Describe the rescue techniques and considerations necessary when dealing with a non-responsive worker found inside a confined space, factoring in the hazards present and the limitations of different methods.

When a worker is found unresponsive inside a confined space, a swift and well-executed rescue is critical. However, the rescue operation must carefully consider the unique hazards of the confined space and the limitations of different rescue techniques to ensure the safety of both the victim and the rescuers. The primary goal is to remove the worker from the hazardous environment as quickly and safely as possible, while avoiding further risk.

The first consideration in any confined space rescue is that the attendant should never enter the confined space to rescue the unresponsive worker. The primary responsibility of the attendant is to monitor conditions inside the confined space, and to call for rescue help, and any entrance into the space, by the attendant, would place two people at risk. Instead, non-entry rescue should be attempted first. Non-entry rescue techniques involve using equipment from outside the confined space to remove the unresponsive worker. For example, if the unresponsive worker is wearing a harness and retrieval line, the attendant can try to pull the worker out, taking care to avoid causing further injury. This technique has limitations, since the path of retrieval must be clear, without obstructions or narrow areas that could cause the line to snag, or cause injuries from contact with objects while being pulled out. Also, this non-entry technique will not be possible if the worker has not been wearing a harness. All confined space workers should wear a harness with a retrieval line whenever working in an entry confined space. Non-entry retrieval, while quick and easy, may not be suitable in all situations. The attendant should be aware of the limitations of this approach, and know when to move on to other methods of rescue.

If non-entry rescue isn't possible, then an entry rescue by a trained rescue team must be initiated. This rescue team must be equipped with appropriate personal protective equipment (PPE) including full-face respirators with self-contained breathing apparatus (SCBA), harnesses, and retrieval equipment. When entering the confined space, the rescue team must be aware of all hazards, atmospheric and physical. For instance, if the space is known to have an oxygen-deficient atmosphere, the team must use SCBA or air-line respirators for breathing. If flammable gases are a known hazard, only explosion-proof tools and lighting can be brought into the confined space. Before beginning the rescue, the rescue team will create a plan of approach, and must be very careful to avoid adding additional hazards, or moving too quickly. For example, when the rescue team enters a tank that is filled with liquid, the team must be very aware of slip hazards. They must take slow, deliberate actions, and must always think one or two steps ahead.

After reaching the non-responsive worker, the team must assess the worker's condition to understand the extent of injuries and prepare for any further actions. The rescue team must confirm if the worker is breathing and has a pulse. If the worker is not breathing, cardiopulmonary resuscitation (CPR) should start immediately, either inside the space if conditions are stable and safe enough, or after removal. Rescue teams often are made up of members who are trained in CPR and emergency first aid. The team must also stabilize any possible injuries to the worker, such as broken limbs or neck injuries, before removing the worker.

The chosen method of removal will depend on the space's configuration, its opening, and the victim's condition. If the opening is large enough, a horizontal extraction using a backboard or stretcher is preferable because it reduces the potential for further injury. For example, if a worker has fallen from a high point inside the confined space, the team may need to bring in a specialized rescue stretcher to ensure that no injuries are worsened during transport. However, if the opening is small or vertical, a vertical lift might be required using a tripod, winches, and the worker's harness. In a vertical lift, the worker should always be protected to prevent contact with edges of the entry hole that may cause further injury. For example, if the opening is a narrow manhole cover, the team may need to use a rescue tripod and winch to pull the worker out vertically. The use of a harness and retrieval lines is critical in this situation. The team must always think about where the worker is, and where they will be moving the worker, to ensure that there are no additional risks or hazards that might make the situation worse.

Throughout the entire rescue operation, the rescue team must maintain continuous communication with the attendant outside the confined space. They must use clear and concise communications to ensure that everyone on the team is fully aware of the current conditions inside, and that they are all following the plan. Any changes to the conditions must be quickly and effectively communicated to the outside team so that the necessary changes to the plan can be made. Rescue team members should work as a team, and each person should be aware of their own role, and be prepared to adapt and make changes as needed, to ensure a safe and effective rescue operation.

In summary, the rescue of an unresponsive worker from a confined space is a complex operation that requires careful planning, trained personnel, and appropriate equipment. By understanding the limitations of different rescue methods, and by carefully considering the physical and atmospheric hazards within the confined space, rescue teams can execute an effective rescue operation, while minimizing risks to everyone involved.