1. Size-up involves assessing the situation and determining  safe action plan

   1. Using the 9 step size-up model

2. Search Involving locating survivors and documenting their location.

3. Rescue Involves the procedures and methods required to extricate the survivors

First response to trapped survivors immediately after almost every disaster is by

1. Spontaneous

2. untrained

3. Well-intentioned persons

   1. who rush to the site of collapse in an attempt to free the survivorsPe

      1. often these spontaneous rescue efforts result in

         1. serious injuries

         2. compounded problems

4. Plan and practice rescue efforts in advance

5. people including rescuers

   1. have died when the rescuers were not prepared and trained.

The 3 factors of deciding to attempt a rescue

1. Risks involved to both the rescuer and the survivor

2. The overall goal of doing the greatest good for the greatest number of people

3. Resources and labor available

The goals of search and rescue operation are to:

1. Rescue the greatest number of people in the shortest amount of time.

2. Get the walking wounded and ambulatory survivors out first.

3. Rescue lightly trapped survivors next

4. Keep the rescuers and survivors safe

Effective search and rescue operations hinge on:

1. Effective size-up

2. Rescuer Safety

3. Survivor Safety

This unit focuses on the components of an effective search and rescue operation

1. Size up

2. Search

3. Rescue

4. the methods and techniques that rescuers can use to locate and safely remove survivors

Steps to Search and rescue Size-up

1. Gathering Facts

2. Assessing Damage

3. Considering Probabilities

4. Assessing your Situation

5. Establishing Priorities

6. Make decisions

7. Developing a plan of action

8. Taking action

9. Evaluating progress

1. Step 1 Gather Facts

   1. Time

      1. Does the time of day or week affect search and rescue efforts?

      2. how?

   2. Type of Construction

      1. What types of structures is (are) involved?

      2. What types of construction is (are) involved?

      3. What type(s) of terrain is (are) involved?

   3. Occupancy

      1. Are the structures occupied?

         1. if yes how many people are likely to be affected?

      2. Are there special considerations

         1. If yes what are the special considerations?

   4. Weather 

      1. will weather conditions affect your safety?

         1. If yes how will your safety be affected

      2. Will weather condition affect the search & Rescue situation?

         1. if yes, how will the search and rescue situation be affected?

   5. Hazards

      1. Are hazardous materials involved?

         1. if yes at what location?

      2. Are any other types of hazards involved?

         1. if yes what other hazards

2. Step 2 Assess and communicate the damage

   1. For structural searches, take a lap around the building

      1. is the damage beyond the CERTs capability

         1. if yes what special requirements or specifications are required.

   2. Have you communicated the facts and the initial damage assessment to the appropriate person.

3. Step 3 Consider Possibilities

   1. Is the situation stable?

   2. Is there a great risk or potential for more disaster activity that will affect personal safety? 

   3. if yes what are the known risks

4. Step 4: assess your own situation

   1. what available resources do you have to attempt the search and rescue?

   2. What equipment is available

5. Step 5: Establish priorities

   1. Can CERT volunteers attempt a search and rescue safely?

      1. if no do not attempt a search and rescue

   2. Are there any other more pressing needs now?

      1. if yes list.

6. Step 6: Make Decisions

   1. Where will deployment of available resources do the most good while maintaining an adequate margin of safety.

7. Step 7: Develop Plan of Action

   1. Determine how best to deploy personnel and other resources.

8. Step 8: Take Action

   1. Put the plan into effect.

9. Step 9: Evaluate Progress

   1. Continually size up the situation to idenify changes in the scope of the problem

1. The time and day of the week

2. Construction type and terrain

3. Occupancy

4. Weather

5. Hazards

The facts of the situation must guide your search and rescue efforts. When gathering facts, CERT volunteers need to consider:

1. The time of the event and day of the week.

   1. at night more people will be in their homes

      1. the greatest need for search and rescue will be in residential settings

   2. Conversely during the day

      1. people will be at work

         1. so the need will be in commercial buildings

   3. The locations of people in their homes and the amount of daylight available may also affect search and rescue operations

2. Construction type and terrain

   1. Some types of construction are more susceptible to damage and the type of terrain will affect how best to conduct the search

3. Occupancy

   1. The design purpose of the structure may indicate the likely number of survivors and their location.

4. Weather

   1. Severe weather will impact survivors and rescuers alike

      1. will hamper rescue efforts

   2. Consider forecasts of severe weather as a limiting factor

      1. on the period during which search and rescue can occur.

5. Hazards

   1. Knowledge of other potential hazards in the general and immediate areas is important to search and rescue efforts.

      1. For example

         1. if you suspect a gas leak

            1. taking the time to locate and shut off the gas can have a big impact in terms of loss of life.

Communicating Damage using the ABCD standard

1.  You can describe different locations within and around the structure by using the ABCD standard.

   1. With a representing the front of the building

   2. B,C,D the sides of the building rotating clockwise

2. Volunteers can break down the area inside a structure by quadrants to facilitate communication

   1. A hazard or survivor located closest to 

   2. the A and B sides of the structure 

      1. is in the A/B Quadrant.

Remember you must communicate your findings to the CERT command post or responding agencies

Because you will be working close proximity to the dangerous situation

1. How stable is the situation?

2. What secondary factors should CERT volunteers consider?

3. What Else could go Wrong?

4. What does it all mean for the search and rescue

5. Considering 

   1. what will probably happen

   2. what could happen

      1. are of critical Importance

         1. be sure to identify potentially life-threatening hazards and ask:

            1. How Stable is the situation?

               1. CERT volunteers should think about what they already know about the structure that has been damaged

            2.  Are lawn chemicals, paints, or other potentially hazardous materials stored within the structure?

               1. How are they stored?

               2. Where are they?

                  1. It will not take volunteers much time to answer these types of questions

                     1. the answers could make a huge difference in how they approach the search

            3. What secondary factors should CERT volunteers consider?

               1. Take a moment to look around

                  1. assess the situation outside the immediate area

                     1. what is the weather doing?

                     2. Is the wind changing?

                     3. Is a storm moving that would affect the response?

                     4. Is there a crowd growing?

                     5. Are there very few people around?

                     6. Do you hear first responders in the distance or is everything quiet?

            4. What else could go wrong?

               1. Based on the information gathered during steps 1 and 2 of the size-up

                  1. Step 1- Gather Facts

                  2. Step 2- Assess and Communicate Damage

               2. CERT volunteers should take a few moments to play what if?

                  1. to try and identify additional risks they may face

               3. What happens if the power goes out during the search?

               4. What if a wall that appears stable shifts and collapses?

               5. Applying Murphys law to the situation could save CERT volunteers lives

            5. What does it all mean for the search and rescue?

               1. Based on all probabilities

                  1. CERTs should think about what they could do to reduce risks associated with the probabilities they have identified

                  2. Is a spotter necessary to look for movement that could indicate a possible collapse and warn the resue team?

                  3. Is some remedial action required to stabilize non-structural hazards before beginning the search?

                  4. CERT Search and rescue teams must remember that their own is the priority.

Remember that size-up is a compounding process

1. Each step builds upon the previous step.

   1. until the decision is made to either begin the search and rescue operation

   2. or that the situation is not safe to begin

2. Use steps 1-3 to determine

   1. whether the situation is safe enough to continue.

   2. The risks that rescuers will face if they continue

   3. The available resources volunteers will need to Conduct the operation safely

3. Assessing resources, including personnel, tools, and equipment is extremely important

1. to search and rescue operations

Rescue Resources

1. Search and rescue resources include

   1. personnel 

   2. equipment

   3.  tools

Search and Rescue Resource Planning questions

1. Personnel

   1. How many trained CERT volunteers are available for this situation?

   2. Who lives and or works in the area?

   3. During what hours are these people most likely to be available?

   4. What skills or hobbies do they have that might be useful in search and rescue operations?

2. Equipment

   1. What Equipment is available locally that might be useful for search and rescue?

   2. Where is it located?

   3. How can volunteers access it?

   4. On which structures (or types of structures) might it be most effective?

3. Tools 

   1. What tools are available that might be use to 

      1. lift

      2. move

      3. cut disaster debris

   2. What tools are available that will aid communication?

At this point the size-up you will 

1. make decisions about where to deploy your resources to do the most good 

2. While maintaining an adequate margin of safety.

   1. you will base many of your decisions on the priorities established during step 5.

You do not have to write down an action plan, but when search and rescue operations are required, the situation is probably complex enough that a written plan of some type will be important.

1. A plan should

   1. Help focus the operation on established priorities and decisions.

   2. Provide for documentation to give to responding agencies when they arrive on scene.

   3. Provide for documentation that will become part of the record of the CERT's overall operation.

2. Keep notes as you develop your action plan

   1. Volunteers should document any changes made to the initial plan based on new information that emerges. 

This step involves putting the plan developed in step 7 into action.

1. The most critical step

   1. Not only in evaluating whether the plan works

   2. But also from a safety standpoint.

2. Remember that size-up is ongoing

   1. information gained during step 9 needs to be fed back into the decision-making process

      1. For possible revision of priorities and updated action planning.

Specific Safety Considerations

1. Regardless of the severity of structural damage

2. Rescuer safety must be the primary concern

   1. the most frequent causes of rescuer deaths are 

      1. disorientation

      2. secondary collapse

Search and Rescue Operation Guidelines

1. Follow these guidelines during all search and rescue operations

   1. use the buddy system

      1. successful search and rescue depend on teamwork,

   2. Be alert for hazards

      1. power lines

      2. natural gas leaks

      3. hazardous materials

      4. sharp objects

         1. you should never attempt to search an area where water is rising.

   3. Use safety equipment

      1. Wearing gloves - protects rescuers hands

      2. helmet- protects rescuers head

      3. Kneepads

      4. Coveralls

      5. Thick soled boots

         1. will protect a rescuer from glass and other sharp objects found on the ground 

            1. following many natural disasters

      6. The primary cause of rescuer problems after working in a structural collapse is breathing dust

         1. a dust mask is essential

            1. a dust mask will not filter out all harmful materials

      7. If volunteers suspect the presence of chemical or biological agents

         1. they must evacuate to an upwind location and notify professional responders.

   4. Have Backup teams available to allow 

      1. rotation of teams

      2. Prevent fatigue

      3. Ensure help if team gets into trouble

1. When a CERT makes the decision to initiate operations

   1. CERT volunteers will inspect the area assigned by the CERT TL.

      1. The search operation involves two processes

         1. Employing search techniques based on the size up 

         2. locating survivors

            1. by using these two processes search operations will be more

               1. 1. efficient

                  2. thorough

                  3. safe

      2. They will also facilitate later rescue operations

         2. 1. although the processes are related this section addresses one at a time

               1. Interior search operations are the most common

               2. and discussed first

               3. exterior search operations will be discussed later in this unit.

Interior Search Operations

Locating potential survivors in a structure

1. The first step in locating a potential survivor in a structure is to

   1. Gather more precise information about damage

   2. develop priorities and plans by conducting a size up of the interior of the building

   3. the data gathered will provide more information about possible areas of entrapment or voids.

Structural Voids

1. pancake void

2. lean-to-void

3. V void

Survivors may be trapped in a structural void

If you hear any signs of life coming from a structural void.

1. Report it to the TL immediately

2. Make appropriate markings to direct professional rescuers

3. do not attempt the rescue yourself

4. attempting to rescue a person from a structural void without proper equipment

   1. may result in completing the collapse and harming the trapped person

5. If CERT volunteers see collapsed floors or walls they should leave the premises immediately

Individual voids

1. individual voids are spaces into which the survivor may have crawled for protection

   1. Examples of individual voids include bathtubs and the space underneath desks

      1. Children may seek shelter in smaller places like cabinets

2. After identifying the possible areas of entrapment, CERT volunteers must

3. Determine the number of survivors

4. identify the most probable areas of entrapment

5. Some information may be known through assessment

   1. CERT volunteers may need to get some information by talking to bystanders or those who are familiar with the structure.

6. CERT volunteers should ask questions when talking with these individuals

   1. How many people live/work in the building?

   2. where would they be at this time?

   3. what is the building layout?

   4. What have you seen or heard?

   5. Has anyone come out?

   6. What are normal exit routes from the building?

7. Be aware that the event may confuse bystanders

   1. They may tend to exaggerate potential numbers

   2. or may not remember the event accurately

   3. Gather as much information as you can though because

      1. it will be useful for planning search priorities

      2. implementing the search

Search methodology

an effective search methodology 

1. indicates rescuer location

2. locates survivors as quickly and safely as possible

3. prevents duplication of effort

Search markings

Experienced search and rescue use the following system

1. CERT will use the same system

   1. This will save time for fellow CERT volunteers and other responders during the search and continual size-up of the structure.

2. Upon entering the search area

   1. you will make a mark next to the door to indicate that you are entering

      1. Do not make the mark on the door on the wall where the door swings

      2. Make a single slash  and write the agency or group ID at the 9'O'clock position.

         1. Then write the date and time in at the 12 o clock position

3. Upon exiting the search area

   1. make another slash to form an x

      1. the agency of group ID will be in the left quadrant.

         1. enter the search time out in the top quadrant

4. Right Quadrant

   1. enter the areas of the structure searched and any specific information about hazards

5. Lower quadrant

   1. enter information about the survivors found in the search area

      1. L represents living

      2. D represents dead

   2. The search marking on the front of a structure or building should contain the total number of survivors

   3. Search markings inside the structure or building will include survivor totals for specific search areas.

      1. Indicat where survivors were taken.

6. Search methodology

   1. Use the buddy system

      1. Always remain within rms reach of at least one other CERT volunteer when conduction an interior search.

      2. This is to enable assistance in the event of a slip or fall

         1. to be able to push or pull one another 

            1. out of harms way

   2. Upon entering each space or room, call out survivors

      1. shout something like

         1. If anyone can hear my voice come here

            1. if any survivors come to you 

               1. ask them for any information that they may have about the building 

                  1. or other s who may be trapped then

                     1. depending on the condition of the building 

                        1. give them further directions such as

                        2. stay here

                        3. wait outside

   3. Remember that even those who are able to get to you may be in shock and confuse

      1. when giving directions to survivors CERT volunteers should 

         1. look directly at the survivors

         2. speak in short sentences

         3. keep their directions simple

   4. use  a systematic search pattern

      1. Ensure that all areas of the building are covered

         1. examples of systematic search patterns to use include

            1. bottom-up/top-down

            2. Right wall/left wall

   5. Keep in mind that every interior space has six sides (including floor an cieling)

   6. Rescuers must chcck all six sides to locate hazards such as fixtures that may be hanging from the ceiling 

   7. Stop frequently to listen

      1. listen for tapping

      2. movement

      3. voices

   8. Triangulate

      1. Consider using Triangulation when a potential survivors location is obscured.

         1. if access permits three rescuers guided by survivor sounds

            1. form a triangle around the area and direct flashlights into the area

               1. the light shining from different direction will eliminate shadows

                  1. that could otherwise hide survivors

                     1. triangulation should not be used as an initial search method

   9. Report results

      1. Keep complete records both of removed survivors and of survivors who remain trapped or are dead.

         1. Report this information to emergency services personnel when they reach the scene

Exterior search

In addition to search inside a structure, CERT volunteers may need to search open areas outside of buildings.

1. Conducting an effective search in open areas

   1. requires that searchers work methodically

      1. and follow standard procedures established by those in charge of the search operation

   2. This is true in all cases

      1. especially if the area is a crime scene

      2. where all potential evidence must be protected

2. If searchers are needed they should assemble in a central staging area and sign in.

   1. Authorities will be brief the searchers on 

      1. what they will need to be looking for

      2. what areas they are responsible for searching

      3. the pattern of the search

      4. what they should do if they discover the

         1. missing person

         2. evidence

         3. related information

   2. Exterior search patterns include

      1. grid

      2. line

      3. quadrant 

      4. zone 

      5. spiral

   3. Typically, a grid pattern is used in large open areas

      1. or small areas when hands-and-knees search is conducted

   4. Grid is one of the most commonly used types of search patterns

      1. keep the guidelines below in mind when conducting a grid search

         1. view the search area as a grid

            1. searchers initially positioned at one side of the grid

      2. The distance between the searchers should be set according to visibility and debris

         1. in all cases searchers must remain within line of sight and voice contact with searchers on either side of them

      3. The searchers proceed maintaining as straight a line as possible across the entire search area.

         1. as each searcher moves accross the area they conduct a thorough search for survivors within their designated row of the grid.

      4. To ensure full coverage CERTS must record each area search

      5.  a grid search might be particularly usefull following a tornado or hurricane.

1. Moving objects and debris to create a safer rescue environment and free survivors

2. Assessing survivors, checking for life-threatening conditions such as

   1. airway obstruction

   2. severe bleeding

   3. low body temperature

3. Removing survivors as safely and as quickly as possible

The 3 safety considerations for all rescue operations

1. maintain rescuer safety

2. Assess survivors in lightly and moderately damaged buildings

3. Evacuate survivors as quickly as possible from moderately damaged buildings

   1. while minimizing additional injury

CERTs cannot achieve these considerations without creating as safe an environment as possible before attempting rescue. 

Therefore, there are certain precautions that rescuers must take to minimize risk.

1. There are certain precautions that rescuers must take to minimize risk and increase their chances of achieving their rescue goals.

2. Know your limitations:

   1. Many volunteers have been injured or killed during rescue operations because

      1. they did not pay attention to their own physical and mental limitations

      2. CERT rescuers shoul take the time to

         1. drink fluids

         2. eat

         3. relax

         4. rest

            1. so that they can return with

               1. a clear mind

               2. improved energy

3. Follow Safety Procedures

   1. CERT volunteers should always use the proper safety equipment Required for the situation

      1. Follow established procedures including:

         1. Work in pairs

         2. Assess and treat only in lightly damaged buildings

         3. In moderately damaged buildings, 

            1. assess only and remove survivors as quickly as possible

         4. Never enter an unstable structure

         5. Lift by 

            1. bending the knees,

            2. keeping the back straight,

            3. pushing up with the legs

         6. Carry the load close to the body

         7. Lift and carry no more than is reasonable

4. Remove Debris

   1. Remove debris as needed to minimize risk to rescuers and to free entrapped survivors.

Leveraging and Cribbing

1. You may encounter situations in which moving debris is needed to free survivors

   1. In these situations

      1. CERT rescuers should consider leveraging and cribbing 

         1. to move and stabilize the debris until the rescue is complete

      2. Leveraging is accomplished by wedging a lever under the object that needs to be moved

         1. with a stationary object underneath, it to act as a fulcrum

            1. when the lever is forced down over the fulcrum

               1. the far end of the lever will lift the object

      3. A crib is a wooden framework used for support or strengthening the object

         1. Box cribbing means arranging pairs of wood pieces alternately to form a stable rectangle

         2. You may use a variety of cribbing materials for these procedures

            1. you will need to improvise by using materials such as tires or structural debris.

         3. Whatever you use do not put form over function.

   2. Volunteers may use leveraging and cribbing together by alternately

      1. lifting the object 

      2. and placing cribbing materials underneath the lifted edge to stabilize it.

   3. Safety is number one 

      1. lift an inch, crib an inch

   4. Leveraging and cribbing should be gradual for

      1. stability

      2. safety

      3. efficiency

   5. It may also be necessary to use leveraging and cribbing at more than one location

      1. Front and back to ensure stability

   6. Never leverage and crib on opposite ends at the same time

      1. doing so will increase the instability of the debris

   7. If leveraging is required at both ends

      1. lift and crib at one end

         1. then repeat the process at the other end

   8. Positioning the lever and the fulcrum correctly is critical for safe operations

      1. The fulcrum and pry tool must be perpendicular (90 degrees) 

         1. to the edge of the object being lifted

      2. Attempting to leverage a heavy object using too sharp an angle is inefficient and result in back injury.

   9. Box cribbing is stable but it requires pieces of cribbing material of relatively uniform size

      1. When such material is not available

         1. unboxed cribbing can also work effectively to

            1. support

            2. stabilize

            3. A heavy object

   10. When you are able to achieve sufficient lift,

       1. you should remove the survivor and 

          1. reverse the leveraging

             1. and cribbing procedure

                1. to lower the object

       2. you should never leave an unsafe condition unless the event has left the 

          1. structure 

          2. building

             1. obviously compromised

       3. When you must remove debris to locate survivors

          1. you should set up a human chain 

             1. pass the debris from one person to the next

                1. be careful however to set up the chain in a position that will not interfere with rescue operations

       4. Wear your PPE to protect yourself always

          1. Kneepads can be an important addition to your PPE during rescue operations

Leveraging and Cribbing Steps

2. Conduct a size-up of the scene. Gather facts, identify hazards, and establish priorities

3. Have one person in charge

   1. formulate a plan of action based upon the information you have recieved

      1. to identify how and where to lift and crib and to determine

         1. how and where

            1. to lift and crib

            2. and to determine how you will remove the survivor from underneath the debris

4. Gather necessary material for lifting/cribbing operations

   1. lever

   2. fulcrum

   3. cribbing blocks

   4. spacers/wedges

      1. During an actual emergency you may have to use creative substitute materials

5. Use cribbing material to stabilize the object prior to lifting.

6. Distribute cribbing materials as necessary to be readily accessible during the lifting operation

7. Prepare to life the object;

   1. assemble the lever and fulcrum at the previously identified location

8. Assign a person to monitor and be ready to remove the survivor as soon as possible

9. Initiate the lift, using the lever and fulcrum for mechanical advantage.

10. As the object is lifted, add cribbing as needed one layer at a time.

11. Once the object is adequately supported, 

    1. remove the lever and fulcrum

       1. you may then remove the survivor

12. Unless the event has left the structure obviously compromised

    1. requiring you to evacuate immediately

       1. reinitiate the lift and begin removing cribbing materials

          1. reversing the process by which you built the crib

13. Progressively lower the object to the ground

    1. Always return the heavy object to a stable position unless you have to evacuate immediately

14. Before you leave, remember to collect the lifting/cribbing supplies to be available for additional operations.

Leveraging/cribbing operations Team organization

1. Group Leader

   1. In front of collapse, positioned so that he or she can view the entire operation while remaining out of the rescuer's way

2. Lever Person

   1. At the front edge of the collapsed wall and positioned so that he or she can positin a fulcrum and lever under the wall

3. Crib Persons

   1. On either side of the collapsed wall and positioned to enable the place of cribbing as the wall is raised with the lever

4. Medical Care/Survivor Removal Person

   1. Next to the crib person who is closet to the survivors head.

Steps for building box cribbing

1. Position to pieces of wood parallel to each other on either side of the collapse.

2. Place to pieces of wood perpendicularly across the base pieces.

3. Add addtional layers of wood, with each perpendicular to the previous level.

4. Add addition layers of wood, with each perpendicular to the previous level.

The basic types of survivor removal are;

1. Self-removal or assist

2. Lifts and drags

   1. it is usually best to allow an ambulatory survivor to extricate him or herself.

   2. Be aware that ambulatory survivors are not always as strong and free of injury as they believe.

   3. When survivors are freed, they may need assistance to exit the structure.

1. General Stability of the immediate environment

2. Number of rescuers available

3. Strength and ability of the rescuers

4. Condition of the survivor

If safety and time permit 

1. you should not use lifts and drags to remove survivors when

   1. you suspect the survivors have close-head or spinal injuries.

      1. in such cases

         1. stabilize the spine using a backboard

2. you can use 

   1. doors

   2. tables

   3. similar materials as improvised backboards

      1. The backboard must be able to carry the person and remember to use proper lifting techniques.

         1. When moving survivors, rescuers must use teamwork and communication and try to keep the survivor's spine in a straight line.

         2. Rescuer safety and the condition of the building will dictate the approach.

One-Person Arm Carry

If a rescuer is physically able and the survivor is small, the rescuer may us the one-person arm carry to lift and carry the survivor by.

1. Reaching around the survivors back and under the knee's

2. Lifting the survivor while keeping your back straight and lifting with your legs.

   1. Consider the size of the survivor and the distance in which you will need to carry him or her before using this carry.

Pack Strap Carry:

Another way for a single rescuer to lift a survivor safely is by using the one-person pack-strap carry. 

1. Using this method, you should

   1. Stand with your back to the survivor

   2. Place the survivors arms over your shoulders and grab the hand in front of your chest

   3. Hoist the survivor by bending forward slightly

      1. until the survivors' feet just clear the floor

Note* the pack-strap carry is most effective for quick removal of a survivor over a short distance.

Two rescuers can also remove a survivor by seating him or her on a chair:

Two person carry:

1. Survivor removal is easier when multiple rescuers are available. 

2. The survivors upper body will weigh more than his or her lower body.

3. therefore position rescuers with greater body strength at the survivors upper body.

4. Two rescuers working together can remove a survivor using a two-person carry.

Rescuer 1:

1. Squat at the survivors head 

2. grasp the survivor from behind around the midsection

3. Reach under the arms and grasp the survivor's left wrist with rescuers right hand, an vice versa.

4. Crossing the wrists creates a more secure hold on the survivor

   1. pulling their arms an elbows closer to their body.

5. This will be helpful if rescuers need to carry the survivor through any narrow passages. 

Rescuer 2:

1. Squat between the survivors knees

   1. facing either toward or away from the survivor

2. Note that, if the rescuers will carry the survivor over uneven areas such as stairs

   1. the rescuers will need to face each other

   2. grasp the outside of the survivors' legs at the knees

Both rescuers

1. Rise to a standing position simultaneously

   1. keeping backs straight and lifting with the legs

      1. Walking the survivor to safety

Chair Carry

Two rescuers can also remove a survivor by seating him or her on a chair

1. Rescuer 1

   1. Cross the survivors arms in his or her lap.

      1. facing the back of the chair.

         1. grasp the back upright

2. Rescuer 2

   1. Grasp the two front legs of the chair.

3. Both rescuers

   1. tilt the chair back

   2. lift simultaneous

   3. and walk out

      1. it is best to use a sturdy, non-swivel chair for this lift.

*Note: if rescuers will need to carry the survivor over uneven surfaces, such as stairs, the rescuers must face each other. 

Blanket Carry

1. Use the blanket carry for survivors you cannot remove by other means. 

2. The blanket carry requires four to six rescuers to ensure stability for the survivor and one rescuer designate the lead person.

   1. Position a blanket next to the survivor, ensuring that the blanket will extend under the survivor's head.

   2. Tuck the blanket under the survivor

      1.  assist the survivor in moving to the center of the blanket. 

      2. If necessary, use the log rolling technique to position them on the blanket.

   3. With three rescuers squatting on each side

      1. roll up the edges of the blanketagainst the survivor to grasp a handle

   4. the lead person calls out ready to lift on the count of three- one, two ,three, lift

   5. The team lifts and stands in unison- keeping the survivor level- and carries the survivor feet first.

      1. *note that if rescuers will need to carry the survivor over uneven surfaces such as stairs, the rescuers must face each other.

   6. The team must also lower the survivor together, using the following steps:

      1. the lead person calls out, ready to loweron the count of three; one, two, three, lower

      2. the team lowers the survivor in unison, exercising caution to keep the survivor level.

         1. you can use a variety of material-such as 

            1. blankets

            2. carpets

            3. folded tables

               1. as improved stretchers

Log rolling

1. Rescuers should us the "log rolling" technique to move survivors with a 

   1. suspected

   2. confirmed

      1. spine injury

Drag/Blanket Drag

1. When a rescuer is not able to carry a survivor

   1. They can drag the survivor by grasping either the feet or the shoulders

      1. dragging him/her out clear of the hazard.

2. If a blanket is available

   1. use the blanket drag by following these steps

      1. Wrap the survivor in a blanket

      2. Squat don and grasp an edge of the blanket

      3. Drag the survivor across the floor