In my Machinery Rescue Awareness and Machinery Rescue Operations courses, I teach a concept called the Machinery Rescue Sequence. Like other disciplines that have a “sequence,” such as water rescue (self, reach, throw, row, go), most machinery entrapments can be safely handled by following a pre-determined order of tactics.

Step 1 – Stabilization and Perform Lockout/Tagout

The first step is to prevent the situation from getting worse. For example, if the patient is being crushed by the machine, we need to prevent the crushing force from intensifying. If the patient is being pulled into the machine, we need to prevent them from being pulled in further. We accomplish this first step by physically stabilizing the machine in its current position and performing lockout/tagout. This is also something we do at virtually every vehicle rescue – we stabilize the vehicle and disconnect the battery.

The order in which these two actions take place may vary from incident to incident. For large or complex machines, it will be beneficial to have a subject matter expert from the facility with you to help determine the safest way to accomplish stabilization and lockout/tagout.

Another point to consider is stabilizing the patient. If the patient is suspended in air or even simply in a standing position with their arm trapped in a machine, we want to stabilize them. A patient standing up with a limb entrapped in a machine can injure themselves further if they lose consciousness and pass out.

Step 2 – Remove the Patient from the Machine

Your first option to free the trapped limb is to perform gentle manipulation to remove the limb. If there is not enough room to safely do this, or if the mechanism of entrapment is too complex, then you will have to proceed onto the next step.

Step 3 – Disassemble the Machine

The next tactic that should be considered is simple disassembly. An operations level rescue can be accomplished by using this tactic with simple hand tools. Again, having a subject matter expert on-scene may help you determine the best way to disassemble the machine.

Step 4 – Force the Machine

If necessary, you may have to force the machine. This tactic can include actions such as spreading or cutting with electric, pneumatic, or hydraulic rescue tools. Remember that for every action there is an equal and opposite reaction. Be sure to protect the patient from any movement that may be caused by the forcing action you need to perform.

It is important to note that you should progress through these steps in order, but you should always be re-evaluating the situation because it may be appropriate at times to revert to a previous step. For example, after removing a piece of the machine at Step 3, you may have created enough space to remove the limb without any further actions.

If you would like to set up our Machinery Rescue Awareness and Operations courses for your station, send me an email. They make great back-to-back drill night programs. They are also appropriate for EMS agencies, because EMS providers play a pivotal role in these incidents.

Bill Elder
Elder Technical Rescue Services, LLC