Litter Evacuation Guidelines
The following outline of litter evacuation operations is intended as a guideline. It is not 100% comprehensive nor are all steps / leadership position / etc. required for every litter evacuation. It’s intended to address salient considerations and best practices.
Incident Commander (IC)
· Interview the patient / party / complainant by phone (if possible)
o Patient location
§ If required, advise PSAP and instruct the complainant to call 911, enabling the PSAP to obtain a location of the caller
o Medical condition & patient information (name, DOB, etc.)
o Approximate patient height & weight
o Ascertain total number in party and their general condition
· Contact NOAA for a spot weather forecast
o On-line request via NOAA Burlington Website or by telephone
o Important year round
· Design extrication plan
o Define trail access
§ ATV / Snowmobile access?
o Define route to access patient
o Define extrication route
o Define required resources (see details below)
o Can the extrication be completed in one operational period? Are replacement resources required in 6-10 hours?
· Document a mission briefing for Team Leaders & Officers outlining logistics
o Radio frequencies, cell phone numbers, patient location, patient’s medical condition / information (name, DOB, etc.), directions, maps, coordinates, number in party, etc.
· Designate and deploy Hasty team (see details below)
· Designate Rescue Team Leader (see details below)
· Designate Operations Officer (see details below)
· Directs operations
· Communications with Team Leaders, Rescue Team Leader and Operations Officer
o Periodic check in (radio/cell) with field teams
o Tracks & documents team locations / times
· Dispatch ambulance based on litter team ETA
Human Resources
Difficult Extrication / Critical Patient: 18 - 25 Rescuers
· Management = 7 Rescuers
· IC, Operations Officer, Rescue Team Leader, Litter Team Lead, Medical Officer, Passing Team Lead & Rope Team Lead
· Team Members = 18 Rescuers
· 2 – Rope Team
· 6 – Litter Team
· 9 – Passing Team
· 1 – Medical Team
Moderate Extrication / Non-Critical Patient: 12 - 15 Rescuers
· Management = 3
o IC/Operations Officer, Rescue Team Leader/Litter Team Lead/Medical Officer & Passing Team Leader
· Team members = 12
§ 6 - Litter Team
§ 6 - Passing Team
Easy Extrication / Non-Critical Patient: 8 - 10 Rescuers
· Management = 2
o IC/Operations Officer, Rescue Team Leader/Litter Team Lead/Medical Officer/Passing Team Leader
· Team members = 8
o 6 - Litter Team
o 2 - Passing Team
Equipment
· Ordered by priority
o Medical gear - Hasty Team
o Patient environmental protection - Hasty Team
§ Sleeping bag, bivy sack, ground insulation, tarp, etc.
o Any additional equipment requested by the Hasty Team
o Litter
§ 1 - 25’ length of 1” webbing for patient harness
§ 1 - 25’ length of 1” webbing for Litter Team Leader (head of litter)
§ 2 - short loops of 1” webbing attached to head of litter (attach trail rope)
o Vacuum mattress / insulating pad / padding
o Litter wheel
o Trail rope & system equipment – optional, terrain dependent
§ Following is an example of a “complete kit”, the sub-set required for a given call will be determined by the terrain. For example, pulleys and Prusiks are rarely used, only required for terrain with a litter raise. In some cases a rope and a terrain belay is all that is required.
§ 60 M x 8 mm rope with locking carabiner
§ 2 – 120 cm spectra runners with locking carabiners
§ 1 - 7 mm Cordelette with a locking carabiner
§ 2 - HMS/Pear Carabiners (Munter / Uber Munter)
§ 3 – micro pulleys with locking carabiners
§ 3 – 6 mm Prusik Loops
· 9 – locking carabiners total
Assignments from IC - Initial Release of Field Assets
Operations Officer
Mission: Assist IC with delegated Command Post activities and controls the release of resource
· Communicates with IC
· Verifies personnel are adequately prepared for the mission
· Issues supporting mission information (directions, maps, coordinates, etc.)
· Assemble teams to move resources to patient and assign numeric designations
o Identify team leaders and required team equipment
o Team Leaders communicate with IC
o These teams remain intact until they arrive at the patient
o Rescue Team leader will then organize the litter extraction team and designate field team leaders for the extrication
· Logs resource: name, time in staging, team designation, team equipment, time released to field and time returned to staging
· Releases resources based on IC direction
Hasty Team
Mission: Locate and stabilize patient
· Communicates with IC
· Two rescuers, with designated team leader
o Desired attributes: EMS certification, fit / fast hikers, ideally would ultimately staff a field leadership role on the litter team
o Adequate personal equipment to be comfortable while stabilizing the patient
§ Fire starting kit, tarp, extra clothing, etc.
· Appropriate medical equipment
o Vacuum mattress should come in w/a subsequent team, not the hasty team
· Appropriate patient environmental protection
o Sleeping bag, bivy sack, ground insulation, tarp, etc.
o Some level of protection is required year round
· GPS if ambiguity in patient location
· Hasty Team remains intact until Rescue Team Leader re-assigns a litter extrication team
Rescue Team Leader
Mission: Coordinates all litter extrication operations, overall command of field personnel and operations
· Assigns Litter Extrication Team Leaders / Medical Officer as dictated by rescue scenario
· Point of contact for all communications w/the Incident Commander (IC)
· Communicates with: IC, Litter Team Leader, Passing Team Leader, Medical Officer & Rope Team Leader
· On-going risk management / Safety Officer
Assignments from Rescue Team Leader - Assembling Litter Extrication Team
Litter Team Leader
· Reports and communicates with Rescue Team Leader
· The litter team leader would take the "brake" position (downhill), or "pull" position (uphill) on the head of the litter, utilizing a length of webbing/cord used to control litter speed
· Ensures safe litter operations
· Manages the 6 rescuers on the litter
· Directs all litter operations (keeping the litter level, keeping the litter moving, etc)
· Evaluate litter attendants fatigue, requests replacements from Passing Team Leader as required
o Litter attendants being replaced raise a hand as replacements approach the litter
o Replaced litter attendants peal off litter, move in front of litter and report to Passing Team Leader
Passing Team Leader
· Reports and communicates with Rescue Team Leader
· Manages all personnel not actively on the litter
· Ensures safety of personnel and passing operations
· Maintains personnel in front of the litter at a distance close enough that replacement litter attendants can be facilitated, but not so close they slow the litter
· Makes route selection decisions and communicates these directions to the Litter Team
· Identifies / communicates hazards (drops, slippery sections, etc.) to the Letter Team
· Identifies terrain that will require a litter pass and mange personnel thru these passing sections
· Litter Team Leader makes resource requests (replacement of litter attendants) of Passing Team Leader
· Passing Team Leader allocates resources, considering when possible, fatigue skill levels of resources
Rope Team Leader
· Optional position, terrain dependent
· Reports and communicates with Rescue Team Leader
· 1-3 (terrain dependent) rescuers in front of the Passing team
· Ensures safe rope operations
· Identify terrain requiring raise / lower systems
· Set up and execute required rope system
Medical Officer
· Optional position, patient condition dependent
· Reports and communicates with Rescue Team Leader
· Medical Officer is responsible to direct all patient care
Expandable / collapsible command structure
· For calls w/few rescuers, in moderate terrain, the Rescue Team Leader Litter Team Leader roles can be combined
· For patients w/minor injuries, the Litter Team Leader and Medical Officer roles can be combined
· Conversely, larger operations or "sick" patients would require an independent Rescue Team Leader, Medical Officer & Litter Team Leader
· This system should provide a reasonable span of control for multi-agency litter carries
Stowe Mountain Rescue Page 1 8/8/17