokes basket/lifting with ropes is a low frequency, but high risk operation.
On land, firefighters are frequently called upon to handle rescues of this type. At sea, this job falls to the Coast Guard. They have the trucks/helicopters, equipment, and training to ensure the happy ending to an otherwise awful tragedy.
Taken by Patti Phillips during a Writers’ Police Academy demonstration in Wisconsin.
(WARNING: Some photos may be upsetting to some people.)
Last month, Sheila and I had a chance to attend a simulation with law enforcement, firefighters, EMS professionals, and students in action at a multi-casualty accident scene. We saw how their skills are tested when a drunk driver runs a traffic light and smashes into a yard sale, killing and maiming several people.
How do the EMS, firefighters, and police learn to work together to handle the horrific scene? They practice, in demonstrations just like this one.
Typically, an onlooker at an accident calls 911, gives whatever details are available – location of the accident, number of people injured, whether or not there is more than one car involved. Rarely are the callers calm and collected, but the dispatcher has to keep his/her cool, no matter how bad it sounds. The information is passed on to the agencies that can help and usually, the closest one to the accident site responds.
The First Responder assesses the accident, notifies Dispatch as to what other help may be needed, and establishes a perimeter. In this scenario, the First Responder was a deputy from the Sheriff’s Department.
He took a look at the scene, called for backup, made some decisions, checked to see who was still alive, and helped those he could while he waited.
Fire and Rescue arrived at the scene next.
The driver of the car did not appear to be injured, was not pinned inside, and no gasoline was leaking from anywhere, but the Firefighters were needed to lift the car off two victims who were trapped underneath it. One was ‘dead,’ but one was still alive.
The Firefighters used a Hurst Spreader (commonly known as the ‘jaws of life’) in addition to assorted chocks and lumber in order to stabilize the car before pulling the victims free.
Standard procedure indicates that after the initial assessment and after additional help has arrived, law enforcement takes care of the driver issues and rescue takes care of the victims. Law enforcement continues to help where needed.
A Breathalyzer test was administered to the driver, since the road was not wet, and there was no other apparent reason for him to plow into a front yard full of people. Witness statements were taken from those involved at the scene. Onlookers were kept at a safe distance throughout the simulation.
The ambulances arrived and EMS workers evaluated the injured people.
While cries of “Please help us,” and “She needs help,” were heard continuously in the background, one of the EMS workers assigned black, red and yellow tags to the victims.
Yellow tag: broken bones, but alert
Red tag: will die if not treated immediately, still breathing on own
Black tag: not breathing
After the car was elevated, the person underneath was pulled out, strapped onto a stretcher, then transported to the hospital.
EMS workers enlisted the aid of lightly injured victims and urged them to talk to the more seriously hurt. Keeping the injured awake and alert was an important part of assessment. If the victims lost consciousness, or had slurred speech, then they went to the head of the line for treatment and transport.
One of the EMS gals told us later that it’s not unusual to have to talk people into leaving others behind in order to get help for themselves at the hospital. Some victims appear to be fine, but wander around the area in confusion and shock, unaware of cuts and more serious injuries of their own.
One of the victims who kept crying out for help for others, eventually collapsed, was
put on backboard and then lifted to a gurney for transport.
The last victim was treated and transported, the driver was arrested and taken to jail and all that remained was the cleanup. The firefighters took off their jackets, gathered their gear and re-stowed it in the rescue truck.
What was the difference between this simulation and the explosion simulation we witnessed last year? That one included unknown perpetrators and a continuing threat that widened from the campus to the airport and public transportation. Both law enforcement and EMS personnel gathered evidence at the scene (which in some cases was imbedded in the victims).
At the Yard Sale simulation, the evidence collected was in the form of photos of the scene, the Breathalyzer test, as well as witness statements from onlookers and victims. The threat was specific to the scene and dealt with.
Both were crime scenes, but played out quite differently.
As we saw last year at the explosion simulation, the three groups at the ‘Yard Sale’ were professional and took the simulation seriously. Their interaction appeared seamless and we were impressed by the way they worked near each other in order to complete their assigned tasks and then jumped in to help each other when needed. Well done!
*Photos by Patti Phillips, except one.
All taken at Guilford County Community College, in North Carolina.
*Photo taken and shared by Terry Odell, writer. Thanks! Follow her blog and find out about her books at www.terryodell.com
Firefighters have one of the most dangerous jobs in the world. Walking into a house fire that could reach 1000 degrees in under a minute (that’s not a typo) or a chemical fire that may reach double or triple that temperature in seconds, while battling smoke inhalation as well, means a firefighter’s life depends on being supplied with the best equipment that money can buy. Without the proper gear, firefighters can’t stay inside a burning structure long enough to rescue victims or fight the fire successfully.
So, what is the right gear that keeps them safe and still allows them to do their jobs?
Tim Fitts, a veteran firefighter in North Carolina, and Coordinator of certification classes for firefighters and rescue squads at Guilford Technical Community College, demonstrated his gear on a 95 degree day in September. Fire isn’t selective about the weather, so it’s a good thing for us that firefighters train and work under all kinds of conditions.
The firefighter uniform is generally called ‘turnout gear’ by firefighters because they turn it inside out when not in use, so that they can step into it quickly and pull it on/up when the fire bell/siren sounds. Firefighters need to get completely dressed in about a minute, so any safe system that will speed up the process is used. Some guys pull on the boots and pants, grab the rest of the gear and finish getting dressed in the truck as it pulls out of the fire station.
The official name for the gear is Personal Protective Equipment (PPE).
Parts of the firefighter uniform:
While on the job at a fire or rescue operation that might result in a fire, most firefighters will wear these pieces of clothing:
These three hoods are made of different fabrics: Kevlar blend, PBI/Kevlar, and Nomex.
Firefighters put a hood on before the jacket, so that it sits properly on the shoulders. They tend to wear two hoods to protect against a flashover, giving their heads the extra defense needed in the intense heat. If a flashover occurs, the firefighter will have about two seconds to get out of the building. If the hoods are not providing enough coverage, it will feel like 1000 bees stinging the ears at one time – it’s too hot to stand. It’s time to get out.
The helmets are made of thick, heat resistant plastic and often include Kevlar or Nomex flaps for the ears.
Firefighters are taught to fight fires on their knees (not while crawling) so the extra padding helps cushion the wear and tear on the knees.
In addition, the firefighters put on:
The PASS device (Personal Alert Safety System) is a personal safety device used by firefighters entering a hazardous environment – a burning building. When the firefighter does not move for 30 seconds, it makes a loud, shrill, really annoying sound, letting others in the area know that something is wrong.
The mask on the left is a newer model, the one on the right? Older. There has been an upgrade in technology for the plastic in the mask, developed because at high temperatures, the old plastic would fail (melt). It was the weakest part of the uniform. The new version will not fail as quickly.
Note that even the air tank is protected with a fire retardant fabric.
The idea is to be protected from the fire and to be able to breathe safely while he/she works. The positive pressure mask on the SCBA (Self Contained Breathing Apparatus) gear keeps the toxic air out as much as possible by allowing the tank air to flow continuously, even if the firefighter is not inhaling. By the way, the tanks are full of compressed air, not oxygen.
Most of the clothes have reflective tape so that the firefighter can be seen more easily through the smoke and low light/darkness. Some departments are large enough that they use color-coded reflective tape in order to tell the full-time firefighters and the volunteers apart.
The uniforms are sized to the individual firefighters, so that when they bend over, there is at least a two-inch overlap with the fabric pieces, and no skin is exposed to the crippling, blistering heat.
Hip boots of years ago, are now old school because of the area of the body they left unprotected from heat. Now the boots have steel toes and shanks and are calf high or knee high in length.
When fully dressed, the firefighter is wearing about 70 pounds of equipment. Add more weight for the tools they have to carry – picks, axes, etc – needed to fight the fire.
After ten years, all turnout gear must be thrown away. It wears out because of repeated exposure to the intense heat and toxic elements. Many large, active fire departments dispose of the clothing after only five years, because of their more frequent use and improvements in technology.
Firefighting gear is not fireproof. It is fire retardant.
Some of the clothing has 3 layers, each layer performing a different function. People can only tolerate temperatures to 135 degrees, so the specialized fabrics extend the time available to do the job. Firefighters get very uncomfortable at 250 degrees, and the time limit for the firefighter at that point is about 30 seconds to reach someone and get out. One of the firefighters at Command keeps track of the men/women – where they are in the structure and how long they’ve been working the fire.
Nomex degrades at 400 degrees, so needs to be used in addition to other fabrics if fighting a structural fire. It tends to split when the wearer is running. When combined with Kevlar, it becomes more flexible and the fabric breathes a bit better.
PBI degrades at 1100 degrees, allowing a much better chance for the firefighter to stay safe while fighting a house blaze. It stays intact in the extreme temperatures and allows the firefighter extra time to get to a victim and then get out.
Gortex helps shed water.
Heat goes through each layer a bit at a time. Each layer is a necessary barrier, in its place to protect the firefighter and keep his body from getting hotter than is safe.
After fires, all of the clothing needs to be taken apart and washed, because everything in a fire is carcinogenic. Hmm…that means that the entire time a firefighter is working the fire, his equipment has to protect him from the flames and the smoke, as well as anything else thrown into the air, both in the active fire and in the area outside the building.
Some fire Captains insist that the clothing be stored away from the sleeping area at the station, because it may still contain toxins even after being washed. If you get a chance to visit a Fire Station, you might be able to tell where the gear is kept, before you ever reach the room. The smoky odor is sharp and unforgettable.
Cost of Basic Turnout Gear (approximate)
Tim Fitts told us about the testing going on at NC State’s College of Textiles, in the search for better, more effective, fire retardant fabrics.
To see a demonstration of how a firefighter’s uniform reacts to fire, click here for NC State’s PyroMan video:
For a demonstration of how quickly heat from a flame penetrates protective layers before reaching the skin, click here for NC State’s PyroMan animation:
Every second counts when rescuing you or your pets in a fire. We know that a simple house fire can fully engulf an 8’x10’ room in 90 seconds. That’s not a typo. If the firefighters are on the scene before that happens to the entire house, they need as much lead time as possible in order to keep a rescue operation from becoming a recovery operation. That’s when the best turnout gear on the market is worth every dime.
*Photos by Patti Phillips, taken at Guilford Technical Community College, NC, during The 2014 Writers’ Police Academy.
Thanks to Tim Fitts for generously sharing his knowledge and expertise. Tim is a veteran firefighter and Fire Occupational Extension Coordinator at GTCC. He’s in charge of all Con Ed certification and non-certification classes in Fire and Rescue subjects to members of NC fire departments and rescue squads. Any errors in fact are mine, not his.
If you’re curious about what it takes to qualify for Firefighter Training, read “How do you become a firefighter?”