The golden rules

JOHN FALCHETTO: Training can prevent tragedies.

John Falchetto, managing director of Daribni Technical Training, explains why emergency response teams need training targeted to site conditions.

It is a reasonable assumption that a construction site will at some point experience some type of crisis or emergency.

When a wall collapses or a worker falls, the critical timelines are measured in minutes. The Golden Hour rule, applicable to all types of major trauma or severe injury, requires that the victim reaches the operating room within the first hour to maximise chances of survival.

Due to the nature of traffic conditions in the UAE and the remoteness of some sites, dialing 999 and waiting is not an option. Hence, some sites are now developing rescue skills among their workforce by creating Emergency Response Teams (ERTs) in order to intervene quickly and safely before a simple incident becomes a tragedy.

If we consider the construction industry's biggest killer, falls, most of the fatalities can be prevented by a simple fall protection harness, but this is only half the solution.

A worker hanging in his fall arrest harness for more than 20 minutes will quickly develop suspension trauma and die. Having a well-trained ERT on site can help save the worker's life and, in turn, save the company hundreds of thousands of dirhams in penalties, site closure and associated legal costs.

What skills an ERT needs to possess depends primarily on the safety manager's estimate of existing site hazards. The expertise of an ERT team for a company building a 30-storey tower in downtown Dubai will not be the same as an ERT for a company building a resort in the middle of the desert in Liwa.

The team at the 30-storey tower will undoubtedly have technical rope rescue skills to be able to perform a "pick-off", a technique used to bring a worker hanging in their fall arrest harness to safety. In addition to rope skills the team would also have training in firefighting, basic first-aid and confined space search and rescue training.

The team in Liwa may have similar skills but also Wilderness First Responder training which will allow them to treat a patient in a remote setting over an extended period of time. Standard first aid courses assume that definitive care is nearby and can be delivered quickly.

With more work happening in remote areas, Wilderness First Responder courses are devised to deal with the extended time and limited resources inherent when a medical crisis occurs in a wilderness setting.

It is important to keep in mind that a wilderness setting doesn't have to be the high seas, being a mere two hours away from a medical facility automatically places the site in a wilderness context. It is easy to think of places in or around Dubai, and the rest of the UAE, where access to definitive care is two hours away.

While rescuing a victim is only part of the challenge in remote sites, getting a victim to a trauma centre within the Golden Hour often means having an ambulance on site, especially on remote sites where the response time of emergency services can take hours.

In a UAE first, the contractor Alec recently launched the first company-owned customised 4x4 ambulance on its Liwa site, due to the fact that the closest ambulance would be coming from Mafraq hospital near Abu Dhabi, some 160 km away.

When looking at training standards for ERTs it is important to choose a widely-recognised standard. In the UAE, the Dubai Police Rescue team and the Civil Defence all use the National Fire Protection Association (NFPA) US standard. The rescue standards for ERTs and their training are clearly defined in NFPA 1670 Standard on Operations and Training for Technical Rescue Incidents.

The NFPA 1670 standard identifies and establishes levels of functional capability for conducting operations at technical search and rescue incidents while minimising threats to rescuers.

The scope of this standard covers a wide array of incidents including confined spaces, technical rope rescue, collapsed structures, vehicle and machinery search and rescue, water search and rescue. More importantly it allows for a standardisation of rescue responses between onsite ERT and emergency services.

But managing a big and busy site and having a group of skilled ERT members without a proper emergency response plan doesn't really help. A comprehensive site pre-incident plan will describe how the ERT should respond.

With some 800,000 workers in the construction field, it is not simply a question of "if" this incident happens but rather a "when". Most reputable construction companies are setting up their own ERTs, a move which precedes local legislation and HSE client requirements in some cases.

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