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North Dakota Firefighter's Association Certification System TECHNICAL RESCUE CERTIFICATION STANDARD For the following specialties: Technical Rescuer (chapter 5) Rope Rescue Level I/II (chapter 6) Confined Space Rescuer Level I/II (chapter 7) Trench Rescue Rescuer Level I/II (chapter 8) Structural Collapse Rescuer Level I/II (chapter 9) 2013 Standard

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Page 1: TECHNICAL RESCUE - ND Portal

North Dakota Firefighter's Association

Certification System

TECHNICAL

RESCUE

CERTIFICATION STANDARD

For the following specialties:

❖ Technical Rescuer (chapter 5)

❖ Rope Rescue Level I/II (chapter 6)

❖ Confined Space Rescuer Level I/II (chapter 7)

❖ Trench Rescue Rescuer Level I/II (chapter 8)

❖ Structural Collapse Rescuer Level I/II (chapter 9)

2013 Standard

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16 Firefighter Life Safety Initiatives

2

1. Define and advocate the need for a cultural change within the fire service relating to safety;

incorporating leadership, management, supervision, accountability and personal responsibility.

2. Enhance the personal and organizational accountability for health and safety throughout the fire

service.

3. Focus greater attention on the integration of risk management with incident management at all

levels, including strategic, tactical, and planning responsibilities.

4. All firefighters must be empowered to stop unsafe practices.

5. Develop and implement national standards for training, qualifications, and certification

(including regular recertification) that are equally applicable to all firefighters based on the duties

they are expected to perform.

6. Develop and implement national medical and physical fitness standards that are equally

applicable to all firefighters, based on the duties they are expected to perform.

7. Create a national research agenda and data collection system that relates to the initiatives.

8. Utilize available technology wherever it can produce higher levels of health and safety.

9. Thoroughly investigate all firefighter fatalities, injuries, and near misses.

10. Grant programs should support the implementation of safe practices and/or mandate safe

practices as an eligibility requirement.

11. National standards for emergency response policies and procedures should be developed and

championed.

12. National protocols for response to violent incidents should be developed and championed.

13.Firefighters and their families must have access to counseling and psychological support.

14.Public education must receive more resources and be championed as a critical fire and life safety

program.

15. Advocacy must be strengthened for the enforcement of codes and the installation of home fire

sprinklers.

16. Safety must be a primary consideration in the design of apparatus and equipment.

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16 Firefighter Life Safety Initiatives

3

The 16 initiatives, listed on the preceding page, address the 6 root causes of firefighter injuries, close

calls, and Line of Duty Death.

1. Ineffective policies and procedures.

2. Ineffective decision making.

3. Lack of preparedness.

4. Ineffective leadership.

5. Lack of personal responsibility.

6. Extraordinary and unpredictable circumstances.

For more information on the

Courage to Be Safe …. So Everyone Goes Home program

Contact NDFA

At: 701-222-2799

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NDFA Firefighters Certification Committee

The NDFA Certification Committee is a 12-member committee, which consists of 9- members from the North Dakota fire service; the committee members function as liaison between the fire service and the North Dakota Firefighters Association Executive Board. Members of the committee are:

➢ NDFA 1st Vice President

➢ State Fire Marshal

➢ (1) A member from the North Dakota Fire Chief’s Association that will serve a 2-year term.

➢ (1) A member from the North Dakota Fire Prevention Association that will serve a 2-year term.

➢ (1) A member from the North Dakota Instructor Society that will serve a 2-year term.

➢ (4) Four NDFA members at large, one member elected from each of the 4 training regions: NW, SW,

NE, and SE: (their terms will mirror the Trustee from their region).

➢ (1) A member of the Fargo Fire Department (Delegated Authority).

➢ The NDFA Training Director will serve as compliance officer and serve the Certification Committee

as a non-voting member of the committee.

North Dakota Firefighter’s Association

Please direct North Dakota Firefighter certification questions and comments to:

NDFA, Training Director

Robert Knuth

PO Box 6127

6909 Aurora Loop

Bismarck, North Dakota 58506

PH: (701) 222-2799 CP: (701) 516-4457 FAX: (701) 222-2899

Please visit our Web site at: www.ndfa.net

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TABLE OF CONTENTS

Introduction 6

Certification Requirements for Firefighter I 7

Entrance Requirements 7

Physical Fitness Requirements 7

Department Training 8

Written Objective 8

Manipulative Objectives 9

Department Training Officers 10

Department Training Records 10

Department In-House Comprehensive Examination 10

Certification Examinations 11

Written Examinations 11

Manipulative Skills “Spot” Examination 12

Operational Levels 13

Prerequisites for Certification 13

SECTION I – Chapter 5

Technical Rescuer (JPRs) 14

Technical Rescuer (Training Records) 38

SECTION II – Chapter 6

Rope Rescuer Level I (JPRs) 40

Rope Rescuer Level II (JPRs) 49

Rope Rescuer Level I&II (Training Records) 58

SECTION III – Chapter 7

Confined Space Rescuer Level I (JPRs) 60

Confined Space Rescuer Level II (JPRs) 66

Confined Space Rescuer Level I&II (Training Records) 70

SECTION IV – Chapter 8

Trench Rescue Rescuer Level I (JPRs) 72

Trench Rescue Rescuer Level II (JPRs) 80

Trench Rescue Rescuer Level I&II (Training Records) 87

SECTION V – Chapter 9

Structural Collapse Rescuer Level I (JPRs) 89

Structural Collapse Rescuer Level II (JPRs) 103

Structural Collapse Rescuer Level I&II (Training Records) 120

Appendix A – IN-HOUSE PROCTOR INSTRUCTIONS 122

Appendix B – EXAMINATION REQUEST FORM 124

Appendix C – CANDIDATE ACKNOWLEDGEMENT FORM 127

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INTRODUCTION

The world we live in is changing so fast, and the many phases of the fire service are becoming so technical and complex that fire service training must be utilized to its maximum potential. Any overlap, fragmentation, and lack of basic structure must be eliminated. Standardization is the natural complement and necessity.

The fire service in North Dakota, through a state certification program, can meet the needs of future growth and establish uniformity through certification. We will then have more effective and efficient utilization of resources so as to provide the best possible fire protection service for all the citizens throughout the state of North Dakota. The following certification requirements are based on the objectives listed in the National Fire Protection Association (NFPA) 1006 standard for Technical Rescuer Professional Qualifications, 2013 Edition, Chapters 5, 6, 7, 8, & 9 as verified and adopted by the NDFA Certification Committee.

Through these national standards and certification, firefighters and fire departments have a tool to measure specific levels of skills, abilities and knowledge. The NDFA Firefighters Certification Committee believe by participating in this certification program, firefighters and fire departments will be better prepared to provide quality life safety and fire protection for their communities.

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CERTIFICATION REQUIREMENTS

Entrance Requirements:

Certification as a Technical Rescuer is a unique process. Qualification is specific to a specialty area. For

qualification, a rescuer shall receive and complete training on the job performance requirements in

Chapter 5 and Chapter 6.1 (Rope Rescuer – Level I). This is the prerequisite for all job performance

requirements listed in all offered specialty areas (chapters 6.2 through 9). Technical rescuers will be identified by

their specialty area and level of qualification (i.e., Rope Rescuer — Level I, Confined Space Rescuer—Level II,

etc.).

Rescuers must:

a. Receive and complete a Department Training Record for the Technical specialty area.

b. Pass an "In House" practical skills examination.

c. Meet any other training requirements/prerequisites as defined by the Certification Committee.

d. Pass both written and practical skills Certification examination administered by evaluators appointed

by the Certification Committee.

e. Request Technical Rescue Certification for the specialty area completed.

The NDFA acknowledges the importance of and need for entrance requirements as listed in the NFPA 1001, Standard on Fire Fighter Professional Qualifications. Many agencies and departments have existing policies, regulations, etc. already in place regarding these requirements. The handling of entrance requirements is a LOCAL MATTER, outside the authority and jurisdiction of the NDFA. The NDFA will not check, test, evaluate or determine how individual agencies meet these requirements. Some departments have found it necessary to waive any type of entrance requirements due to their own special needs. As a local decision, this is permitted. However, due to the amount of physical, mental and emotional stress inherent in this profession, the NDFA strongly recommends

careful evaluation before altering or doing away with any existing entrance requirements.

Physical Fitness Requirements:

The requirements listed in NFPA 1001, Chapter 4 are:

1. Meet the minimum educational requirements established by the authority having jurisdiction.

2. Meet the medical requirements of NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.

3. Physical fitness requirements for entry-level personnel shall be developed and validated by the authority having jurisdiction. Physical fitness requirements shall be in compliance with applicable Equal Employment Opportunity regulations and other legal requirements.

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DEPARTMENT TRAINING

The position of a Technical Rescuer is one that requires a high level of skill and knowledge. The training that

is given to and received by the candidate should be of the highest quality and degree. All training received

must meet the requirements of NFPA 1006 Chapter 5 and at least one specialty area (chapters 6-9, 2013

edition) and the skills as approved by the Certification Committee contained within the NDFA Standard. All

training received must be documented and recorded in the Training Record. All testing for Technical Rescue

will be conducted following the Policies and Procedures of the NDFA.

Training for Technical Rescue can be obtained by completing one of the following training courses or

methods to qualify to take the state Certification examination.

• Technical Rescue course in one of the following Technical Specialty areas: Ropes, Confined Space,

Trench, Structural Collapse. A Training Record as given in this standard must be completed for each

person.

• Department Based Training – Departments can create their own Technical Rescue course which

meets the requirements as outlined in NFPA 1006 Chapter 5, plus the chapter containing the

Technical Specialty areas contained in Chapter 6 -9, 2013 edition). A Training Record as given in this

standard must be completed for each person involved in the department-based training.

The course material should be referenced to the following textbook to prepare the candidate to successfully pass the state certification examination.

Written Objectives:

The course material should be referenced to the following textbook(s) to prepare the candidate to successfully

pass the State Certification examination.

Written objectives for Technical Rescue are covered in the following texts for each of the specialty areas:

Chapter 6, Rope Rescue:

> Jones & Bartlett, High Angle Rope Rescue Techniques, Levels I and II, 4th Ed.

Chapter 7, Structural Collapse Rescue:

> FEMA National US & R Response System, Structural Collapse Technician; and

> Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

> J&B Learning, Emergency Medical Responder, 5th Edition

Chapter 8, Confined Space Rescue:

> CMC, Confined Space Entry and Rescue, Revised 2nd Ed; and

> J&B Learning, Emergency Medical Responder, 5th Edition

Chapter 9, Trench Rescue:

> Jones & Bartlett, Trench Rescue Principles and Practice to NFPA 1006 and 1670, 3rd Edition

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Manipulative Objectives:

There are numerous methods departments have used to help prepare their personnel for the written

examination. Considering the elevated level of skill and knowledge that is required of a Rescue Technician,

the Certification Committee recommends that the candidate participate in a comprehensive class and receive

instruction on both manipulative skills and written requirements

Each participant must be trained and evaluated in the performance of all-manipulative skills as found in this

certification standard.

Each of the manipulative skill objectives shall be completed swiftly, safely and with competence as defined

below:

• Swiftly – Each manipulative skill objective must be completed within the allotted time.

• Safely – Each manipulative skill objective must be completed safely. Actions that could injure individual or damage equipment are unacceptable. Equipment should be checked prior to skill testing or training to see that it is safe and functional.

• Competence – Each manipulative skill objective is performed in accordance with the North Dakota Standard. This includes performing the proper steps as outlined in the respective JPR skill sheet. Competence will be measured in accordance with the NDFA manipulative skill objectives.

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Department Training Officers:

For departments to enroll in the certification process, it is necessary for the department to assign training officers. It is recommended the department assign at least two personnel as training officers to coordinate and provide certification training.

Department training officers should be State Certified at the level they are teaching. In addition, the NDFA strongly recommends training officers be state certified at the Instructor I level.

Department training officers will be responsible for certification training. Their primary responsibility will be to teach, evaluate, and “In-House” test department personnel on the manipulative skill and evolution requirements for each level of certification training.

Departments who do not have certified personnel to act as training officers for certification training should contact the NDFA-Training Director at (701) 222-2799 for assistance in setting up and monitoring certification training.

Department Training Records:

Each candidate shall have a training record on file with the department, which indicates whether he/she has trained on all manipulative skill objectives. This record shall be signed off or initialed by a department training officer. Training records must indicate the date, instructor, and total number of hours trained for each manipulative skill objective. Departments shall use the one provided at the end of the section correlating to the standard for which he/she is attempting.

Department "In-House" Comprehensive Examination:

At the completion of the department’s manipulative skills training, the department is required to hold an “in-house” comprehensive examination for the level being trained. This is a comprehensive “In-House” test conducted by the department training officers or course instructors. This test is to ensure that skill mastery has been obtained from the beginning to the end of the training process, and to prepare participants for the state examination. Training officers may utilize other personnel to assist in administering the exam; however, all personnel assisting with the testing should be certified at the level they are “In-House” testing.

In-House testers shall follow the Tester Instruction sheet to provide for uniformity and fairness during the exam. It is recommended candidates be given two attempts at any skill. If they fail on

the second try, then they have failed the evaluation and are required to go through additional

training by the department trainer. No training, teaching, or coaching is allowed during the test. After the evaluation, using the test to teach and train is recommended.

If manipulative skill weaknesses are evident, the department shall conduct additional training and hold a new department “In-House” comprehensive examination. Only those candidates who successfully pass the department’s skills and fire ground evolutions “In-House” test will be allowed to participate in the state certification exam. Department training records must show all candidates have successfully passed the “In-House” examination.

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CERTIFICATION EXAMINATIONS

After completion of the training process, the Fire Chief/Head of Department can request testing for the department. Using the “Request Examination” form in Appendix B. The Fire Chief/Head of Department may request a written examination and manipulative test for certification. A testing fee may be charged at the time of certification. A separate application must be sent to the NDFA for each attempt. Request forms must reach the NDFA no later than 30 days prior to the examination date. The entire examination process must be completed within 1 year of the first written exam date.

Written Examinations:

The written examinations are randomly generated, 20-30 question per level, tests covering the

written objectives of the Technical Rescue standard of NFPA 1006 (2013 ed.) in Chapters 5, 6, 7,

8, & 9. A minimum score of 70% is required to pass the certification exam. Candidates failing the

first attempt of the written exam will be permitted to retest no sooner than 30 days from the date

of the last exam. Three attempts are given to pass the exam. If a participant fails the written

examination three times, he/she has failed the certification process and must wait 1 year from the

date of the last failed exam before re-entering the testing process. Exam results are forwarded to

the Chief/Administrator within 30 days following the receipt of the completed Exam.

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Manipulative Skills “Spot Check” Examination:

This is a two-step examination. A department record check and the manipulative skills "spot check" examination. A certification tester appointed by the NDFA Certification Advisory Committee conducts the examination. Training records are checked. If records are inadequate, corrective action must be taken before proceeding to the next step. The records must meet minimum requirements and are checked for the following:

• Participant has been trained in each manipulative skill for the level being evaluated.

• A department training officer has signed off each manipulative skill.

• Each trainee has passed a department "in-house" manipulative skills examination. The manipulative skill "spot check" examination is graded on a 100% pass/fail basis. The test is graded in the following three areas: Swiftly - Each manipulative skill objective must be completed within the allotted time. Safely - Each manipulative skill objective must be completed safely. Conduct that could injure an individual or damage equipment is unacceptable. Equipment should be checked prior to skill testing or training to see that it is safe and functional. Competence - Each manipulative skill objective is performed in accordance with the Utah Standard. This includes performing the proper steps in sequence. Competence will be measured in accordance with the UFSCS manipulative skill objectives. Participants are "spot checked" on three manipulative skills, or one scenario depending upon the level. The skills will be from NFPA 1006 (2013 ed.) Chapter 5 and the Technical Specialty areas in which the candidate has received training as contained in Chapter 6, 7, 8, or 9. No prior notification of which skill being tested will be given. Participants are given two attempts initially (if necessary) to perform each skill. If they fail on the second attempt, the applicants must wait 30 days before the third and final attempt. Participants taking third attempts will test on the skill they missed plus an additional skill from the section of the standard they failed during the previous two attempts. No training, teaching, or coaching is allowed during the state test. Participants who have failed the third attempt of the written examination or the manipulative skills examination have failed the certification process and must wait 1 year from the date of the failed third attempt to re-enter state testing. The participant will begin testing with a new 1st attempt of the written examination.

When all requirements for certification have been met, applicants are eligible to be certified. The

Chief/Administrator may apply to the North Dakota Firefighter’s Association for certification for

those participants who have successfully completed the certification training/testing process.

Request for state certification will be submitted to the NDFA using the "Request for Certification"

form provided in Appendix C. The names are then checked against the official state records to

ensure that everyone listed has met all requirements and prerequisites.

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Operational Levels.

The AHJ shall establish written standard operating procedures (SOPs) consistent with one of the following

operational levels for each of the disciplines defined in this document:

a. Level I. This level shall apply to individuals who identify hazards, use equipment, and apply limited

techniques specified in this standard to perform technical rescue operations.

b. Level II. This level shall apply to individuals who identify hazards, use equipment, and apply advanced

techniques specified in this standard to perform technical rescue operations.

TECHNICAL RESCUER CERTIFICATION PREREQUISITES:

Standard Edition Level Prerequisites

1006 2013 Rope Rescue Level I Sections 5.2 through 5.5

Rope Rescue Level II Section 6.1

Confined Space Level I Sections 5.2 through 5.5

Confined Space Level II Section 7.1

Trench Rescue Level I Sections 5.2 through 5.5

Trench Rescue Level II Section 8.1

Structural Collapse Level I Sections 5.2 through 5.5

Structural Collapse Level II Section 9.1

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SECTION – I

CHAPTER 5 – TECHNICAL RESCUER

JOB PERFORMANCE REQUIREMENTS

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Technical Rescuer Skills Assessment

Skill Sheet #1

IDENTIFY NEEDED SUPPORT RESOURCES

JPR: NFPA 1006-2013 edition, Section 5.2.1

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, applicable reference material, and portable radio

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will identify the needed support resources, given a specific type of rescue incident, so that a

resource cache is managed, scene lighting is provided for the tasks to be undertaken, environmental concerns are

managed, personnel rehabilitation is facilitated, and the support operation facilitates rescue operational objectives.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail 1st Attempt 2nd attempt

____ ____ 1. Resource cache is managed and tracked

____ ____ 2. Scene lighting is provided for the tasks to be undertaken

____ ____ 3. Environmental concerns are managed

____ ____ 4. Personnel rehab is facilitated

____ ____ 5. Personnel rotations are managed

____ ____ 6. The support operation facilitates rescue operational objectives

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #2

SIZE UP A RESCUE INCIDENT

JPR: NFPA 1006-2013 edition, Section 5.2.2

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, applicable reference material, and portable radio

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will size up a rescue incident, given background information and applicable reference

materials, so that the type of rescue is determined, the number of victims is identified, the last reported location of

all victims is established, witnesses and reporting parties are identified and interviewed, resource needs are assessed,

search parameters are identified, and information required to develop an incident action plan is obtained.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Type of rescue is determined

____ ____ 2. Number of victims and last reported location of all victims is established

____ ____ 3. Witnesses and reporting parties are identified and interviewed

____ ____ 4. Resource needs are assessed

____ ____ 5. Search parameters are identified

____ ____ 6. Information required to develop an incident action plan is obtained and provided to Incident

Command

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #3

MANAGE INCIDENT HAZARDS

JPR: NFPA 1006-2013 edition, Section 5.2.3

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, applicable reference material, portable radio, and equipment

pertinent to a rescue

Evaluator Equipment Required: Proper PPE

Read to Candidate: For this skill event, you will manage incident hazards, given scene control barriers, personal

protective equipment, requisite equipment, and available specialized resources, so that all hazards are identified, re-

source application fits the operational requirements, hazard isolation is considered, risks to rescuers and victims are

minimized, and rescue time constraints are taken into account.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. All hazards are identified

____ ____ 2. Resource applications fit the operational requirements

____ ____ 3. Hazards were isolated to minimize risk to rescuers and victims

____ ____ 4. Rescue time constraints were taken into account

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #4

MANGE RESOURCES IN A RESCUE INCIDENT

JPR: NFPA 1006-2013 edition, Section 5.2.4

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, applicable reference material, portable radio, and equipment

pertinent to a rescue

Evaluator Equipment Required: Proper PPE

Read to Candidate: For this skill event, you will manage resources in a rescue incident, given incident

information, a means of communication, resources, tactical worksheets, personnel accountability protocol,

applicable references, and standard operating procedures, so that references are utilized, personnel are accounted for,

deployed resources achieve desired objectives, incident actions are documented, rescue efforts are coordinated, the

command structure is established, task assignments are communicated and monitored, and actions are consistent

with applicable regulations.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. References are utilized

____ ____ 2. Incident management system used

____ ____ 3. Completes tactical worksheets

____ ____ 4. Evaluates incident information

____ ____ 5. Uses correct resources for operational needs

____ ____ 6. Manages and operates communication equipment

____ ____ 7. Communicates effectively so that objectives are met

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #5

INITIATE A DISCIPLINE SPECIFIC SEARCH

JPR: NFPA 1006-2013 edition, Section 5.2.5

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, applicable reference material, portable radio, and equipment

pertinent to a search

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will initiate a discipline-specific search, given hazard-specific PPE, equipment pertinent to

search mission, an incident location, and victim investigative information, so that search parameters are established;

the victim profile is established; the entry and exit of all people either involved in the search or already within the

search area are questioned and the information is updated and relayed to command; the personnel assignments match

their expertise; all victims are located as quickly as possible; applicable technical rescue concerns are managed; risks

to searchers are minimized; and all searchers are accounted for.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Search parameters are established

____ ____ 2. Victim profile is established

____ ____ 3. The entry and exit of all people either involved in the search or already within

the search area are questioned and the information is relayed to command

____ ____ 4. Personnel assignments match their expertise

____ ____ 5. All victims are located as quickly as possible

____ ____ 6. Applicable technical rescue concerns are managed

____ ____ 7. Risks to searchers are minimized

____ ____ 8. All searchers are accounted for

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #6

PERFORM GROUND SUPPORT ACTIVITIES FOR HELICOPTER OPERATIONS

JPR: NFPA 1006-2013 edition, Section 5.2.6

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, portable radio, and requisite equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will perform ground support operations for helicopter activities, given a rescue

scenario/incident, helicopter, operational plans, PPE, requisite equipment, and available specialized resources, so

that rescue personnel are aware of the operational characteristics of the aircraft and demonstrate operational

proficiency in establishing and securing landing zones and communicating with aircraft personnel until the

assignment is complete.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Rescue personnel are aware of the operational characteristics of the aircraft ____ ____ 2. Rescue personnel demonstrate operational proficiency in establishing and

securing landing zones

____ ____ 3. Rescue personnel communicate with the aircraft personnel until assignment

is complete

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #7

TERMINATE A TECHNICAL RESCUE OPERATION

JPR: NFPA 1006-2013 edition, Section 5.2.7

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, incident scenario, assigned resources, and site safety data

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, terminate a technical rescue operation, given an incident scenario, assigned resources, and site

safety data, so that rescuer risk and site safety are managed, scene security is maintained, and custody transferred to

a responsible party, personnel and resources are returned to a state of readiness, recordkeeping and documentation

occur, and post event analysis is conducted.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Hazard recognition

____ ____ 2. Risk Analysis

____ ____ 3. Use of site control equipment and methods

____ ____ 4. Use of data collection and management systems

____ ____ 5. Use of asset and personnel tracking systems

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #8

TRIAGE VICTIMS

JPR: NFPA 1006-2013 edition, Section 5.3.1

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, portable radio, and triage tags

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will triage victims, given triage tags and local protocol, so that rescue versus recovery

factors are assessed, triage decisions reflect resource capabilities, severity of injuries is determined, and victim care

and rescue priorities are established in accordance with local protocol. This is not a timed event.

To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Dons appropriate PPE

____ ____ 2. Assesses victims per local triage protocol

____ ____ 3. Determines if victims can be rescued or if this is a recovery

____ ____ 4. Applies triage tag with correct category to the victim, based on local protocol

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #9

MOVE A VICTIM IN A LOW-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 5.3.2

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rope rescue system, a specified minimum travel distance for the litter

tender, life safety harnesses, litters, bridles, and specialized equipment necessary for the environment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will move a victim in a low-angle environment, given victim transport equipment, litters,

other specialized equipment, and victim removal systems specific to the rescue environment, so that the victim is

moved without undue further injuries, risks to rescuers are minimized, the integrity of the victim’s securement

within the transfer device is established and maintained, the means of attachment to the rope rescue system is

maintained, and the victim is removed from the hazard.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Select and secured victim to transport equipment

____ ____ 2. Assemble and operate environment-specific victim removal systems

____ ____ 3. Maneuver across the terrain

____ ____ 4. Manage the litter while suspended from the rope rescue system

____ ____ 5. Evaluate surroundings for potential hazards

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 24: TECHNICAL RESCUE - ND Portal

24

Technical Rescuer Skills Assessment

Skill Sheet #10

INSPECT AND MAINTAIN HAZARD-SPECIFIC PPE

JPR: NFPA 1006-2013 edition, Section 5.4.1

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, technical rescue references, and requisite equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will inspect and maintain hazard specific PPE, given clothing or equipment for the

protection of the rescuers, cleaning and sanitation supplies, maintenance logs or records, and such tools and

resources as are indicated by the manufacturer’s guidelines for assembly or disassembly of components during

repair or maintenance, so that damage, defects, and wear are identified and reported or repaired, equipment has been

performed and documented consistent with the manufacturer’s recommendations.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Identifies wear and damage indicators for PPE

____ ____ 2. Evaluates the operational readiness of PPE

____ ____ 3. Completes logs and records

____ ____ 4. Uses reference materials and cleaning equipment specific to the task

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #11

INSPECT AND MAINTAIN RESCUE EQUIPMENT

JPR: NFPA 1006-2013 edition, Section 5.4.2

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, technical rescue references, and requisite equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will inspect and maintain rescue equipment, given maintenance logs and records, tools, and

resources as indicated by the manufacturer’s guidelines, equipment replacement protocol, and organizational

standard operating procedure, so that the operational status of equipment is verified and documented, all components

are checked for operation, deficiencies are repaired or reported as indicated by standard operating procedure, and

items subject to replacement protocol are correctly disposed of and changed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Identifies wear and damage indicators for rescue equipment

____ ____ 2. Evaluates operational readiness of equipment

____ ____ 3. Completes logs and records

____ ____ 4. Selects and uses correct maintenance tools per manufacturer guidelines

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 26: TECHNICAL RESCUE - ND Portal

26

Technical Rescuer Skills Assessment

Skill Sheet #12

DEMONSTRATE KNOTS, BENDS, AND HITCHES

JPR: NFPA 1006-2013 edition, Section 5.5.1

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, 8mm “prusik” rope, ½” rescue rope, rescue webbing

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will demonstrate knots, bends, and hitches, given ropes, webbing, and a list of knots used by

the agency, so that the knots are dressed, recognizable, and backed up as required.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly ties end-of-line loop (figure eight on a bight)

____ ____ 2. Correctly ties midline loop (butterfly knot)

____ ____ 3. Correctly secures rope around desired object (figure eight follow through)

____ ____ 4. Correctly joins rope or webbing ends together (water knot)

____ ____ 5. Correctly ties “gripping rope” (clove hitch)

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 27: TECHNICAL RESCUE - ND Portal

27

Technical Rescuer Skills Assessment

Skill Sheet #13

CONSTRUCT A SINGLE POINT ANCHOR SYSTEM

JPR: NFPA 1006-2017 edition, Section 5.5.2

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, suitable anchor, requisite equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will construct a single-point anchor system, given life safety rope and other auxiliary rope

rescue equipment, so that the chosen anchor system fits the incident needs, meets or exceeds the expected load, and

does not interfere with rescue operations, an efficient anchor point is chose, the need for redundant anchor points is

assessed and used as required, the anchor system is inspected and loaded prior to being placed into service, and the

integrity of the system is maintained throughout the operation.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Evaluates anchor for required strength, location, and surface contour

____ ____ 2. Selects appropriate rope and equipment

____ ____ 3. Ties appropriate knots correctly

____ ____ 4. Rigs the system correctly

____ ____ 5. Performs system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #14

PLACE EDGE PROTECTION

JPR: NFPA 1006-2013 edition, Section 5.5.3

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, requisite equipment, and a sharp or abrasive edge

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, place edge protection, given life safety rope or webbing traversing a sharp or abrasive edge, edge

protection, and other auxiliary rope rescue equipment, so that the rope or webbing is protected from abrasion or

cutting, the rescuer is safe from falling while placing the edge protection, the edge protection is secure, and the rope

or webbing is securely placed on the edge protection.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selects appropriate protective devices for protecting rope and webbing

____ ____ 2. Uses personal fall protection while working near edges

____ ____ 3. Secures edge protection

____ ____ 4. Secures ropes or webbing in a specific location

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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29

Technical Rescuer Skills Assessment

Skill Sheet #15

CONSTRUCT A SIMPLE ROPE MECHANICAL ADVANTAGE SYSTEM

JPR: NFPA 1006-2013 edition, Section 5.5.4

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, life safety rope, carabiners, pulleys, rope grab devices, and auxiliary

rope rescue equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, construct a simple rope mechanical advantage system, given life safety rope, carabiners, pulleys,

rope grab devices, and auxiliary rope rescue equipment, so that the system constructed can accommodate the load, is

efficient, and is connected to an anchor system and the load.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Tie appropriate knots

____ ____ 2. Choose and rig systems

____ ____ 3. Attach mechanical advantage system to the anchor system and load

____ ____ 4. Perform a system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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30

Technical Rescuer Skills Assessment

Skill Sheet #16

DIRECT A TEAM IN THE OPERATION OF A SIMPLE ROPE MECHANICAL

ADVANTAGE SYSTEM IN A LOW-ANGLE RAISING OPERATION

JPR: NFPA 1006-2013 edition, Section 5.5.5

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, life safety rope, carabiners, pulleys, rope grab devices, and auxiliary

rope rescue equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, direct a team in the operation of a simple rope mechanical advantage system in a low-angle

raising operation, given rescue personnel, a specified minimum travel distance for the load, an established rope

rescue system incorporating a simple rope mechanical advantage system, a load to be moved, and an anchor

system, so that the movement is controlled; a reset is accomplished; the load can be held in place when needed;

operating methods do not stress the system to the point of failure; commands are used to direct the operation; and

potential problems are identified, communicated, and managed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Load movement is controlled

____ ____ 2. Reset is accomplished properly

____ ____ 3. Load held in place as directed by IC

____ ____ 4. System not overly stressed

____ ____ 3. Proper commands used to direct operations

____ ____ 4. Problems identified, communicated, and managed

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #17

FUNCTION AS A LITTER TENDER IN A LOW-ANGLE LOWERING OR RAISING

OPERATION

JPR: NFPA 1006-2017 edition, Section 5.5.6

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rope rescue system, specified minimum travel distance for the liter

tender, life safety harness, litters, bridles, and specialized equipment necessary for the environment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, perform the activities of a litter tender in a low-angle lowering or raising operation, given a rope

rescue system, a specified minimum travel distance for the litter tender, life safety harnesses, litters, bridles, and

specialized equipment necessary for the environment, so that risks to victims and rescuers are minimized; the means

of attachment to the rope rescue system is secure; and the travel path is negotiated while minimizing risks to

equipment or persons.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Uses proper PPE

____ ____ 2. Attaches life safety harness to the rope rescue system

____ ____ 3. Maneuver the litter past obstacles

____ ____ 4. Manage the litter while attached to the rope rescue system

____ ____ 5. Evaluate surroundings for potential hazards

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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32

Technical Rescuer Skills Assessment

Skill Sheet #18

CONSTRUCT A LOWERING SYSTEM

JPR: NFPA 1006-2013 edition, Section 5.5.7

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, an anchor system, life safety rope, descent control device, auxiliary

rope rescue equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, construct a lowering system, given an anchor system, life safety rope(s), descent control device,

and auxiliary rope rescue equipment, so that the system can accommodate the load, is efficient, is capable of

controlling the descent, is capable of holding the load in place or lowering with minimal effort over the required

distance, and is connected to an anchor system and the load.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Dons appropriate PPE

____ ____ 2. Tie appropriate knots

____ ____ 3. Perform rigging

____ ____ 4. Attach descent control device

____ ____ 5. Anchor system and load

____ ____ 6. Perform system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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33

Technical Rescuer Skills Assessment

Skill Sheet #19

DIRECT A LOWERING OPERATION IN A LOW-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 5.5.8

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rescue personnel, established lowering system, specified minimum

travel distance for the load and a load.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, direct a lowering operation in a high-angle environment, given rescue

personnel, an established lowering system, a specified minimum travel distance for the load, and a load to be moved,

so that the movement is controlled, the load can be held in place when needed, operating methods do not stress the

system to the point of failure, rope commands are used to direct the operation, and potential problems are identified,

communicated, and managed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Direct personnel using operational commands

____ ____ 2. Analyzes system efficiency

____ ____ 3. Manage movement of the load in a high-angle environment

____ ____ 4. Identify safety concerns

____ ____ 5. Perform a system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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34

Technical Rescuer Skills Assessment

Skill Sheet #20

CONSTRUCT A BELAY SYSTEM

JPR: NFPA 1006-2013 edition, Section 5.5.9

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, life safety rope, anchor system, rope rescue equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, construct a belay system, given life safety rope, anchor systems, PPE, and rope rescue

equipment, so that the system is capable of arresting a fall, a fall will not result in system failure, the system is not

loaded unless actuated, actuation of the system will not injure or otherwise incapacitate the belayer, the belayer is

not rigged into the equipment components of the system, and the system is suitable to the site and is connected to an

anchor system and the load.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Select a belay system

____ ____ 2. Wear appropriate task specific PPE

____ ____ 3. Tie rescue knots with safety knots as required

____ ____ 4. Perform rigging

____ ____ 5. Attach to anchor system and load

____ ____ 6. Perform system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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35

Technical Rescuer Skills Assessment

Skill Sheet #21

OPERATE A BELAY SYSTEM DURING A LOWERING OR RAISING OPERATION

JPR: NFPA 1006-2013 edition, Section 5.5.10

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, operating lowering or raising mechanical advantage system, specified

minimum travel distance for the load, a belay system and a load

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, operate a belay system during a lowering or raising operation, given an operating lowering or

raising mechanical advantage system, a specified minimum travel distance for the load, a belay system, and a load,

so that the potential fall factor is minimized, the belay device system is not actuated during operation of the primary

rope rescue system, the belay system is prepared for actuation at all times during the operation, the belayer is

attentive at all times during the operation, the load’s position is continually monitored, and the belayer moves the

rope through the belay device as designed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Don task specific PPE

____ ____ 2. Tie approved knots

____ ____ 3. Properly attach a belay line to a belay device

____ ____ 4. Perform a system safety check

____ ____ 5. Manage and communicate belay system status effectively

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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36

Technical Rescuer Skills Assessment

Skill Sheet #22

BELAY A LOAD IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 5.5.11

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, a belay system and a falling load

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, belay a falling load in a high-angle environment, given a belay system and a dropped load, so

that the belay line is not taut until the load is falling, the belay device is actuated when the load falls, the fall is

arrested in a manner that minimizes the force transmitted to the load, the belayer utilizes the belay system as

designed, and the belayer is not injured or otherwise incapacitated during actuation of the belay system.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Don task specific PPE

____ ____ 2. Tie approved knots

____ ____ 3. Operate a belay system as designed

____ ____ 4. Recognize and arrest a falling load ____ ____ 5. Communicate belay system actuation

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Technical Rescuer Skills Assessment

Skill Sheet #23

CONDUCT A SYSTEM SAFETY CHECK

JPR: NFPA 1006-2013 edition, Section 5.5.12

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rope rescue system and rescue personnel.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will conduct a system safety check, given rope rescue system and rescue personnel, so that a

physical/visual check of the system is made to ensure proper rigging, a load test is performed prior to life-loading

the system, and verbal confirmation of these actions is announced and acknowledged before life-loading the rope

rescue system.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Dons appropriate PPE

____ ____ 2. Inspects rope rescue system components for damage

____ ____ 3. Assesses rope rescue system for configuration and secure equipment

components

____ ____ 4. Inspects all rigging

____ ____ 5. Performs a system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 38: TECHNICAL RESCUE - ND Portal

TECHNICAL RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 5 – Job Performance Requirements

38

NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Pre-Requisite

Chapter 5

IDENTIFY NEEDED SUPPORT RESOURCES 1

SIZE UP A RESCUE INCIDENT 2

MANAGE INCIDENT HAZARDS 3

MANGE RESOURCES IN A RESCUE INCIDENT 4

INITIATE A DISCIPLINE SPECIFIC SEARCH 5

PERFORM GROUND SUPPORT ACTIVITIES FOR HELICOPTER

OPERATIONS 6

TERMINATE A TECHNICAL RESCUE OPERATION 7

TRIAGE VICTIMS 8

MOVE A VICTIM IN A LOW-ANGLE ENVIRONMENT 9

INSPECT AND MAINTAIN HAZARD-SPECIFIC PPE 10

INSPECT AND MAINTAIN RESCUE EQUIPMENT 11

DEMONSTRATE KNOTS, BENDS, AND HITCHES 12

CONSTRUCT A SINGLE POINT ANCHOR SYSTEM 13

PLACE EDGE PROTECTION 14

CONSTRUCT A SIMPLE ROPE MECHANICAL ADVANTAGE

SYSTEM

15

DIRECT A TEAM IN THE OPERATION OF A SIMPLE ROPE

MECHANICAL ADVANTAGE SYSTEM IN A LOW-ANGLE

RAISING OPERATION

16

Page 39: TECHNICAL RESCUE - ND Portal

TECHNICAL RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 5 – Job Performance Requirements

39

SECTION

TRAINING IN-HOUSE

MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Chapter 5

(cont.)

FUNCTION AS A LITTER TENDER IN A LOW-

ANGLE LOWERING OR RAISING OPERATION 17

CONSTRUCT A LOWERING SYSTEM 18

DIRECT A LOWERING OPERATION IN A LOW-ANGLE

ENVIRONMENT

19

CONSTRUCT A BELAY SYSTEM 20

OPERATE A BELAY SYSTEM DURING A LOWERING OR

RAISING OPERATION

21

BELAY A LOAD IN A HIGH-ANGLE ENVIRONMENT 22

CONDUCT A SYSTEM SAFETY CHECK 23

Page 40: TECHNICAL RESCUE - ND Portal

40

SECTION – II

CHAPTER 6 – ROPE RESCUE - Level I

JOB PERFORMANCE REQUIREMENTS

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41

Rope Rescue Level I Skills Assessment

Skill Sheet #1

DIRECT A TEAM IN THE OPERATION OF A SIMPLE ROPE MECHANICAL

ADVANTAGE SYSTEM IN A HIGH-ANGLE RAISING OPERATION

JPR: NFPA 1006-2013 edition, Section 6.1.1

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rescue personnel, established rope rescue system incorporating a simple

rope mechanical advantage system, a specified minimum travel distance for the load, a load to be moved, and an anchor

system

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, direct a team in the operation of a simple rope mechanical advantage system in a high-angle

raising operation, given rescue personnel, an established rope rescue system incorporating a simple rope mechanical

advantage system, a specified minimum travel distance for the load, a load to be moved, and an anchor system, so

that the movement is controlled, a reset is accomplished, the load can be held in place when needed, operating

methods do not stress the system to the point of failure, commands are used to direct the operation and potential

problems are identified, communicated, and managed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Directs personnel effectively

____ ____ 2. Uses operational commands

____ ____ 3. Analyzes system efficiency

____ ____ 4. Identify safety concerns

____ ____ 5. Perform system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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42

Rope Rescue Level I Skills Assessment

Skill Sheet #2

DIRECT A LOWERING OPERATION IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.1.2

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rescue personnel, established lowering system, specified minimum

travel distance for the load and a load.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, direct a lowering operation in a high-angle environment, given rescue

personnel, an established lowering system, a specified minimum travel distance for the load, and a load to be moved,

so that the movement is controlled, the load can be held in place when needed, operating methods do not stress the

system to the point of failure, rope commands are used to direct the operation, and potential problems are identified,

communicated, and managed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Direct personnel using operational commands

____ ____ 2. Analyzes system efficiency

____ ____ 3. Manage movement of the load in a high-angle environment

____ ____ 4. Identify safety concerns

____ ____ 5. Perform a system safety check

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 43: TECHNICAL RESCUE - ND Portal

43

Rope Rescue Level I Skills Assessment

Skill Sheet #3

CONSTRUCT A MULTIPLE-POINT ANCHOR SYSTEM

JPR: NFPA 1006-2017 edition, Section 6.1.3

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, suitable anchor, requisite equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will construct a multiple-point anchor system, given life safety rope and other auxiliary rope

rescue equipment, so that the chosen anchor system fits the incident needs, the system strength meets or exceeds the

expected load and does not interfere with rescue operations, equipment is visually inspected prior to being put in

service, the nearest anchor point that will support the load is chosen, the anchor system is system safety checked

prior to being placed into service, the integrity of the system is maintained throughout the operation, and weight will

be distributed between more than one anchor point.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. The chosen anchor system fits the incident needs

____ ____ 2. The system meets or exceeds the expected load

____ ____ 3. Selects effective knots

____ ____ 4. Evaluate incident operations as related to interference concerns and setup

____ ____ 5. Perform a system safety check

____ ____ 6. Evaluate system components for comprised integrity

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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44

Rope Rescue Level I Skills Assessment

Skill Sheet #4

CONSTRUCT A COMPOUND ROPE MECHANICAL ADVANTAGE SYSTEM

JPR: NFPA 1006-2013 edition, Section 6.1.4

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, a load, an anchor system, life safety rope, carabiners, pulleys, rope grab

devices, and rope rescue equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, construct a compound rope mechanical advantage system, given a load, an anchor system, life

safety rope, carabiners, pulleys, rope grab devices, and rope rescue equipment, so that the system constructed

accommodates the load and reduces the force required to lift the load, operational interference is factored and

minimized, the system is efficient, a system safety check is completed, and the system is connected to an anchor

system and the load.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Determines incident needs as related to choosing compound rope systems

____ ____ 2. Select effective knots

____ ____ 3. Calculate expected loads

____ ____ 4. Evaluate incident operations as related to interference concerns and setups

____ ____ 5. Perform system safety check

____ ____ 6. Evaluate system components for compromised integrity

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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45

Rope Rescue Level I Skills Assessment

Skill Sheet #5

CONSTRUCT A FIXED ROPE SYSTEM

JPR: NFPA 1006-2013 edition, Section 6.1.5

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, anchor system, life safety rope, rope rescue equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, construct a fixed rope system, given an anchor system, a life safety rope, and rope rescue

equipment, so that the system constructed can accommodate the load, is efficient, and is connected to an anchor

system and the load, and a system safety check is performed, and the results meet the incident requirements for

descending or ascending operations.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Select effective knots

____ ____ 2. Calculate expected loads

____ ____ 3. Evaluate operational interference concerns and setup

____ ____ 4. Perform system safety check

____ ____ 5. Evaluate system components for compromised integrity

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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46

Rope Rescue Level I Skills Assessment

Skill Sheet #6

DIRECT THE OPERATION OF A COMPOUND ROPE MECHANICAL ADVANTAGE

SYSTEM IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.1.6

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rope rescue system incorporating a compound rope mechanical

advantage system, a load to be moved, a specific minimum travel distance

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, direct the operation of a compound rope mechanical advantage system in a high-angle

environment, given a rope rescue system incorporating a compound rope mechanical advantage system and a load to

be moved, and a specified minimum travel distance for the load, so that a system safety check is performed; a reset

is accomplished, and the movement is controlled; the load can be held in place when needed; operating methods do

not stress the system to the point of failure; operational commands are clearly communicated; and potential

problems are identified, communicated, and managed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Determines incident needs

____ ____ 2. Evaluates incident operations as related to interference concerns

____ ____ 3. Complete system safety check

____ ____ 4. Continually evaluate system components for compromised integrity

____ ____ 5. Direct personnel effectively

____ ____ 6. Communicate commands

____ ____ 7. Analyze system efficiency

____ ____ 8. Manage load movement

____ ____ 9. Identify Concerns

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 47: TECHNICAL RESCUE - ND Portal

47

Rope Rescue Level I Skills Assessment

Skill Sheet #7

ASCEND A FIXED ROPE IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.1.7

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, anchored fixed rope system, specified minimum distance for the

rescuer, system to allow ascent of a fixed rope, a structure, a belay system and life safety harness.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, ascend a fixed rope in a high-angle environment, given an anchored fixed rope system, a

specified minimum distance for the rescuer, a system to allow ascent of a fixed rope, a structure, a belay system, a

life safety harness worn by the person ascending, and PPE, so that the person ascending is secured to the fixed rope

in a manner that will not allow him or her to fall; the person ascending is attached to the rope by means of an ascent

control device(s) with at least two points of contact; injury to the person ascending is minimized; the person

ascending can stop at any point on the fixed rope and rest suspended by his or her harness; the system will not be

stressed to the point of failure; the person ascending can convert his or her ascending system to a descending system;

obstacles are negotiated; the system is suitable for the site; and the objective is reached.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Select and use rescuer harness

____ ____ 2. Select proper PPE

____ ____ 3. Use a system for ascending a fixed rope

____ ____ 4. Use of ascent control devices

____ ____ 5. Minimum of 2 connections from rescuer harness to the fixed rope system

____ ____ 6. Maneuver around existing environmental and system specific obstacles

____ ____ 7. Convert the ascending system to a descending system while suspended from

the fixed rope; and evaluate surroundings for potential hazards.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 48: TECHNICAL RESCUE - ND Portal

48

Rope Rescue Level I Skills Assessment

Skill Sheet #8

DESCEND A FIXED ROPE IN A HIGH-ANGLE ENVIORNMENT

JPR: NFPA 1006-2013 edition, Section 6.1.8

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, anchored fixed rope system, specified minimum distance for the

rescuer, system to allow descent of a fixed rope, a structure, a belay system and life safety harness.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, ascend a fixed rope in a high-angle environment, given an anchored fixed rope system, a

specified minimum distance for the rescuer, a system to allow descent of a fixed rope, a belay system, a life safety

harness worn by the person descending, and PPE, so that the person descending is secured to the fixed rope in a

manner that will not allow him or her to fall; the person descending is attached to the rope by means of an descent

control device; the speed of descent is controlled; injury to the person descending is minimized; the person

descending can stop at any point on the fixed rope and rest suspended by his or her harness; the system will not be

stressed to the point of failure; the system is suitable for the site; and the objective is reached.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Select and use rescuer harness

____ ____ 2. Select proper PPE

____ ____ 3. Use a system for descending a fixed rope

____ ____ 4. Use of a descent control device

____ ____ 5. Evaluate surroundings for potential hazards

____ ____ 6. Maneuver around existing environmental and system specific obstacles

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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49

SECTION – II

CHAPTER 6 – ROPE RESCUE - Level II

JOB PERFORMANCE REQUIREMENTS

Page 50: TECHNICAL RESCUE - ND Portal

50

Rope Rescue Level II Skills Assessment

Skill Sheet #1

COMPLETE AN ASSIGNMENT WHILE SUSPENDED FROM A ROPE RESCUE

SYSTEM IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.2.1

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, portable radio, and requisite equipment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

Complete an assignment while suspended from a rope rescue system in a high-angle environment, given a rope

rescue system, an assignment, life safety harnesses, litters, bridles, and specialized equipment necessary for the

environment, so that risks to victims and rescuers are minimized; the means of attachment to the rope rescue system

is secure; selected specialized equipment facilitates efficient rescuer movement; and specialized equipment does not

unduly increase risks to rescuers or victims.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selects and uses proper harness and PPE for the environment

____ ____ 2. Attach harness to rope rescue system

____ ____ 3. Maneuver around existing environmental and system specific obstacles

____ ____ 4. Movement of system is controlled

____ ____ 5. Performed work while suspended from rope rescue system

____ ____ 6. Evaluated surroundings for potential hazards

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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51

Rope Rescue Level II Skills Assessment

Skill Sheet #2

MOVE A VICTIM IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.2.2

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rope rescue system, a specified minimum travel distance for the litter

tender, life safety harnesses, litters, bridles, and specialized equipment necessary for the environment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will manage the movement of the victim as the rescuer in a high-angle environment, given a

rope rescue system, a specified minimum travel distance for the victim, victim transfer devices, and specialized

equipment necessary for the environment, so that risks to victims and rescuers are minimized; undesirable

victim movement within the transfer device is minimized; the means of attachment to the rope rescue system is

maintained; the victim is removed from the hazard; selected specialized equipment facilitates efficient victim

movement; and the victim can be transported to the local EMS provider.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selects and uses proper PPE for the conditions

____ ____ 2. Choose proper patient transfer devices

____ ____ 3. Attach transfer device to rope rescue system

____ ____ 4. Hazards reduced for rescuer(s) and victim(s)

____ ____ 5. Determined specialized equipment needs for victim movement

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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52

Rope Rescue Level II Skills Assessment

Skill Sheet #3

FUNCTION AS A LITTER TENDER IN A HIGH-ANGLE LOWERING OR RAISING

OPERATION

JPR: NFPA 1006-2013 edition, Section 6.2.3

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, rope rescue system, specified minimum travel distance for the liter

tender, life safety harness, litters, bridles, and specialized equipment necessary for the environment

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, perform the activities of a litter tender in a high-angle lowering or raising operation, given a rope

rescue system, a specified minimum travel distance for the litter tender, life safety harnesses, litters, bridles, and

specialized equipment necessary for the environment, so that risks to victims and rescuers are minimized; the means

of attachment to the rope rescue system is secure; and the travel path is negotiated while minimizing risks to

equipment or persons.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Uses proper PPE

____ ____ 2. Attaches life safety harness to the rope rescue system

____ ____ 3. Maneuver the litter past obstacles

____ ____ 4. Manage the litter while attached to the rope rescue system

____ ____ 5. Evaluate surroundings for potential hazards

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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53

Rope Rescue Level II Skills Assessment

Skill Sheet #4

DIRECT A TEAM IN TO REMOVE A VICTIM SUSPENDED FROM ROPE OR

WEBBING IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.2.4

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE and system for removal of the victim

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, Direct a team in the removal of a victim suspended from rope or webbing in a high-angle

environment, given a victim suspended by a harness attached to anchored rope or webbing, devices for removal of

the victim from the rope or webbing, and a means of removal of the victim to the ground or other safe area, so that

risks to victims and rescuers are minimized, injury to the victim is minimized, the means of attachment to the rope

rescue system is maintained, the victim is removed from the rope or webbing, and the victim is brought to a safe

area for transfer to EMS.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Construct system for rapid removal of stranded victim suspended

____ ____ 2. Manage operation of the rope rescue system

____ ____ 3. Triage victim(s)

____ ____ 4. Minimizes hazards for rescuers and victims

____ ____ 5. Determine specialized equipment needs for victim removal

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 54: TECHNICAL RESCUE - ND Portal

54

Rope Rescue Level II Skills Assessment

Skill Sheet #5

DIRECT A TEAM IN THE CONSTRUCTION OF A ROPE RESCUE SYSTEM INTENDED

TO MOVE A SUSPENDED RESCUE LOAD HORIZONTALLY

JPR: NFPA 1006-2013 edition, Section 6.2.5

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, life safety rope, rope rescue equipment and a suitable anchor

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, participate as a member of a team in the construction of a rope rescue system intended to move a

suspended rescue load along a horizontal path to avoid an obstacle, given rescue personnel, life safety rope, rope

rescue equipment, and a suitable anchor capable of supporting the load, so that personnel assignments are made and

clearly communicated; the system constructed can accommodate the load; tension applied within the system will not

exceed the rated capacity of any of its components’ parts; a system safety check is performed; movement on the load

is efficient; and loads can be held in place or moved with minimal effort over the required distance.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Uses proper PPE

____ ____ 2. Determines incident needs as related to construction of a system

____ ____ 3. Evaluates incident site as related to interference concerns and setup

____ ____ 4. Identifies obstacles to avoid

____ ____ 5. Selects a system for the defined task

____ ____ 6. Limits excessive force to system components

____ ____ 7. Communicates with personnel effectively

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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55

Rope Rescue Level II Skills Assessment

Skill Sheet #6

DIRECT A TEAM IN THE OPERATION OF A ROPE RESCUE SYSTEM TO MOVE A

SUSPENDED RESCUE LOAD HORIZONTALLY

JPR: NFPA 1006-2013 edition, Section 6.2.6

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, life safety rope, rope rescue equipment and a suitable anchor

Evaluator Equipment Required: Proper PPE

Read to Candidate:

Direct a team in the operation of a rope system to move a suspended rescue load along a horizontal path, given

rescue personnel, an established system, a target for the load, a load to be moved, and personal protective

equipment, so that the movement is controlled; the load is held in place when needed; operating methods do not

stress the system to the point of failure; personnel assignments are made; tasks are communicated; and potential

problems are identified, communicated and managed.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Uses proper PPE

____ ____ 2. Determines incident needs

____ ____ 3. Complete system safety check

____ ____ 4. Evaluate system components for integrity

____ ____ 5. Selects and communicates with personnel effectively

____ ____ 6. Manage movement of the load

____ ____ 7. Evaluate for potential problems

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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56

Rope Rescue Level II Skills Assessment

Skill Sheet #7

ACCESS A VICTIM IN A HIGH-ANGLE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 6.2.7

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE and rope rescue system

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, access a victim in a high-angle environment using techniques that require rescuers to climb up or

down natural or manmade structures given a belay, a belay system, or other mechanisms, so that the risks from a fall

are minimized or eliminated; the patient is accessed; and the objective is achieved.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Construct system for rapid removal of stranded victim suspended

____ ____ 2. Manage operation of the rope rescue system

____ ____ 3. Minimizes fall potential and factors for rescuers and victims

____ ____ 4. Objective achieved

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 57: TECHNICAL RESCUE - ND Portal

57

Rope Rescue Level II Skills Assessment

Skill Sheet #8

ISOLATE AND MANAGE POTENTIALLY HARMFUL ENERGY SOURCES

JPR: NFPA 1006-2013 edition, Section 6.2.8

Reference: High-Angle Rope Rescue Techniques: Levels I and II, 4th Edition

Candidate Equipment Required: Proper PPE, hazard securing and disabling devices

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, Isolate and manage potentially harmful energy sources found in erected structures, including

power systems and construction materials, given personal protective equipment, so that all hazards are identified,

systems are managed, beneficial system use is evaluated, and hazards to rescue personnel and victims are

minimized.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Construct system for rapid removal of stranded victim suspended

____ ____ 2. Manage operation of the rope rescue system

____ ____ 3. Minimizes fall potential and factors for rescuers and victims

____ ____ 4. Objective achieved

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 58: TECHNICAL RESCUE - ND Portal

ROPE RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 6 – Level I

58

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Level I

DIRECT A TEAM IN THE OPERATION OF A SIMPLE ROPE

MECHANICAL ADVANTAGE SYSTEM IN A HIGH-ANGLE

RAISING OPERATION

1

DIRECT A LOWERING OPERATION IN A HIGH-ANGLE

ENVIRONMENT

2

CONSTRUCT A MULTIPLE-POINT ANCHOR SYSTEM 3

CONSTRUCT A COMPOUND ROPE MECHANICAL

ADVANTAGE SYSTEM

4

CONSTRUCT A FIXED ROPE SYSTEM 5

DIRECT THE OPERATION OF A COMPOUND ROPE

MECHANICAL ADVANTAGE SYSTEM IN A HIGH-ANGLE

ENVIRONMENT

6

ASCEND A FIXED ROPE IN A HIGH-ANGLE ENVIRONMENT 7

DESCEND A FIXED ROPE IN A HIGH-ANGLE ENVIORNMENT 8

Page 59: TECHNICAL RESCUE - ND Portal

ROPE RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 6 – Level II

59

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Level II

COMPLETE AN ASSIGNMENT WHILE SUSPENDED FROM A

ROPE RESCUE SYSTEM IN A HIGH-ANGLE ENVIRONMENT

1

MOVE A VICTIM IN A HIGH-ANGLE ENVIRONMENT 2

FUNCTION AS A LITTER TENDER IN A HIGH-ANGLE

LOWERING OR RAISING OPERATION

3

DIRECT A TEAM IN TO REMOVE A VICTIM SUSPENDED

FROM ROPE OR WEBBING IN A HIGH-ANGLE ENVIRONMENT

4

DIRECT A TEAM IN THE CONSTRUCTION OF A ROPE RESCUE

SYSTEM INTENDED TO MOVE A SUSPENDED RESCUE LOAD

HORIZONTALLY

5

DIRECT A TEAM IN THE OPERATION OF A ROPE RESCUE

SYSTEM TO MOVE A SUSPENDED RESCUE LOAD

HORIZONTALLY

6

ACCESS A VICTIM IN A HIGH-ANGLE ENVIRONMENT 7

ISOLATE AND MANAGE HARMFUL ENERGY SOURCES 8

Page 60: TECHNICAL RESCUE - ND Portal

60

SECTION – III

CHAPTER 7 – CONFINED SPACE - Level I

JOB PERFORMANCE REQUIREMENTS

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61

Confined Space Level I Skills Assessment

Skill Sheet #1

CONDUCT MONITORING OF THE ENVIRONMENT

JPR: NFPA 1006-2013 edition, Section 7.1.1

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Proper PPE, accurately calibrated detection and monitoring

Equipment, monitoring equipment reference material,

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, conduct monitoring of the environment, given monitoring equipment

reference material, personal protective equipment, accurately calibrated detection and monitoring

equipment, and size-up information, so that a representative sample of the space is obtained,

accurate readings are made, readings are documented, and effects of ventilation in determining

atmospheric conditions and the conditions of the space have been determined for exposures to

existing or potential environmental hazards.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Use detection and monitoring equipment

____ ____ 2. Confirm calibration of detection and monitoring equipment

____ ____ 3. Acquire representative samples of space.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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62

Confined Space Level I Skills Assessment

Skill Sheet #2

PREPARE FOR ENTRY INTO THE CONFINED SPACE

JPR: NFPA 1006-2013 edition, Section 7.1.2

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Proper PPE, confined space prop, confined space rescue tool

kit, detection and monitoring equipment.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will prepare for entry into the confined space, given a confined space

and a confined space rescue tool kit, so that victim communication is established when possible,

continuous atmospheric monitoring is initiated, rescuer readiness is verified, rescuers’ limitations

are identified and evaluated, rescuers unsuitable to entry operations are reassigned and replaced,

route and methods of entry are determined, and rescuer evacuation is planned.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Operated monitoring equipment correctly.

____ ____ 2. Rescuer pre-entry medical exam performed.

____ ____ 3. Rescuer capabilities and limitations evaluated.

____ ____ 4. Victim communication needs identified.

____ ____ 5. Point and route of entry evaluated and determined

____ ____ 6. Evacuation methods selected.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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63

Confined Space Level I Skills Assessment

Skill Sheet #3

ENTER INTO THE CONFINED SPACE

JPR: NFPA 1006-2013 edition, Section 7.1.3

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Proper PPE, confined space prop, confined space rescue tool

kit, detection and monitoring equipment, safety, communication, and operational protocols.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will enter a confined space, given personal protective equipment; safety,

communication, and operational protocols; and a confined space rescue tool kit, so that the

victim is contacted, controlled entry is established and maintained, atmosphere is continuously

monitored, the victim’s mental and physical conditions are further assessed, patient care is

initiated, the patient is packaged to restrictions of the space, and patient removal can be initiated.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and used personal protective equipment correctly.

____ ____ 2. Selected and used rescue-related systems and equipment correctly.

____ ____ 3. Implemented safety, communication, and operational protocols.

____ ____ 4. Used medical protocols to determine treatment priorities.

____ ____ 5. Used medical equipment specific to confined space victim needs.

____ ____ 6. Reassessed and confirmed mode of operation as needed.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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64

Confined Space Level I Skills Assessment

Skill Sheet #4

PACKAGE VICTIM FOR REMOVAL FROM A CONFINED SPACE

JPR: NFPA 1006-2013 edition, Section 7.1.4

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Proper PPE, confined space prop, confined space rescue tool

kit, detection and monitoring equipment, safety, communication, and operational protocols.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will package the victim for removal from a confined space, given a

confined space rescue tool kit, so that damage to the rescue/retrieval equipment is prevented, the

victim is given the smallest possible profile, and further harm to the victim is minimized.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Established and maintained C-Spine immobilization.

____ ____ 2. Packaged victims in harnesses, low-profile devices, and/or litters.

____ ____ 3. Recognized and performed basic management of various traumatic injuries and

medical conditions.

____ ____ 4. Supported respiratory efforts.

____ ____ 5. Performed cardiopulmonary resuscitation as required.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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65

Confined Space Level I Skills Assessment

Skill Sheet #5

REMOVE ALL ENTRANTS FROM A CONFINED SPACE

JPR: NFPA 1006-2013 edition, Section 7.1.5

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Proper PPE, confined space prop, confined space rescue tool

kit, detection and monitoring equipment, safety, communication, and operational protocols.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will remove all entrants from a confined space, given personal protective

equipment, rope and related rescue and retrieval systems, personnel to operate rescue and

retrieval systems, and a confined space rescue tool kit, so that internal obstacles and hazards are

negotiated, all persons are extricated from a space in the selected transfer device, the victim

and rescuers are decontaminated as necessary, and the victim is delivered to the EMS provider.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and used proper personal protective equipment,

____ ____ 2. Selected and operated rescue and retrieval systems for victim removal.

____ ____ 3. Correctly utilized medical equipment as needed.

____ ____ 4. Following local protocols, used decontamination equipment correctly as needed.

____ ____ 5. Patient transferred to EMS provider following applicable local protocols.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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66

SECTION – III

CHAPTER 7 – CONFINED SPACE - Level II

JOB PERFORMANCE REQUIREMENTS

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67

Confined Space Level II Skills Assessment

Skill Sheet #1

PREPLAN A CONFINED SPACE INCIDENT

JPR: NFPA 1006-2013 edition, Section 7.2.1

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Safety, communication, and operational protocols, preplan

forms

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will preplan a confined space incident, given applicable guidelines

and regulations and a preplan form, so that a standard approach is used during a confined space

rescue emergency, hazards are recognized and documented, isolation methods are identified and

documented, all accesses to the location of the entry opening are identified and documented, all

types of entry openings are identified and documented, and internal configurations and special

resource needs are documented for future rescuer use.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and completed appropriate preplan forms.

____ ____ 2. Form included sketch of confined spaces.

____ ____ 3. Identified and evaluated various configurations of confined spaces, access

points, entry openings, isolation procedures, and energy control locations.

____ ____ 4. Recognized general and site-specific hazards.

____ ____ 5. All data documented.

____ ____ 6. Applied all regulatory compliance references.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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68

Confined Space Level II Skills Assessment

Skill Sheet #2

ASSESS THE INCIDENT

JPR: NFPA 1006-2013 edition, Section 7.2.2

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: preplan of the space or size-up information; information from

technical resources, and monitoring equipment, and personal protective equipment.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will assess the incident, given a preplan of the space or size-up

information, information from technical resources, monitoring equipment, and personal

protective equipment required to perform the assessment, so that general area and space-specific

hazards are identified, bystanders and victims are interviewed, immediate and ongoing

monitoring of the space is performed, the victims’ conditions and location are determined, a

risk–benefit analysis is performed, methods of ingress and egress for rescuer and victims are

identified, rescue systems for victim removal are determined, and an emergency means of

retrieval for rescue entrants is established.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and interpreted preplan and size-up information.

____ ____ 2. Conducted interviews as applicable.

____ ____ 3. Selected and utilized appropriate personal protective equipment.

____ ____ 4. Operated monitoring equipment as needed.

____ ____ 5. Identified hazard mitigation options.

____ ____ 6. Identified probable victim location.

____ ____ 7. Performed risk–benefit analysis.

____ ____ 8. Recognized characteristics and hazards of confined spaces.

____ ____ 9. Evaluated specific rescue systems for entry and retrieval of rescuers and

victims during confined space incidents.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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69

Confined Space Level II Skills Assessment

Skill Sheet #3

CONTROL HAZARDS

JPR: NFPA 1006-2013 edition, Section 7.2.3

Reference: CMC, Confined Space Entry and Rescue Manual, Revised 2nd Edition

Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: preplan of the space or size-up information; information from

technical resources, and monitoring equipment, and personal protective equipment.

Evaluator Equipment Required: Proper PPE

Read to Candidate:

For this skill event, you will control hazards, given personal protective equipment and a confined

space tool kit, so that the rescue area is established; access to the incident scene is controlled;

rescuers are protected from exposure to hazardous materials and atmospheres, all forms of

harmful energy releases, and physical hazards; and victims are protected from further harm.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and utilized appropriate personal protective equipment.

____ ____ 2. Placed scene control barriers.

____ ____ 3. Operated monitoring equipment as needed.

____ ____ 4. Isolated dangerous forms of energy.

____ ____ 5. Mitigated physical and atmospheric hazards.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 70: TECHNICAL RESCUE - ND Portal

CONFINED SPACE RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 7 – Level I

70

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Pre-Requisite SECTIONS 5.2 THROUGH 5.5 OF NFPA 1006 Section I

Chapter 7

LEVEL I

CONDUCT MONITORING OF THE ENVIRONMENT 1

PREPARE FOR ENTRY INTO THE CONFINED SPACE 2

ENTER INTO THE CONFINED SPACE 3

PACKAGE VICTIM FOR REMOVAL FROM A CONFINED SPACE 4

REMOVE ALL ENTRANTS FROM A CONFINED SPACE 5

Page 71: TECHNICAL RESCUE - ND Portal

CONFINED SPACE RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 7 – Level II

71

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Pre-Requisite CHAPTER 7 – LEVEL I

Chapter 7

LEVEL II

PREPLAN A CONFINED SPACE INCIDENT 1

ASSESS THE INCIDENT 2

CONTROL HAZARDS 3

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72

SECTION – IV

CHAPTER 8 – TRENCH RESCUE - Level I

JOB PERFORMANCE REQUIREMENTS

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73

Trench Rescue Level I Skills Assessment

Skill Sheet #1

CONDUCT A SIZE-UP OF A COLLAPSED TRENCH

JPR: NFPA 1006-2013 edition, Section 8.1.1

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will conduct a size-up of a collapsed trench, given an incident and

background information and applicable reference material, so that the size-up is conducted

within the scope of the incident management system; the existing and potential conditions are

evaluated within the trench and the rescue area; general hazards are identified; a witness or

“competent person” is secured; the probability of victim existence, number, condition, and

location is determined; potential for rapid, nonentry rescues or victim self-rescue is recognized;

needed personnel, supply, and equipment resources are evaluated; and utility involvement and

location are determined.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Dimensions of the trench are determined.

____ ____ 2. Determined category of soil.

____ ____ 3. Identified type and degree of collapse.

____ ____ 4. Identified severe environmental conditions with implications for

secondary collapse and victim survivability.

____ ____ 5. Interviewed witnesses (”competent persons”).

____ ____ 6. Implemented protocols and resource acquisition agreements.

____ ____ 7. Notified public works for utility location.

____ ____ 8. Performed a risk–benefit analysis to identify response mode.

____ ____ 9. Implemented incident command system.

____ ____ 10. Applied appropriate regulations, policies, and standards.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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74

Trench Rescue Level I Skills Assessment

Skill Sheet #2

IMPLEMENT A TRENCH EMERGENCY ACTION PLAN

JPR: NFPA 1006-2013 edition, Section 8.1.2

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will implement a trench emergency action plan, given size-up

information and a trench incident, so that initial size-up information is utilized; pre-briefing is

given to rescuers; documentation is ongoing; the collapse zone is established; a risk–benefit

analysis is conducted; rapid, nonentry rescues or victim self-rescues are performed; the rescue

area and general area are made safe; strategy and tactics are confirmed and initiated for existing

and potential conditions; rapid intervention team and operational tasks are assigned; other

hazards are mitigated; rescue resources are staged; and a protective system is being utilized. You

MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Used and documented tactical worksheets.

____ ____ 2. Disseminated information to rescue team.

____ ____ 3. Successfully described mechanics and extent of collapse effects.

____ ____ 4. Performed risk–benefit analysis.

____ ____ 5. Performed rapid, nonentry rescues as needed.

____ ____ 6. Mitigated hazards by isolation, removal, or control.

____ ____ 7. Chose strategy and tactics that enhanced successful outcome.

____ ____ 8. Implemented incident management system and resource staging.

____ ____ 9. Applied isolation and/or protective system promptly to surround victim.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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75

Trench Rescue Level I Skills Assessment

Skill Sheet #3

IMPLEMENT SUPPORT OPERATIONS AT TRENCH EMERGENCIES

JPR: NFPA 1006-2013 edition, Section 8.1.3

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will be given an assignment, and equipment and other resources, so

that a resource cache is managed, scene lighting is provided for the tasks to be undertaken,

environmental concerns are managed, a cut station is established, supplemental power is

provided for all equipment, atmospheric monitoring and ventilation are implemented, personnel

rehab is facilitated, operations proceed without interruption, extrication methods are in place, and

the support operations facilitate rescue operational objectives. You MUST verbally describe

those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Managed equipment inventory.

____ ____ 2. Established power supply.

____ ____ 3. Acquired and established appropriate lighting.

____ ____ 4. Choose and deployed dewatering techniques.

____ ____ 5. Acquired or constructed shelter and thermal protection.

____ ____ 6. Selected rehab areas and set-up personnel rotations.

____ ____ 7. Operated atmospheric monitoring and ventilation equipment.

____ ____ 8. Performed patient packaging and removal.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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76

Trench Rescue Level I Skills Assessment

Skill Sheet #4

SUPPORT A NONINTERSECTING STRAIGHT WALL TRENCH

JPR: NFPA 1006-2013 edition, Section 8.1.4

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will support a nonintersecting straight wall trench of 2.4 m (8 ft) or less

as a member of a team, given size-up information, an action plan, a trench tool kit, and an

assignment, so that strategies to minimize the further movement of soil are implemented

effectively; trench walls, lip, and spoil pile are monitored continuously; rescue entry team(s)

remains in a safe zone; any slough-in and wall shears are mitigated; emergency procedures and

warning systems are established and understood by participating personnel; incident-specific

personal protective equipment is utilized; physical hazards are identified and managed; victim

and rescuer protection is maximized; victim extrication methods are considered; and a rapid

intervention team is staged. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Interpreted tabulated data information and tables.

____ ____ 2. Placed shoring and shielding systems appropriately

____ ____ 3. Installed supplemental shoring appropriately.

____ ____ 4. Established emergency protocols and warning systems.

____ ____ 5. Chose appropriate methods to stabilize trench.

____ ____ 6. Properly used personal protective equipment.

____ ____ 7. Anticipated extrication logistics (verbalized).

____ ____ 8. Safe zone identified.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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77

Trench Rescue Level I Skills Assessment

Skill Sheet #5

RELEASE A VICTIM FROM SOIL ENTRAPMENT

JPR: NFPA 1006-2013 edition, Section 8.1.5

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will release a victim from soil entrapment by components of a

nonintersecting collapsed trench of 2.4 m (8 ft) or less in depth, given personal protective

equipment, a trench rescue tool kit, and specialized equipment, so that hazards to rescue

personnel and victims are minimized, considerations are given to crush syndrome and other

injuries, techniques are used to enhance patient survivability, tasks are accomplished

within projected time frames, and techniques do not compromise the integrity of the existing

trench shoring system. You MUST verbally describe those skills which cannot be accomplished

hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

___ ____ 2. Operated rescue tools and stabilization systems.

____ ____ 3. Identified crush syndrome clinical settings.

____ ____ 4. Completed risk–benefit assessments for selected methods of rescue and

time restraints.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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78

Trench Rescue Level I Skills Assessment

Skill Sheet #6

REMOVE A VICTIM FROM A TRENCH

JPR: NFPA 1006-2013 edition, Section 8.1.6

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will remove a victim from a trench, given a disentangled victim, a basic

first aid kit, and victim packaging resources, so that basic life functions are supported as

required, the victim is evaluated for signs of crush syndrome, methods and packaging devices

selected are compatible with intended routes of transfer, universal precautions are employed to

protect personnel from bloodborne pathogens, and extraction times meet time constraints for

medical management. You MUST verbally describe those skills which cannot be accomplished

hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

___ ____ 2. Provided basic medical care and immobilization techniques.

____ ____ 3. Identified the need for advanced life support and crush syndrome management.

____ ____ 4. Used a removal system that matches logistical and medical management time

frame concerns.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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79

Trench Rescue Level I Skills Assessment

Skill Sheet #7

DISASSEMBLE SUPPORT SYSTEMS AT A TRENCH EMERGENCY

INCIDENT

JPR: NFPA 1006-2013 edition, Section 8.1.7

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will disassemble support systems at a trench emergency incident, given

personal protective equipment, trench tool kit, and removal of victim(s), so that soil movement is

minimized, all rescue equipment is removed from the trench, sheeting and shoring are removed

in the reverse order of their placement, emergency protocols and safe zones in the trench are

adhered to, rescue personnel are removed from the trench, the last supporting shores are pulled

free with ropes, equipment is cleaned and serviced, reports are completed, and a post briefing is

performed. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

___ ____ 2. Removed equipment and protective systems.

____ ____ 3. Used trench safety protocols.

____ ____ 4. Cleaned and serviced equipment as needed.

____ ____ 5. Performed an incident debriefing.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 80: TECHNICAL RESCUE - ND Portal

80

SECTION – IV

CHAPTER 8 – TRENCH RESCUE - Level II

JOB PERFORMANCE REQUIREMENTS

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81

Trench Rescue Level II Skills Assessment

Skill Sheet #1

SUPPORT AN INTERSECTING TRENCH

JPR: NFPA 1006-2013 edition, Section 8.2.1

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will support an intersecting trench as a member of a team, given size-up

information and an action plan, a trench tool kit, and an assignment, so that strategies to

minimize the further movement of soil are implemented effectively; trench walls, lip, and spoil

pile are monitored continuously; rescue entry team(s) in the trench remains in a safe zone; any

slough-in and wall shears are mitigated; emergency procedures and warning systems are

established and understood by participating personnel; incident-specific personal protective

equipment is utilized; physical hazards are identified and managed; victim protection is

maximized; victim extrication methods are considered; and a rapid intervention team is staged.

You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Interpreted tabulated data information and tables.

____ ____ 2. Placed shoring and shielding systems appropriately

____ ____ 3. Identified type of intersecting trench.

____ ____ 4. Established emergency protocols and warning systems.

____ ____ 5. Chose appropriate methods to stabilize trench.

____ ____ 6. Properly used personal protective equipment.

____ ____ 7. Anticipated extrication logistics (verbalized).

____ ____ 8. Safe zone identified.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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82

Trench Rescue Level II Skills Assessment

Skill Sheet #2

INSTALL SUPPLEMENTAL SHEETING AND SHORING

JPR: NFPA 1006-2013 edition, Section 8.2.2

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will install supplemental sheeting and shoring for each 2 ft (0.61 m) of

depth dug below an existing approved shoring system, given size-up information, an action plan,

and a trench tool kit, so that the movement of soil is minimized effectively, initial trench support

strategies are facilitated, rescue entry team safe zones are maintained, excavation of entrapping

soil is continued, victim protection is maximized, victim extrication methods are considered, and

a rapid intervention team is staged. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Interpreted tabulated data information and tables.

____ ____ 2. Placed shoring and shielding systems appropriately.

____ ____ 3. Identified supplemental sheeting and shoring needs.

____ ____ 4. Established emergency protocols and warning systems.

____ ____ 5. Chose appropriate methods to stabilize trench.

____ ____ 6. Identified exposure to hazards within the trench relative to

existing safe zones.

____ ____ 7. Properly used personal protective equipment.

____ ____ 8. Anticipated extrication logistics (verbalized).

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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83

Trench Rescue Level II Skills Assessment

Skill Sheet #3

CONSTRUCT LOAD STABILIZATION SYSTEMS

JPR: NFPA 1006-2013 edition, Section 8.2.3

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will construct load stabilization systems, given an assignment, personal

protective equipment, and a trench tool kit, so that the stabilization system will support the load

safely, the system is stable, and the assignment is completed. You MUST verbally describe those

skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and constructed stabilization system.

____ ____ 2. Evaluated and determined structural integrity of the system.

____ ____ 3. Calculated the load limit of the system.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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84

Trench Rescue Level II Skills Assessment

Skill Sheet #4

LIFT A LOAD

JPR: NFPA 1006-2013 edition, Section 8.2.4

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will Lift a load, given a trench tool kit, so that the load is lifted the

required distance to gain access; settling or dropping of the load is prevented; control and

stabilization are maintained before, during, and after the lift; and operational objectives are

attained. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Evaluated and estimated the weight of the load.

____ ____ 2. Correctly operated tools and levers.

____ ____ 3. Applied load stabilization systems.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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85

Trench Rescue Level II Skills Assessment

Skill Sheet #5

COORDINATE THE USE OF HEAVY EQUIPMENT

JPR: NFPA 1006-2013 edition, Section 8.2.5

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will coordinate the use of heavy equipment, given personal protective

equipment, means of communication, equipment and operator, and an assignment, so that

operator capabilities and limitations for task are evaluated, common communications are

maintained, equipment usage supports the operational objectives, and hazards are avoided. You

MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly used hand signals.

____ ____ 2. Correctly used radio equipment.

____ ____ 3. Recognized hazards.

____ ____ 4. Assessed operator for skill and calm demeanor.

____ ____ 5. Assessed heavy equipment for precision of movement and maintenance.

____ ____ 6. Monitored rescuer and victim safety.

____ ____ 7. Properly used personal protective equipment.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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86

Trench Rescue Level II Skills Assessment

Skill Sheet #6

RELEASE A VICTIM FROM ENTRAPMENT BY COMPONENTS OF A

COLLAPSED TRENCH

JPR: NFPA 1006-2013 edition, Section 8.2.6

Reference: -Jones and Bartlett, Trench Rescue: Principles and Practice to NFPA 1006 and 1670, 3rd

Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will release a victim from entrapment by components of a collapsed

trench, given personal protective equipment, a trench rescue tool kit, and specialized equipment,

so that hazards to rescue personnel and victims are minimized, considerations are given to crush

syndrome and other injuries, techniques are used to enhance patient survivability, tasks are

accomplished within projected time frames, and techniques do not compromise the integrity of

the existing trench shoring system. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill

steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

___ ____ 2. Operated rescue tools and stabilization systems.

____ ____ 3. Identified crush syndrome clinical settings.

____ ____ 4. Completed risk–benefit assessments for selected methods of rescue and

time restraints.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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87

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Pre-Requisite

Chapter 8

LEVEL I

CONDUCT A SIZE-UP OF A COLLAPSED TRENCH 1

IMPLEMENT A TRENCH EMERGENCY ACTION PLAN 2

IMPLEMENT SUPPORT OPERATIONS AT TRENCH

EMERGENCIES 3

SUPPORT A NONINTERSECTING STRAIGHT WALL TRENCH 4

RELEASE A VICTIM FROM SOIL ENTRAPMENT 5

REMOVE A VICTIM FROM A TRENCH 6

DISASSEMBLE SUPPORT SYSTEMS AT A TRENCH

EMERGENCY INCIDENT 7

Page 88: TECHNICAL RESCUE - ND Portal

TRENCH RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 8 –Level II

88

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Pre-Requisite

Chapter 8

LEVEL II

SUPPORT AN INTERSECTING TRENCH 1

INSTALL SUPPLEMENTAL SHEETING AND SHORING 2

CONSTRUCT LOAD STABILIZATION SYSTEMS 3

LIFT A LOAD 4

COORDINATE THE USE OF HEAVY EQUIPMENT 5

RELEASE A VICTIM FROM ENTRAPMENT BY COMPONENTS

OF A COLLAPSED TRENCH

6

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89

SECTION – V

CHAPTER 9 – STRUCTURAL COLLAPSE - Level I

JOB PERFORMANCE REQUIREMENTS

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90

Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #1

CONDUCT A SIZE-UP OF A LIGHT FRAME COLLAPSED STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.1.1

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Barlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will conduct a size-up of a light frame collapsed structure, given an incident and specific

incident information, so that existing and potential conditions within the structure and the immediate periphery are

evaluated, needed resources are defined, hazards are identified, construction and occupancy types are determined,

collapse type is identified if possible, the need for rescue is assessed, a scene security perimeter is established, and

the size-up is conducted within the scope of the incident management system. You MUST verbally describe those

skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Categorized light frame construction type.

____ ____ 2. Evaluated structural stability and scene hazards.

____ ____ 3. Implemented resource and security (scene management) protocols.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #2

DETERMINE POTENTIAL VICTIM LOCATIONS IN LIGHT FRAME CONSTRUCTION

COLLAPSE INCIDENTS

JPR: NFPA 1006-2013 edition, Section 9.1.2

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will determine potential victim locations in light frame construction collapse incidents,

given size-up information, a structural collapse tool kit, the type of construction and occupancy, time of day, and

collapse pattern, so that search areas are stablished

and victims can be located. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly interpreted size-up information.

____ ____ 2. Correctly used occupancy classification information.

____ ____ 3. Correctly used search devices.

____ ____ 4. Assessed and categorized type of collapse.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #3

DEVELOP A COLLAPSE RESCUE INCIDENT ACTION PLAN

JPR: NFPA 1006-2013 edition, Section 9.1.3

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will develop a collapse rescue incident action plan, given size-up information and a light

frame collapsed structure, so that initial size-up information is utilized, an incident management system is

incorporated, existing and potential conditions within the structure and the immediate periphery are included,

specialized resource needs are identified, work perimeters are determined, collapse type/category and associated

hazards are identified, construction and occupancy types are determined, incident objectives are established, and

scene security measures are addressed. You MUST verbally describe those skills which cannot be accomplished

hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly interpreted size-up information.

____ ____ 2. Correctly implemented an incident management system.

____ ____ 3. Monitored changing conditions specific to the incident.

____ ____ 4. Determine construction and occupancy types.

____ ____ 5. Identified specific incident security requirements. ____ ____ 6. Create written documentation.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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93

Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #4

IMPLEMENT A COLLAPSE RESCUE INCIDENT ACTION PLAN

JPR: NFPA 1006-2013 edition, Section 9.1.4

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will implement a collapse rescue incident action plan, given an action plan and a light frame

collapsed structure, so that pertinent information is used, an incident management system is established and

implemented, monitoring of dynamic conditions internally and externally is established, specialized resources are

requested, hazards are mitigated, victim rescue and extraction techniques are consistent with collapse and

construction

type, and perimeter security measures are established. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly implement the components of an action plan in a collapse incident.

____ ____ 2. Correctly implemented an incident management system.

____ ____ 3. Initiated hazard mitigation objectives.

____ ____ 4. Requested specialized resources as needed.

____ ____ 5. Initiated rescue objectives. ____ ____ 6. Demonstrated perimeter security measures.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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94

Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #5

SEARCH A LIGHT FRAME COLLAPSED STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.1.5

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will search a light frame collapsed structure, given personal protective equipment, the

structural collapse tool kit, an assignment, operational protocols, and size-up information, so that all victim locations

and potential hazards are identified, marked, and reported; protocols are followed; the mode of operation can be

determined; and rescuer

safety is maintained. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly implemented an incident management system.

____ ____ 2. Applied appropriate search techniques

____ ____ 3. Used appropriate marking systems.

____ ____ 4. Identified and mitigated hazards.

____ ____ 5. Selected and used appropriate victim locating devices.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #6

STABILIZE A COLLAPSED LIGHT FRAME STRUCTURE AS A MEMBER OF A TEAM

JPR: NFPA 1006-2013 edition, Section 9.1.6

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will stabilize a collapsed light frame structure as a member of a team, given size-up

information, a specific pattern of collapse, a basic structural collapse tool kit, and an assignment, so that strategies to

effectively minimize the movement of structural components are identified and implemented; hazard warning

systems are established and understood by participating personnel; incident-specific personal protective equipment

is identified, provided, and utilized; physical hazards are identified; confinement, containment, and avoidance

measures

are discussed; and a rapid intervention team is established and staged. You MUST verbally describe those skills

which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and constructed shoring systems for collapses in light frame structures.

____ ____ 2. Used personal protective equipment.

____ ____ 3. Performed structural load calculations.

____ ____ 4. Determined resource needs.

____ ____ 5. Selected and operate basic and specialized tools and equipment. ____ ____ 6. Implemented communications and safety protocols. ____ ____ 7. Mitigated specific hazards associated with shoring tasks.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #7

IMPLEMENT COLLAPSE SUPPORT OPERATIONS AT A RESCUE

INCIDENT

JPR: NFPA 1006-2013 edition, Section 9.1.7

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will implement collapse support operations at a rescue incident, given an assignment and

available resources, so that scene lighting is adequate for the tasks to be undertaken, environmental concerns are

managed, personnel rehabilitation is facilitated, and the support operations facilitate rescue operational objectives.

You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Managed resources.

____ ____ 2. Established scene lighting.

____ ____ 3. Initiated environmental controls.

____ ____ 4. Set-up rehabilitation for rescuers.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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97

Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #8

RELEASE A VICTIM FROM ENTRAPMENT BY COMPONENTS OF A

LIGHT FRAME COLLAPSED STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.1.8

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will release a victim from entrapment by components of a light frame collapsed structure,

given personal protective equipment and resources for breaching, breaking, lifting, prying, shoring, and/or otherwise

moving or penetrating the offending structural component, so that hazards to rescue personnel and victims are

minimized, considerations are given to crush syndrome, techniques enhance patient survivability, tasks are

accomplished within projected time frames, and techniques do not compromise the integrity of the existing structure

or structural support systems. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Operated rescue tools and stabilization systems.

____ ____ 3. Recognized crush syndrome indicators.

____ ____ 4. Completed risk–benefit assessments for selected methods of rescue

and time constraints.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #9

REMOVE A VICTIM FROM A LIGHT FRAME COLLAPSE INCIDENT

JPR: NFPA 1006-2013 edition, Section 9.1.9

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will remove a victim from a light frame collapse incident, given a disentangled victim, a

basic first aid kit, and victim packaging resources, so that basic life functions are supported as required, victim is

evaluated for signs of crush syndrome, advanced life support is called if needed, methods and packaging devices

selected are compatible with intended routes of transfer, universal precautions are employed to protect personnel

from bloodborne pathogens, and extraction times meet time constraints for medical management. You MUST

verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Performed basic prehospital care of soft-tissue injuries as needed.

____ ____ 3. Performed fracture stabilization as needed.

____ ____ 4. Performed airway maintenance techniques as needed.

____ ____ 4. Performed cardiopulmonary resuscitation as needed.

____ ____ 4. Selected and used appropriate patient packaging equipment.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #10

LIFT A HEAVY LOAD AS A TEAM MEMBER

JPR: NFPA 1006-2013 edition, Section 9.1.10

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will lift a heavy load as a team member, given a structural collapse tool kit and a load to be

lifted, so that the load is lifted; control and stabilization are maintained before, during, and after the lift; and access

can be gained. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Evaluated and estimated the weight of the load.

____ ____ 3. Correctly operated tools and levers.

____ ____ 4. Applied load stabilization systems.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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100

Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #11

MOVE A HEAVY LOAD AS A TEAM MEMBER

JPR: NFPA 1006-2013 edition, Section 9.1.11

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will move a heavy load as a team member, given a structural collapse tool kit, so that the

load is moved the required distance to gain access and so that control is constantly maintained. You MUST verbally

describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Evaluated and estimated the weight of the load.

____ ____ 3. Constructed and used levers and incline planes.

____ ____ 4. Utilized rigging systems appropriately.

____ ____ 4. Successfully stabilized the load.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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101

Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #12

BREACH LIGHT FRAME STRUCTURAL COMPONENTS

JPR: NFPA 1006-2013 edition, Section 9.1.12

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will breach light frame structural components, given an assignment, personal protective

equipment, various types of construction materials, and a structural collapse tool kit, so that the opening supports the

rescue objectives, the necessary tools are selected, structural stability is maintained, and the methods utilized are

safe and efficient. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Selected and used breaching tools.

____ ____ 3. Appropriately implemented breaching techniques based on building construction type.

____ ____ 4. Correctly applied stabilization where required.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level I Skills Assessment

Skill Sheet #13

CONSTRUCT CRIBBING SYSTEMS

JPR: NFPA 1006-2013 edition, Section 9.1.13

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will construct cribbing systems, given an assignment, personal protective equipment, a

structural collapse tool kit, various lengths and dimensions of construction-grade lumber, wedges, and shims, so that

the cribbing system will safely support the load, the system is stable, and the assignment is completed. You MUST

verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Selected and constructed cribbing systems.

____ ____ 3. Appropriately evaluated the structural integrity of the system.

____ ____ 4. Correctly calculated the load.

____ ____ 5. Ensured stability of the cribbing system.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 103: TECHNICAL RESCUE - ND Portal

103

SECTION – V

CHAPTER 9 – STRUCTURAL COLLAPSE RESCUE - Level II

JOB PERFORMANCE REQUIREMENTS

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104

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #1

CONDUCT A SIZE-UP OF A COLLAPSED HEAVY

CONSTRUCTION–TYPE STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.2.1

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will conduct a size-up of a collapsed heavy construction–type structure, given an incident

and specific incident information, so that existing and potential conditions within the structure and the immediate

periphery are evaluated, needed resources are defined, hazards are identified, construction and occupancy types are

determined, collapse type is identified if possible, the need for rescue is assessed, a scene security perimeter is

established, and the size-up is conducted within the scope of the incident management system. You MUST verbally

describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Categorized light frame construction type.

____ ____ 2. Evaluated structural stability and scene hazards.

____ ____ 3. Implemented resource and security (scene management) protocols.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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105

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #2

DETERMINE POTENTIAL VICTIM LOCATIONS IN A HEAVY

CONSTRUCTION–TYPE INCIDENT

JPR: NFPA 1006-2013 edition, Section 9.2.2

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will determine potential victim locations in heavy construction–type collapse incidents,

given size-up information, a structural collapse tool kit, the type of construction and occupancy, time of day, and

collapse pattern, so that search areas are stablished

and victims can be located. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly interpreted size-up information.

____ ____ 2. Correctly used occupancy classification information.

____ ____ 3. Correctly used search devices.

____ ____ 4. Assessed and categorized type of collapse.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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106

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #3

DEVELOP A COLLAPSE RESCUE INCIDENT ACTION PLAN

JPR: NFPA 1006-2013 edition, Section 9.2.3

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will develop a collapse rescue incident action plan, given size-up information and a heavy

construction–type collapsed structure, so that initial size-up information is utilized, an incident management system

is incorporated, existing and potential conditions within the structure and the immediate periphery are included,

specialized resource needs are identified, work perimeters are determined, collapse type/category and associated

hazards are identified, construction and occupancy types are determined, incident objectives are established, and

scene security measures are addressed. You MUST verbally describe those skills which cannot be accomplished

hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly interpreted size-up information.

____ ____ 2. Correctly implemented an incident management system.

____ ____ 3. Monitored changing conditions specific to the incident.

____ ____ 4. Determine construction and occupancy types.

____ ____ 5. Identified specific incident security requirements. ____ ____ 6. Create written documentation.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #4

IMPLEMENT A COLLAPSE RESCUE INCIDENT ACTION PLAN

JPR: NFPA 1006-2013 edition, Section 9.2.4

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will implement a collapse rescue incident action plan, given an action plan and a heavy

construction–type collapsed structure, so that pertinent information is used, an incident management system is

established and implemented, monitoring of dynamic conditions internally and externally is established, specialized

resources are requested, hazards are mitigated, victim rescue and extraction techniques are consistent with collapse

and construction

type, and perimeter security measures are established. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly implement the components of an action plan in a collapse incident.

____ ____ 2. Correctly implemented an incident management system.

____ ____ 3. Initiated hazard mitigation objectives.

____ ____ 4. Requested specialized resources as needed.

____ ____ 5. Initiated rescue objectives. ____ ____ 6. Demonstrated perimeter security measures.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

Page 108: TECHNICAL RESCUE - ND Portal

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Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #5

SEARCH A HEAVY CONSTRUCTION–TYPE COLLAPSED STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.2.5

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will search a heavy construction–type collapsed structure, given personal protective

equipment, the structural collapse tool kit, an assignment, operational protocols, and size-up information, so that all

victim locations and potential hazards are identified, marked, and reported; protocols are followed; the mode of

operation can be determined; and rescuer

safety is maintained. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Correctly implemented an incident management system.

____ ____ 2. Applied appropriate search techniques

____ ____ 3. Used appropriate marking systems.

____ ____ 4. Identified and mitigated hazards.

____ ____ 5. Selected and used appropriate victim locating devices.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #6

STABILIZE A COLLAPSED HEAVY CONSTRUCTION–TYPE STRUCTURE AS A

MEMBER OF A TEAM

JPR: NFPA 1006-2013 edition, Section 9.2.6

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will stabilize a collapsed heavy construction–type structure as a member of a team, given

size-up information, a specific pattern of collapse, a basic structural collapse tool kit, and an assignment, so that

strategies to effectively minimize the movement of structural components are identified and implemented; hazard

warning systems are established and understood by participating personnel; incident-specific personal protective

equipment is identified, provided, and utilized; physical hazards are identified; confinement, containment, and

avoidance measures are discussed; and a rapid intervention team is established and staged. You MUST verbally

describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected and constructed shoring systems for collapses in light frame structures.

____ ____ 2. Used personal protective equipment.

____ ____ 3. Performed structural load calculations.

____ ____ 4. Determined resource needs.

____ ____ 5. Selected and operate basic and specialized tools and equipment. ____ ____ 6. Implemented communications and safety protocols. ____ ____ 7. Mitigated specific hazards associated with shoring tasks.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #7

IMPLEMENT COLLAPSE SUPPORT OPERATIONS AT A RESCUE

INCIDENT

JPR: NFPA 1006-2013 edition, Section 9.2.7

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Barlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will implement collapse support operations at a rescue incident, given an assignment and

available resources, so that scene lighting is adequate for the tasks to be undertaken, environmental concerns are

managed, personnel rehabilitation is facilitated, and the support operations facilitate rescue operational objectives.

You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Managed resources.

____ ____ 2. Established scene lighting.

____ ____ 3. Initiated environmental controls.

____ ____ 4. Set-up rehabilitation for rescuers.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #8

RELEASE A VICTIM FROM ENTRAPMENT BY COMPONENTS OF A

HEAVY CONSTRUCTION–TYPE COLLAPSED STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.2.8

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will release a victim from entrapment by components of a heavy construction–type

collapsed structure, given personal protective equipment and resources for breaching, breaking, lifting, prying,

shoring, and/or otherwise moving or penetrating the offending structural component, so that hazards to rescue

personnel and victims are minimized, considerations are given to crush syndrome, techniques enhance patient

survivability, tasks are accomplished within projected time frames, and techniques do not compromise the integrity

of the existing structure or structural support systems. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Operated rescue tools and stabilization systems.

____ ____ 3. Recognized crush syndrome indicators.

____ ____ 4. Completed risk–benefit assessments for selected methods of rescue

and time constraints.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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112

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #9

REMOVE A VICTIM FROM A HEAVY CONSTRUCTION–TYPE COLLAPSE

INCIDENT

JPR: NFPA 1006-2013 edition, Section 9.2.9

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will remove a victim from a heavy construction–type collapse incident, given a disentangled

victim, a basic first aid kit, and victim packaging resources, so that basic life functions are supported as required,

victim is evaluated for signs of crush syndrome, advanced life support is called if needed, methods and packaging

devices selected are compatible with intended routes of transfer, universal precautions are employed to protect

personnel from bloodborne pathogens, and extraction times meet time constraints for medical management. You

MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Performed basic prehospital care of soft-tissue injuries as needed.

____ ____ 3. Performed fracture stabilization as needed.

____ ____ 4. Performed airway maintenance techniques as needed.

____ ____ 4. Performed cardiopulmonary resuscitation as needed.

____ ____ 4. Selected and used appropriate patient packaging equipment.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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113

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #10

LIFT A HEAVY LOAD AS A TEAM MEMBER

JPR: NFPA 1006-2013 edition, Section 9.2.10

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will lift a heavy load as a team member, given a structural collapse tool kit and a load to be

lifted, so that the load is lifted; control and stabilization are maintained before, during, and after the lift; and access

can be gained. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Evaluated and estimated the weight of the load.

____ ____ 3. Correctly operated tools and levers.

____ ____ 4. Applied load stabilization systems.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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114

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #11

MOVE A HEAVY LOAD AS A TEAM MEMBER

JPR: NFPA 1006-2013 edition, Section 9.2.11

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will move a heavy load as a team member, given a structural collapse tool kit, so that the

load is moved the required distance to gain access and so that control is constantly maintained. You MUST verbally

describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Evaluated and estimated the weight of the load.

____ ____ 3. Constructed and used levers and incline planes.

____ ____ 4. Utilized rigging systems appropriately.

____ ____ 4. Successfully stabilized the load.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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115

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #12

BREACH HEAVY CONSTRUCTION–TYPE STRUCTURAL COMPONENTS

JPR: NFPA 1006-2013 edition, Section 9.2.12

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will breach heavy construction–type structural components, given an assignment, personal

protective equipment, various types of construction materials, and a structural collapse tool kit, so that the opening

supports the rescue objectives, the necessary tools are selected, structural stability is maintained, and the methods

utilized are safe and efficient. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Selected and used breaching tools.

____ ____ 3. Appropriately implemented breaching techniques based on building construction type.

____ ____ 4. Correctly applied stabilization where required.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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116

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #13

CONSTRUCT CRIBBING SYSTEMS

JPR: NFPA 1006-2013 edition, Section 9.2.13

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will construct cribbing systems, given an assignment, personal protective equipment, a

structural collapse tool kit, various lengths and dimensions of construction-grade lumber, wedges, and shims, so that

the cribbing system will safely support the load, the system is stable, and the assignment is completed. You MUST

verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Selected and constructed cribbing systems.

____ ____ 3. Appropriately evaluated the structural integrity of the system.

____ ____ 4. Correctly calculated the load.

____ ____ 5. Ensured stability of the cribbing system.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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117

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #14

STABILIZE A COLLAPSED HEAVY CONSTRUCTION–TYPE STRUCTURE

JPR: NFPA 1006-2013 edition, Section 9.2.14

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate: For this skill event, you will stabilize a collapsed heavy construction–type structure as a member of a team, given size-up

information, hazard-specific personal protective equipment, an assignment, a specific pattern of collapse, a structural collapse

tool kit, specialized equipment necessary to complete the tasks and engineering resources if needed, so that hazard warning

systems are established and understanding by team members is verified, all unstable structural components that can impact the

work and egress routes are identified, alternative egress routes are established when possible, expert resource needs are

determined and communicated to command, load estimates are calculated for support system requirements, all shoring systems

meet or exceed loadbearing demands, shoring systems are monitored continuously for integrity, safety protocols are followed,

a rapid intervention crew (RIC) is established and staged to aid search and rescue personnel in the event of entrapment, an

accountability system is established, atmospheric monitoring is ongoing, and progress is communicated as required. You

MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Selected and constructed appropriate shoring systems.

____ ____ 3. Appropriately evaluated the structural integrity of the system.

____ ____ 4. Correctly calculated the structural load.

____ ____ 5. Determined and requested additional resources as needed.

____ ____ 5. Selected appropriate, and operated, basic and specialized tools and equipment,

____ ____ 5. Implemented communications and rescuer safety protocols.

____ ____ 5. Mitigated specific hazards associated with shoring tasks.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____

1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #15

CUT THROUGH STRUCTURAL STEEL

JPR: NFPA 1006-2013 edition, Section 9.2.15

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will cut through structural steel, given a structural collapse tool kit, personal protective

equipment, and an assignment, so that the steel is efficiently cut, the victim and rescuer are protected, fire control

measures are in place, and the objective is accomplished. You MUST verbally describe those skills which cannot be

accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Determined appropriate tool needs.

____ ____ 3. Used cutting tools correctly.

___ ____ 4. Mitigated hazards successfully.

____ ____ 5. Implemented necessary extinguishment techniques.

____ ____ 6. Stabilized heavy load to ensure protection of victim and rescuer.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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119

Structural Collapse Rescue Level II Skills Assessment

Skill Sheet #16

COORDINATE THE USE OF HEAVY EQUIPMENT

JPR: NFPA 1006-2013 edition, Section 9.2.16

Reference: -FEMA National US & R Response System, Structural Collapse Technician

-Jones and Bartlett, Brannigan’s Building Construction for the Fire Service, 4th Edition

-Jones and Bartlett Learning, Emergency Medical Responder, 5th Edition

Candidate Equipment Required: Appropriate PPE

Evaluator Equipment Required: Appropriate PPE

Read to Candidate:

For this skill event, you will coordinate the use of heavy equipment, given personal protective equipment, means of

communication, equipment and operator, and an assignment, so that common communications are established,

equipment usage supports the operational objective, hazards are avoided, and rescuer and operator safety protocols

are followed. You MUST verbally describe those skills which cannot be accomplished hands on.

This is not a timed event. To pass this station, you must successfully complete 100% of the skill steps.

P-Pass / F-Fail

1st Attempt 2nd attempt

____ ____ 1. Selected, used, and cared for personal protective equipment.

____ ____ 2. Used hand signals correctly.

____ ____ 3. Used radio equipment correctly.

___ ____ 4. Mitigated hazards successfully.

____ ____ 5. Assessed situation for operator and rescuer safety.

Candidate’s Name: _____________________________ Station: P ____ F ____ P ____ F ____ 1st Attempt 2nd attempt

Evaluator’s Signature: ______________________________

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STRUCTURAL COLLAPSE RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 9– Level I

120

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Pre-Requisite

Chapter 9

LEVEL I

CONDUCT A SIZE-UP OF A LIGHT FRAME COLLAPSED

STRUCTURE 1

DETERMINE POTENTIAL VICTIM LOCATIONS IN LIGHT

FRAME CONSTRUCTION COLLAPSE INCIDENTS 2

DEVELOP A COLLAPSE RESCUE INCIDENT ACTION PLAN 3

IMPLEMENT A COLLAPSE RESCUE INCIDENT ACTION PLAN 4

SEARCH A LIGHT FRAME COLLAPSED STRUCTURE 5

STABILIZE A COLLAPSED LIGHT FRAME STRUCTURE AS A

MEMBER OF A TEAM 6

IMPLEMENT COLLAPSE SUPPORT OPERATIONS AT A RESCUE

INCIDENT

7

RELEASE A VICTIM FROM ENTRAPMENT BY COMPONENTS

OF A LIGHT FRAME COLLAPSED STRUCTURE

8

REMOVE A VICTIM FROM A LIGHT FRAME COLLAPSE

INCIDENT

9

LIFT A HEAVY LOAD AS A TEAM MEMBER 10

MOVE A HEAVY LOAD AS A TEAM MEMBER 11

BREACH LIGHT FRAME STRUCTURAL COMPONENTS 12

CONSTRUCT CRIBBING SYSTEMS 13

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STRUCTURAL COLLAPSE RESCUER TRAINING RECORD - NFPA 1006; 2013 Standard Chapter 9– Level II

121

PRINT NAME: LAST 4 of SSN: DEPARTMENT:

SECTION

TRAINING IN-HOUSE MANIPULATIVE SKILL - DEMONSTRATE

CORRESPONDING

SKILL SHEET RECORD COMP. EXAM

DATE INST HRS DATE INST P/F

Chapter 9

LEVEL II

CONDUCT A SIZE-UP OF A COLLAPSED HEAVY

CONSTRUCTION–TYPE STRUCTURE 1

DETERMINE POTENTIAL VICTIM LOCATIONS IN A HEAVY

CONSTRUCTION–TYPE INCIDENT 2

DEVELOP A COLLAPSE RESCUE INCIDENT ACTION PLAN 3

IMPLEMENT A COLLAPSE RESCUE INCIDENT ACTION PLAN 4

SEARCH A HEAVY CONSTRUCTION–TYPE COLLAPSED STRUCTURE 5

STABILIZE A COLLAPSED HEAVY CONSTRUCTION–TYPE

STRUCTURE AS A MEMBER OF A TEAM

6

IMPLEMENT COLLAPSE SUPPORT OPERATIONS AT A RESCUE

INCIDENT

7

RELEASE A VICTIM FROM ENTRAPMENT BY COMPONENTS OF A

HEAVY CONSTRUCTION–TYPE COLLAPSED STRUCTURE

8

REMOVE A VICTIM FROM A HEAVY CONSTRUCTION–TYPE

COLLAPSE INCIDENT

9

LIFT A HEAVY LOAD AS A TEAM MEMBER 10

MOVE A HEAVY LOAD AS A TEAM MEMBER 11

BREACH HEAVY CONSTRUCTION–TYPE STRUCTURAL

COMPONENTS

12

CONSTRUCT CRIBBING SYSTEMS 13

STABILIZE A COLLAPSED HEAVY CONSTRUCTION–TYPE

STRUCTURE

14

CUT THROUGH STRUCTURAL STEEL 15

COORDINATE THE USE OF HEAVY EQUIPMENT 16

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TEC HNICAL RESCUER TRAIN ING R ECORD - NFPA 1006; 2017 Standard Chapter 5 – Rope Rescue TEC HNICAL RESCUER TRAIN ING R ECORD - NFPA 1006; 2017 Standard Chapter 5 – Rope Rescue

122

IN-HOUSE PROCTOR

INSTRUCTIONS

A APPENDIX

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Tester Instructions for “In-House”

Comprehensive Examination

As the training officers for your department you are authorized by NDFA to conduct the 100% skills test for

this level of certification. You must be certified to the level you are testing, i.e., if you’re FF2 you can test FF1

and FF2, Awareness and HM Operations.

*PRIOR TO CONDUCTING TEST, REVIEW TRAINING RECORDS

It is important that before doing this “In-House” exam that the candidate has completed training in all areas for

the level being tested.

*SAFETY OFFICER SELECTED AND BRIEFED

Select a Safety Officer to assist you during the test. This person, if possible, should not be taking the same test

that is being given. The Safety Officer will not assist with the testing process. The Safety Officer is there to

protect the CANDIDATES from injury during the testing process. The Safety Officer shall be in a position to

observe all students and ensure their safety at all times during the testing procedure. By using the following

instructions you will be able to evaluate the skill being tested and determine the candidate’s readiness for the

State “Spot Check” exam.

1. Keep in mind this is a test and there should be no coaching or training during the testing process. If a

candidate fails to perform a skill, it will count as a first attempt failure and they will be given a second

attempt. If they fail a second time they need to be retrained on that skill and tested again. Only

qualified candidates that have passed with 100% should be allowed to take the State SPOT CHECK

exam. Before beginning the testing process meet with all candidates and review the testing process.

Explain that this is a test and that the same process being used for the “In-House” will be used during the

state exam.

2. Designate a secure location for the candidates to remain in while the “In-House” exam is conducted.

This location should be away from the area where the exam is being conducted.

3. If possible, separate your testing stations so candidates cannot observe each other during the test.

4. To evaluate a candidate’s performance, use the following as a guide.

a. the skill is completed in the allotted time,

b. competence is shown by completing all performance criteria,

c. safety is shown while completing the skill.

At each test station the tester will read the SKILL to be demonstrated, the CONDITIONS to be met and the

TIME limit to complete each skill. This information is contained in the skill section of each standards packet.

Do this with each student as they come to each testing station. Ask for any questions. As each skill is tested

and completed sign it off in the section provided on the candidates training record. By conducting the “In-

House” test in this manner, you will prepare your candidates to successfully pass the state “spot check” exam.

This will also assure training records are current and that only those who are truly prepared take the state

certification examination.

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124

APPENDIX B – EXAMINATION

REQUEST FORM

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125

EXAMINATION REQUEST FORM

Please complete all information on BOTH sides of this form and return to the NDFA at least 30 days prior to the requested examination

date. A separate request MUST be made for each level of certification exam desired and for each exam date. Send completed

forms to [email protected].

Technical Rescuer Examination Request for Written / Skills – Check the appropriate level Discipline Written Manipulative Written Manipulative Curriculum Edition

Rope Rescue Level I Level II IFSTA J&B Other

Structural Collapse Level I Level II IFSTA J&B Other

Confined Space Level I Level II IFSTA J&B Other

Trench Rescue Level I Level II IFSTA J&B Other

Number Taking Written Examination: Number Taking Manipulative Exam:

Requested Test Date(s): Requested Test Start Time(s): _______________________________

Testing Tablets Needed for Written Examination: ____________

Examination Location:

Contact Name: Department Name and Address:

Contact Phone Number:

By the signature below we acknowledge that training records exist to support that everyone who will attend the exam has received a

learning experience in each subject area required for testing and has met all other requirements for the level being examined for as specified

in the Certification Policy and Procedures Manual. Department requesting the above exam, will have appropriate space and safe

accommodations and equipment for all written and manipulative skills

Fire Chief/Head of Department (Signature) Training Officer (Signature)

Fire Chief/Head of Department (Typed/Printed) Training Officer (Typed/Printed)

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126

Type or print names of candidates taking examination

Candidates Printed Name Department Last Four of

SSN Email

1 XXX-XX-

2 XXX-XX-

3 XXX-XX-

4 XXX-XX-

5 XXX-XX-

6 XXX-XX-

7 XXX-XX-

8 XXX-XX-

9 XXX-XX-

10 XXX-XX-

11 XXX-XX-

12 XXX-XX-

13 XXX-XX-

14 XXX-XX-

15 XXX-XX-

16 XXX-XX-

17 XXX-XX-

18 XXX-XX-

19 XXX-XX-

20 XXX-XX-

21 XXX-XX-

22 XXX-XX-

23 XXX-XX-

24 XXX-XX-

25 XXX-XX-

Send Request form to:

North Dakota Firefighter’s Association

1502 Grumman Lane, Suite 2, Bismarck, ND 58504

Fax: (701) 222-2899

Email: [email protected]

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127

APPENDIX C – CANDIDATE

ACKNOWLEDGEMENT FORM

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128

Candidate Testing Acknowledgement Form

I (print/type your name) acknowledge that I have been scheduled for my certification

test. I have read and understood the applicable standard and am fully aware of the prerequisites for the certification for

which I am testing. I also understand that I must present a copy of my training record and any proof of prerequisite

completion prior to being tested unless it has been documented by NDFA prior to. I further acknowledge that it is my

sole responsibility to ensure that this documentation has been met.

Please initial each statement below and sign where indicated:

I acknowledge the required prerequisites for the level for which I am testing on and will ensure I present any to the evaluator

prior to testing.

I understand that failure to follow the above requirement will result in my exam being cancelled.

SIGNATURE: I indicate by my signature below that I have read the terms and conditions of this protocol and

acknowledge that I understand it. My signature below indicates that I have read and freely signed this agreement, which

takes effect as a sealed instrument.

Candidate Signature Date