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Rescue

Rescue is the extraction and liberation of individuals or groups from situations of imminent danger, harm, or distress, often involving coordinated efforts by emergency services to ensure safety and provide immediate medical stabilization.^[1] This process encompasses a range of operations, from locating victims in collapsed structures to evacuating people during natural disasters, prioritizing the safety of rescuers, the scene, and then the casualties.^[2] In emergency management, rescue forms a critical component of the response phase, where immediate actions aim to save lives, protect property, and mitigate further risks following incidents like fires, floods, or accidents.^[3] Key types of rescue operations include urban search and rescue (US&R), which focuses on victims trapped in rubble or confined spaces due to structural collapses, utilizing specialized teams equipped with tools for location, extrication, and stabilization.^[4] Other variants encompass mountain rescue, involving technical skills for high-altitude or rugged terrain extractions; maritime rescue, conducted at sea to save individuals from drowning or vessel perils; and wilderness search and rescue, addressing lost or injured persons in remote areas.^[5] These operations often integrate self-rescue techniques, where individuals escape independently, non-entry rescues using retrieval equipment like harnesses and ropes, or entry rescues requiring personnel to enter hazardous environments.^[2] The effectiveness of rescue efforts relies on rigorous planning, training, and interagency coordination to avoid duplication, resource waste, and rescuer endangerment, as emphasized in international frameworks for disaster response. Notable examples include volunteer-based systems like Australia's New South Wales State Emergency Service (SES), which mobilizes over 10,000 members for flood and storm rescues, demonstrating the role of community resilience in bolstering professional responses.^[6] Historical incidents, such as failed rescues due to inadequate hazard assessment, underscore the need for evidence-based protocols to enhance outcomes in high-risk scenarios.^[2]

Fundamentals

Definition and Meaning

Rescue is fundamentally an act of liberation or deliverance from peril, encompassing emergency actions to save lives, property, or assets facing immediate threat. The term originates from the late 14th century in Middle English as "rescuwen," borrowed from Old French "rescourre" or "rescous," meaning to protect, keep safe, or free from danger; this in turn derives from Latin "re-" (intensive prefix, meaning "again" or "back") combined with "excutere," to shake or drive out, evoking the idea of forcefully extracting someone from confinement or harm.^[7]^[8] In its core sense, rescue denotes a targeted intervention to extract individuals or valuables from imminent danger, such as entrapment or environmental hazards, setting it apart from routine aid like preventive healthcare or non-urgent support, which lacks the urgency of life-or-death immediacy.^[9]^[10] The meaning of rescue varies across specialized contexts while retaining its emphasis on urgent extraction. In medical rescue, it involves immediate interventions to stabilize and remove victims from sites of injury or illness, such as extricating accident survivors for life-saving treatment. Technical rescue refers to operations requiring advanced skills and equipment for complex environments, including high-angle recoveries from cliffs or confined-space extractions in industrial settings. Animal rescue applies the concept to non-human subjects, focusing on freeing creatures from traps, disasters, or abuse to prevent suffering or death, often involving veterinary collaboration.^[11] In modern usage, the term has evolved significantly since the early 20th century, influenced by large-scale disasters that necessitated formalized responses. Events like the 1912 Titanic sinking, which highlighted the need for coordinated maritime lifesaving, and World War II air raids, which spurred urban search protocols, shifted "rescue" from ad hoc heroism to structured emergency services integrated with fire, police, and medical systems. By the mid-20th century, post-war developments in the 1940s and 1950s saw the rise of dedicated rescue squads, particularly in the United States, expanding the term to encompass professional, technology-aided operations amid growing urbanization and disaster frequency.^[12]^[13] This evolution underscores rescue's role in broader humanitarian frameworks, briefly encompassing scenarios like natural disasters where swift action prevents escalation of harm.^[3]

Circumstances Requiring Rescue

Rescue operations are frequently necessitated by natural disasters, which pose severe threats to human life through sudden environmental upheavals. Earthquakes, for instance, can cause widespread structural collapses, trapping individuals under rubble and requiring immediate extrication efforts; the 2010 Haiti earthquake, a magnitude 7.0 event centered near Port-au-Prince, resulted in an estimated 220,000 to 300,000 deaths, over 300,000 injuries, and the displacement of 1.5 million people, overwhelming local response capacities.^[14]^[15] Floods similarly demand urgent water-based rescues, as rising waters can submerge communities and isolate survivors; during Hurricane Katrina in 2005, severe flooding in New Orleans stranded thousands on rooftops, prompting a massive operation involving the U.S. Coast Guard and FEMA Urban Search and Rescue teams to evacuate over 33,000 people by air and boat.^[16] Avalanches, often triggered in mountainous regions by heavy snowfall or human activity, bury victims under tons of snow, complicating detection and recovery; the 2017 avalanche at the Rigopiano ski hotel in Italy entombed the structure, leaving about 30 people missing and necessitating specialized dog teams and heavy machinery for extraction amid ongoing seismic risks.^[17] Human-induced hazards also trigger critical rescue interventions, stemming from technological malfunctions, negligence, or systemic errors. Vehicle accidents, a leading global cause of trauma, often involve entrapment in wreckage, with the World Health Organization reporting approximately 1.19 million road traffic deaths annually and 20 to 50 million non-fatal injuries requiring emergency response.^[18] Industrial failures, such as chemical leaks or structural collapses, can release toxic substances or cause explosions that endanger workers and nearby populations; the 1984 Bhopal disaster in India, involving a methyl isocyanate gas release from a Union Carbide plant, killed thousands instantly and injured over 500,000, with rescue efforts hampered by the gas's rapid spread and lack of protective gear.^[19] Urban fires in densely populated high-rises or commercial buildings frequently trap occupants due to smoke inhalation and blocked exits, as seen in the 2017 Grenfell Tower blaze in London, where rapid fire spread led to 72 fatalities and challenged firefighters with vertical evacuation amid collapsing structures. Medical emergencies in challenging environments further underscore the need for prompt rescue, particularly where access is limited. Drowning incidents, often occurring in open water or during floods, lead to rapid unconsciousness and respiratory failure, with the World Health Organization estimating 236,000 global deaths yearly, predominantly in low- and middle-income countries lacking lifeguard services.^[20] Cardiac arrest in remote areas, such as rural or wilderness settings, exacerbates risks due to delayed emergency medical services response times—often exceeding 10 minutes—relying instead on bystander CPR to sustain life until professional help arrives, as studies show rural out-of-hospital cardiac arrest survival rates drop significantly without early intervention.^[21] Specialized rescue scenarios arise in extreme or isolated conditions, demanding tailored expertise beyond standard operations. Space missions, for example, involve life-support failures in vacuum environments; NASA's Apollo 13 mission in 1970 faced an oxygen tank explosion 200,000 miles from Earth, forcing the crew to improvise carbon dioxide scrubbing and power conservation to enable a safe return after aborting the lunar landing.^[22] Wilderness survival cases, common among hikers or adventurers in unforgiving terrains, require search-and-rescue teams to navigate harsh weather and geography; annually, U.S. operations handle thousands of such incidents, with outcomes depending on factors like signaling devices and environmental exposure, as illustrated by prolonged efforts in national parks to locate hypothermic or injured individuals.^[23] Globally, these circumstances contribute to a staggering incidence of disasters, with the United Nations Office for Disaster Risk Reduction estimating over $200 billion in annual direct economic losses from natural events alone, while the World Meteorological Organization reports that weather, climate, and water-related hazards accounted for 50% of all disasters from 1970 to 2019, causing 45% of deaths and 74% of economic impacts.^[24]^[25] Between 2000 and 2019, over 7,348 major disasters affected 4.2 billion people and claimed 1.23 million lives, highlighting the escalating scale of rescue needs amid climate change.^[26]

Legal and Ethical Aspects

Ethics of Rescue

The ethics of rescue involve moral frameworks that balance the imperative to save lives with constraints such as limited resources, time pressures, and conflicting duties, often requiring rescuers to make profoundly difficult choices under uncertainty. These principles emphasize beneficence, justice, and non-maleficence, adapted to crisis contexts where individual needs must sometimes yield to broader societal good. Utilitarian approaches dominate, aiming to maximize overall welfare, while deontological perspectives stress inherent human dignity regardless of outcomes.^[27] Triage in rescue operations exemplifies utilitarian ethics, prioritizing individuals based on survivability to achieve the greatest net benefit for the population affected. In resource-scarce scenarios like mass disasters, rescuers assess patients' likelihood of recovery—such as vital signs, injury severity, and expected resource use—to allocate aid efficiently, potentially deferring or forgoing treatment for those with minimal survival prospects. This method, rooted in the principle of utility, seeks to save the most lives or life-years possible, as seen in guidelines for ventilator allocation during pandemics or disaster response protocols.^[27]^[28] However, it can induce moral distress among rescuers, who grapple with the tension between saving all and optimizing limited interventions.^[28] Ethical dilemmas in rescue often arise when deciding between aiding perpetrators and victims, or in complex environments like war zones, where neutrality complicates moral obligations. In emergency settings, such as active shooter incidents, rescuers face the challenge of treating violent perpetrators with the same impartiality as their victims, viewing medical aid as an act of humanism that upholds ethical standards over retribution. This principle extends to conflict areas, where rescuers must provide protection and assistance to all vulnerable individuals—wounded combatants, civilians, or aid workers—irrespective of affiliation, to prevent discrimination and ensure universal humanity.30328-1/fulltext)^[29]^[30] Such decisions test rescuers' commitment to impartiality, especially when aiding former adversaries risks personal safety or prolongs conflict.^[30] Cultural variations shape rescue ethics, with collectivist orientations prioritizing communal welfare and group harmony, while individualist approaches emphasize personal autonomy and individual rights. In collectivist societies, often prevalent in regions with high disaster risk, ethical decisions in rescue may favor strategies that sustain community networks and shared survival, reflecting interdependence and social obligations. Conversely, individualist cultures, common in Western contexts, stress equitable treatment based on merit or need, potentially leading to more formalized, rights-based triage. These differences influence how rescuers interpret justice in resource allocation, underscoring the need for cultural humility in global operations.^[31]^[32] A poignant historical illustration of rescue ethics occurred during the Titanic's sinking in 1912, where triage decisions prioritized women and children, resulting in stark survival disparities—75% of women survived compared to 19% of men. This "women and children first" protocol, while rooted in chivalric norms, exemplified worthiness-based prioritization that modern bioethics critiques as arbitrary, arguing that no inherent value justifies valuing one life over another in crises. The event highlighted the moral pitfalls of subjective triage, influencing later standards to favor objective survivability assessments over social conventions.^[33] Professional codes, such as the Hippocratic Oath adapted for medical rescuers, provide foundational guidance by mandating that practitioners prioritize patient welfare, avoid harm, and maintain impartiality in all interventions. For emergency medical personnel, these oaths reinforce duties like confidentiality and non-discrimination, ensuring ethical consistency in high-stakes rescue environments, from disaster zones to conflict areas. Modern iterations, including the Declaration of Geneva, extend this to respect for human dignity and social justice, helping rescuers navigate dilemmas while upholding professional integrity.^[34]

Legal Frameworks

Legal frameworks governing rescue activities vary significantly across jurisdictions, establishing duties, liabilities, and protections for rescuers while balancing individual rights with public safety imperatives. In many civil law countries, such as France, a mandatory duty to rescue is codified, requiring individuals to provide assistance to those in peril under threat of criminal penalties. Article 223-6 of the French Penal Code stipulates that "whoever voluntarily fails to provide to a person in danger the assistance that, without risk for himself or a third party, he could have provided" faces 5 years' imprisonment and a fine of €75,000.^[35] This provision emphasizes immediate action or summoning help, reflecting a societal expectation of affirmative intervention without personal endangerment. In contrast, common law jurisdictions like the United States generally impose no general duty to rescue for bystanders, prioritizing personal autonomy over mandatory aid. Good Samaritan statutes in the U.S. encourage voluntary assistance by offering limited liability protections but do not penalize non-intervention, with exceptions in states such as Vermont, where 12 V.S.A. § 519 imposes a general duty to aid those exposed to grave physical harm, to the extent that it can be rendered without danger or peril to oneself.^[36]^[37] Internationally, treaties provide structured obligations for coordinated rescue efforts, particularly in maritime contexts. The International Convention on Maritime Search and Rescue (SAR Convention), adopted in 1979 under the auspices of the International Maritime Organization (IMO), mandates that contracting states ensure adequate search and rescue services within their designated areas, promote regional cooperation through rescue coordination centers, and facilitate the expeditious entry of foreign rescue units into territorial waters.^[38] This framework divides global oceans into 13 search and rescue regions, requiring parties to develop plans responsive to maritime distress needs and integrate aeronautical and maritime services for efficient operations. Amendments in 1998 and 2004 further emphasized disembarkation rights for rescued persons and enhanced coordination protocols.^[38] Liability issues for rescuers are addressed through immunity provisions to mitigate fears of litigation, though protections are not absolute. In the U.S., Good Samaritan laws across all states shield volunteers from civil claims arising from ordinary negligence during emergency aid, provided no compensation is expected and no prior duty exists, but they do not extend to gross negligence or willful misconduct.^[36] Post-rescue negligence claims may arise if rescuers exacerbate harm through reckless actions, such as improper medical intervention, underscoring the requirement to act as a reasonably prudent person. Internationally, similar immunities appear in frameworks like the SAR Convention, which implicitly supports rescuers by prioritizing coordinated efforts without assigning individual liability for good-faith actions.^[38] Following the September 11, 2001, terrorist attacks, legal frameworks in the U.S. were updated to bolster rescue capabilities in terrorism scenarios, integrating emergency response into national security structures. The Implementing Recommendations of the 9/11 Commission Act of 2007 enhanced coordination among federal, state, and local agencies, expanding grants for first responders and improving urban search-and-rescue teams under the Department of Homeland Security (DHS) to address mass-casualty incidents from terrorist threats.^[39] These reforms emphasized interoperability in communications and equipment for rapid deployment in high-risk environments, such as collapsed structures from bombings. U.S. case law illustrates the limits of rescue obligations, particularly in medical contexts. In Hurley v. Eddingfield (1901), the Indiana Supreme Court held that a physician has no legal duty to treat a patient in distress absent a prior professional relationship or contract, affirming the defendant's refusal to aid despite the patient's death en route to another doctor.^[40] This ruling underscored the common law principle that refusal to enter a rescue contract does not constitute actionable negligence, influencing subsequent Good Samaritan developments by highlighting the absence of affirmative duties for professionals.

Operations

Types of Rescue Operations

Rescue operations are broadly classified by the primary environment and hazards involved, enabling specialized response strategies to locate, stabilize, and extract victims efficiently. These classifications encompass land-based, water-based, aerial, confined space, and mass casualty operations, each requiring distinct expertise and coordination to mitigate risks such as structural instability, environmental extremes, or overwhelming scale. Land-based rescue operations focus on terrestrial environments where victims may be trapped in collapsed structures or natural formations. Urban Search and Rescue (USAR) involves locating, extricating, and providing initial medical stabilization to victims in urban structural collapses, such as those caused by earthquakes or building failures, with FEMA's National US&R Response System deploying Type 1 task forces of 70 specialists including search teams, engineers, and medical personnel for rapid deployment within six hours.^[3] Cave rescue addresses entrapments in underground cave systems, emphasizing slow, deliberate teamwork to navigate tight passages, water hazards, and vertical drops, often coordinated by volunteer organizations like the National Cave Rescue Commission (NCRC), which provides training in techniques such as small party assisted rescue for isolated incidents.^[41] Water-based rescues target aquatic hazards, distinguishing between surface and submerged scenarios with protocols prioritizing victim and rescuer safety. Swiftwater rescue operations manage fast-moving currents in rivers or floods, employing throw bags, swiftwater boats, and in-water swims to reach and extract victims, as outlined in National Park Service training manuals that stress hazard assessment and self-rescue principles.^[42] Scuba rescue, or public safety diving, involves underwater searches and recoveries in low-visibility conditions like lakes or harbors, following standards such as NFPA 1006 for diver proficiency in equipment handling and emergency ascents. The International Life Saving Federation (ILS) establishes global guidelines for these operations, including drowning prevention strategies that inform rescue protocols for open-water and swiftwater incidents through coordinated international standards.^[43] Aerial rescue operations leverage aviation for access to remote or elevated terrains, integrating helicopter capabilities with ground efforts. Helicopter extractions use hoist systems or short-haul techniques to lift victims from inaccessible sites, guided by standards like the NWCG Standards for Helicopter Operations, which detail rigging, pilot positioning, and safety zones to prevent rotor wash hazards during hoisting.^[44] Mountain rescue combines aerial insertions with ground teams to address high-altitude injuries or avalanches, coordinated by organizations such as the International Commission for Alpine Rescue (ICAR), which disseminates recommendations on multi-casualty management and stress resilience for operations in rugged, weather-exposed environments.^[45] Confined space rescues occur in enclosed industrial or mining environments like tanks, silos, or shafts, where atmospheric hazards such as toxic gases or oxygen deficiency pose immediate threats to entrants and rescuers. OSHA regulations under 29 CFR 1910.146 mandate non-entry retrieval systems with harnesses and mechanical winches for vertical entries exceeding five feet, alongside annual practice drills for rescue teams to ensure proficiency in hazard evaluation and victim extraction without secondary casualties.^[46] These operations prioritize pre-planning, including informing external rescue services of site-specific risks, to facilitate rapid response in settings like chemical plants or underground mines. Mass casualty rescue operations address large-scale disasters overwhelming local resources, classified by the National Incident Management System (NIMS) into five types based on complexity and duration. Type 1 incidents involve the highest resistance with regional impacts lasting over two weeks, requiring extensive evacuations and multi-agency coordination for triage and extraction, as seen in FEMA's framework for events like hurricanes or terrorist attacks.^[47] Type 5 represents the least complex, resolving minor incidents like single-vehicle crashes within hours, while intermediate types scale resources for moderate to significant effects, emphasizing unified command to prioritize life-saving interventions across widespread casualties.^[47]

Techniques and Procedures

Rescue operations begin with structured assessment phases to ensure responder safety and effective victim location. The initial scene size-up prioritizes evaluating hazards such as structural instability, fire, or environmental risks through a 360-degree walkthrough, stabilizing vehicles by engaging brakes and using chocking, and controlling access with barriers or traffic personnel to prevent secondary incidents.^[48] This phase integrates standard precautions, including personal protective equipment, to minimize exposure to bloodborne pathogens or other contaminants.^[48] Following scene safety confirmation, primary assessment focuses on identifying life threats by checking airway, breathing, and circulation while maintaining manual cervical spine stabilization if trauma is suspected.^[48] Victim location employs specialized tools during the search phase to accelerate detection in low-visibility conditions. Thermal imaging cameras detect heat signatures to pinpoint trapped individuals, enabling navigation through smoke-filled or debris-obscured environments by interpreting thermal contrasts between victims and surroundings.^[49] Procedures require incident commander approval for interior use and emphasize combining thermal data with traditional search patterns, such as primary rapid sweeps of likely areas followed by secondary thorough scans, to avoid over-reliance on the device due to limitations like battery failure or false readings.^[49] Training mandates competency in size-up techniques and overland search applications to ensure accurate victim identification and reduce rescue times.^[49] Extraction methods prioritize victim stabilization and efficient movement tailored to the environment. For lightweight, non-ambulatory victims without spinal injuries, the cradle carry involves the rescuer placing one arm behind the victim's back and the other under the knees to lift and transport them securely over short distances, ensuring the victim's head remains supported to prevent further harm.^[50] In high-angle scenarios, such as cliffs or buildings, rope systems provide controlled lowering or raising using static kernmantle ropes with a minimum 20 kN minimum breaking strength, rigged through mechanical advantage setups like 3:1 hauling systems with pulleys and prusik minding devices for load distribution.^[51] These systems incorporate belay mechanisms, such as tandem prusik hitches or descent control devices compliant with NFPA 1983, to manage tension and enable knot passing for continuous operation, always adhering to a 10:1 safety factor.^[51] Communication protocols rely on the Incident Command System (ICS) to coordinate actions and maintain situational awareness. Under NFPA 1561 and integrated with NIMS, ICS establishes a modular hierarchy with the incident commander setting objectives, operations section chief directing tactical branches like rescue groups, and safety officers monitoring hazards in real time.^[52] Standardized radio communications use plain language and common terminology, with progress reports structured as CLAN (Conditions, Location, Actions, Needs) to facilitate two-way updates and resource allocation, ensuring all personnel operate within a unified span of control typically limited to five subordinates.^[52] Post-chemical rescues require immediate decontamination to mitigate secondary exposure. Procedures, as outlined in OSHA 29 CFR 1910.120, involve establishing dedicated zones for removing contaminants from personnel and equipment using methods like physical wiping, chemical neutralization, or high-volume water flushing, performed in areas that isolate clean zones from contaminated ones.^[53] All protective gear must be decontaminated or disposed of, with monitoring by site safety supervisors to verify efficacy and prevent re-exposure; wetted impermeable clothing necessitates prompt removal and showers to avoid skin absorption.^[53] Training levels, from operations (8 hours) to technician (24 hours), ensure responders can implement these steps without compromising scene integrity.^[53] The post-rescue handover to medical teams follows standardized protocols to ensure seamless continuity of care. INSARAG guidelines recommend using victim extrication forms to document injuries, treatments administered, and vital signs during transfer, coordinating with local health agencies at triage points for efficient patient routing.^[54] Checklists verify confidentiality of records, proper PPE removal from patients, and repatriation plans for team members if needed, minimizing delays in advanced medical intervention.^[54]

Resources

Equipment

Personal protective equipment (PPE) forms the foundation of rescuer safety in hazardous environments, including helmets and full-body harnesses designed to mitigate impacts, falls, and other risks. Helmets for technical rescue operations must comply with NFPA 1951 standards, which specify performance requirements for impact attenuation, penetration resistance, and electrical insulation to protect against overhead hazards and environmental exposures during search and rescue activities.^[55] Full-body harnesses, integral to fall arrest and work positioning systems, adhere to ANSI/ASSE Z359.1 guidelines, ensuring they support loads between 130 and 310 pounds (59 to 140 kg) while incorporating energy-absorbing components to limit deceleration forces in arrests.^[56] These standards also extend to rescue-specific subsystems under ANSI/ASSE Z359.4, emphasizing assisted-rescue capabilities for efficient victim extraction without compromising rescuer mobility.^[56] Location and extraction tools enable precise victim recovery in diverse terrains, with ropes and winches serving as core components in technical operations. Static kernmantle ropes, characterized by low stretch and high tensile strength, are standard for main and belay lines in high-angle rescues, providing stability for loads up to several tons when properly rigged.^[57] Winches, often portable and powered, offer mechanical advantage for controlled lifting and lowering, such as in confined spaces or vertical extractions, with models like tripod-mounted systems allowing single-person operation for loads exceeding 500 pounds. Drones, or unmanned aerial vehicles (UAVs), have revolutionized scouting and location since the post-2010 era, equipped with thermal imaging and AI-driven convolutional neural networks for real-time target detection, as demonstrated in operations like the 2013 Lushan earthquake where they achieved an 80% identification rate over disaster zones.^[58] Medical equipment in rescue operations prioritizes immediate life support, including automated external defibrillators (AEDs) for cardiac arrest response, portable oxygen kits for hypoxia management, and splints for fracture immobilization. AEDs deliver automated shocks to restore heart rhythm, with guidelines from organizations like the American Heart Association recommending their integration into first-responder kits for out-of-hospital emergencies, potentially increasing survival rates by up to 70% when used within minutes.^[59] Oxygen delivery systems, typically comprising cylinders, regulators, and non-rebreather masks, provide high-flow oxygen (up to 15 liters per minute) to victims in respiratory distress, essential in smoke inhalation or drowning scenarios.^[59] Splints, including rigid and soft variants, stabilize injuries to prevent further damage during extrication, with innovative designs incorporating adjustable straps for rapid field application in trauma situations.^[60] Specialized equipment addresses environment-specific challenges, such as self-contained breathing apparatus (SCBA) for fire rescues and sonar devices for water operations. SCBAs supply breathable air from high-pressure cylinders (2,216 to 5,500 psi) via a demand regulator and full-facepiece, protecting against toxic gases and complying with NFPA 1981 standards to withstand temperatures over 500°F, thereby enabling extended operations in IDLH atmospheres.^[61] In water rescues, handheld sonar systems like the AquaEye Pro utilize dual-frequency sonar and AI to scan up to 8,000 m² in under five minutes, detecting human targets at depths to 50 meters and marking them for precise recovery, reducing search times by 90% compared to traditional methods.^[62] Innovations in rescue technology increasingly incorporate AI-assisted robots, particularly for urban search and rescue in collapsed structures, as highlighted by the DARPA Subterranean (SubT) Challenge. This initiative, culminating in the final event in 2021, developed heterogeneous robot teams with wheeled, legged, and aerial units using AI for autonomous navigation, communication, and mapping in underground urban environments like tunnels and subways, with applications in real-world collapsed structure assessments to enhance survivor safety.^[63]

Personnel and Training

Rescue operations rely on a diverse array of personnel, including first responders such as firefighters and emergency medical technicians (EMTs), who arrive early to provide immediate assistance, stabilize victims, and coordinate initial scene safety.^[64] Specialists, like tactical medical providers or SWAT medics, operate in high-risk environments where standard EMS cannot safely enter, delivering medical care during active threats or complex rescues.^[65] These roles demand specialized qualifications, often including certifications in advanced life support, hazardous materials handling, and technical rescue disciplines.^[3] Training programs for rescue personnel emphasize hands-on skills and scenario-based learning, with certifications like FEMA's Urban Search and Rescue (USAR) courses forming a core component. USAR task forces, comprising 70 members, require training in search, medicine, and logistics, often spanning 40-hour modules for basic specialist roles such as logistics or medical support.^[66] Additional programs adhere to standards like NFPA 1006 for technical rescuers, ensuring proficiency in operations ranging from structural collapses to water rescues.^[3] Physical requirements are rigorous to withstand demanding conditions, with many agencies mandating the Candidate Physical Ability Test (CPAT), a 10-minute, 20-second evaluation simulating firefighting tasks like hose drags and stair climbs while wearing a 50-pound vest.^[67] Mental preparation focuses on building psychological resilience through programs like SAMHSA's Shield of Resilience training, which equips first responders with coping strategies for trauma exposure in a one-hour module.^[68] These elements foster endurance against stress, with evidence-based interventions preventing long-term distress in rescue workers.^[69] Team structures typically follow the Incident Command System (ICS), where an incident commander oversees operations, supported by section chiefs for planning, logistics, and safety to ensure unified command during multi-agency responses.^[70] Support roles, including communication specialists and canine handlers, integrate into this hierarchy to maintain efficiency.^[3] Globally, rescue systems vary between volunteer and professional models; in Japan, as of April 2024, approximately 747,000 volunteer firefighters organized into 2,174 corps handle routine emergencies and disaster prevention, supplemented by professional Japan Self-Defense Forces (JSDF) units for large-scale operations requiring advanced training and deployment.^[71]^[72] This hybrid approach contrasts with fully professional systems in many Western nations, emphasizing community involvement alongside military expertise.^[73]

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Feb 5, 2022 · On the Titanic, the triage system favored women and children first. Of the first-class passengers, 97% of the 141 female passengersopens in a ...
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Oaths, codes, and charters in medicine over the ages
Jan 30, 2017 · Oaths and codes summarize the profession's mission to protect and restore human health. Taking an oath is the hallmark of a physician's ...Missing: rescuers | Show results with:rescuers
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Good Samaritan Laws - StatPearls - NCBI Bookshelf
Sep 12, 2022 · Good Samaritan laws provide liability protection against "ordinary negligence," which refers to the failure to act as a reasonably prudent ...Definition/Introduction · Issues of Concern · Clinical Significance
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International Convention on Maritime Search and Rescue (SAR)
The 1979 Convention, adopted at a Conference in Hamburg, was aimed at developing an international SAR plan, so that, no matter where an accident occurs, ...
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Implementing 9/11 Commission Recommendations
Oct 20, 2022 · The United States has made significant progress in securing the nation from terrorism since the September 11, 2001 attacks.Missing: rescue | Show results with:rescue
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Hurley v. Eddingfield :: 1901 :: Supreme Court of Indiana Decisions
Supreme Court of Indiana. HURLEY v. EDDINGFIELD. 156 Ind. 416 (1901). BAKER, J. The appellant sued appellee for $10,000 damages for wrongfully causing the ...Missing: text | Show results with:text
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5 Types of Technical Rescue Services - Capstone Fire
Dec 17, 2024 · 5 Types of Technical Rescue Services · Confined Space Rescue · Rope Rescue · Trench Rescue · Water Rescue · Structural Collapse Rescue.
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National Cave Rescue Commission
The National Cave Rescue Commission (NCRC) provides specialized cave rescue training and shares essential knowledge, skills, and resources for effective cave ...NCRC Resources · NCRC Staff · About · Safety
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[PDF] Swiftwater Rescue Manual
This manual provides instruction for NPS personnel in swiftwater rescue training, but it cannot make a person proficient by reading it alone.
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[PDF] Drowning Prevention Strategies - International Life Saving Federation
Jul 27, 2015 · The International Life Saving Federation (ILS) is reviewing drowning prevention strategies. This third edition of Drowning Prevention ...
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[PDF] NWCG Standards for Helicopter Operations, PMS 510
The NWCG Standards for Helicopter Operations (NSHO) establishes the standards by which helicopter operations are to be conducted under the exclusive ...Missing: extraction | Show results with:extraction
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International Commission for Alpine Rescue: ICAR
ICAR provides a platform for mountain rescue and related organizations to disseminate knowledge with the prime goal of improving mountain rescue services.Recommendations · Congress/Meetings · ICAR members · ICAR partnersMissing: operations | Show results with:operations
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1910.146 - Permit-required confined spaces | Occupational Safety and Health Administration
### Summary of Confined Space Rescue Requirements and Operations (OSHA 1910.146)
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[PDF] NIMS Incident Complexity Guide - FEMA
Examples: Type 5 incidents, events and exercises can include a vehicle fire, a medical response to an injured/sick person, a response to a suspicious package/ ...
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[PDF] National Emergency Medical Services Education Standards - EMS.gov
Applies scene information and patient assessment findings (scene size-up, primary and secondary assessment, patient history, reassessment) to guide emergency ...
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[PDF] Standard Operating Guideline for Thermal Imaging Cameras
Size-up techniques and examples. Search and rescue techniques and examples. Overland search techniques and examples. 4. How many hours of training are required ...
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[PDF] First Aid Manual - Red Cross
Cradle Carry. • Used when lightweight casualties are unable to walk. • Lift ... ✓ This method is mostly used to carry a casualty who is unable to assist.
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[PDF] TE C HN IC A L R ES C UE HA ND B OOK
Performing a high-angle rope rescue with a litter using tender(s) to negotiate obstacles, manipulate or position the patient, or provide medical care while ...
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[PDF] Incident Command System and Resource Management for the Fire ...
This is a student manual for the Incident Command System and Resource Management for the Fire Service, used for NFA state-sponsored courses.
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1910.120 - Hazardous waste operations and emergency response. | Occupational Safety and Health Administration
Summary of each segment:
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[PDF] volume iii: operational field guide - INSARAG
Guidance for patient handover from the USAR Team to local medical system as well as medical treatment and medical evacuation plans for an injured USAR. Team ...
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NFPA 1951 Standard Development
This standard presents requirements for the protection of emergency services personnel assigned to or involved in search, rescue, treatment, recovery, ...
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Fall Protection - Standards | Occupational Safety and Health Administration
### Summary of ANSI Z359 Standards for Fall Protection
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Rope Rescue Equipment - Rigging Lab Academy
Sep 3, 2025 · Winches provide massive mechanical advantage, capable of lifting and lowering significant loads with precision. The Multi-Purpose Device ...
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Unmanned Aerial Vehicles for Search and Rescue: A Survey - MDPI
The deployment of drones in SAR operations has several benefits. The ease of deployment of drones could contribute to their quick dispatch in disaster zones, ...
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Essential Equipment for Disaster Management: From Rescue to ...
Dec 28, 2024 · Advanced trauma care equipment: Includes intubation sets, intravenous (IV) supplies, surgical instruments, splints, and emergency medications ...
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Firefighter Basics: Wearing SCBA - Fire Engineering
Mar 15, 2022 · All firefighters must wear and use their SCBA when they are exposed to any abnormal working environment.
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AQUAEYE® - THE FIRST MOBILE SEARCH AND RESCUE SONAR ...
The AquaEye Pro is a handheld sonar device designed for first responders and water rescue teams to locate missing persons underwater quickly and efficiently.
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Deep underground, robotic teamwork saves the day
Jul 20, 2023 · Participants in the DARPA challenge used teams of robots to explore a varied underground space that included tunnels, caves and urban spaces ...Missing: AI- assisted
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[PDF] Emergency Services Sector Profile - CISA
In addition to possessing firefighting skills, firefighters may be trained to provide technical rescue services to perform complex rescue operations (e.g., ...Missing: specialists | Show results with:specialists
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What is Tactical Medicine? | Tactical and Law Enforcement ... - ACEP
Tactical Medical Providers (TMPs) render medical care during training and at high-threat deployments where normal EMS and Fire personnel cannot safely respond.
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DHS ODP FEMA Rescue Training Courses
Course requires 5 days (40 hours). US&R Logistics Specialist. This program is designed to train logistics personnel ...
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Candidate Physical Ability Test (CPAT) - IAFF
The CPAT (Candidate Physical Ability Test) is a standardized pre-employment physical ability test developed by the IAFF/IAFC Task Force to ensure fire fighter ...
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Shield of Resilience Training Course - SAMHSA
Jun 2, 2025 · This 1-hour online training helps law enforcement officers to better understand and address behavioral health stressors unique to law enforcement.
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Disaster Rescue and Response Workers - National Center for PTSD
And, unlike psychological debriefing, resilience training does not appear to cause harm in regard to psychological distress measures or memory performance.
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[PDF] APPENDIX B: INCIDENT COMMAND SYSTEM - FEMA
Dec 1, 2008 · The Safety Officer, Operations. Section Chief, Planning Section Chief, and Logistics Section Chief must coordinate closely regarding operational ...
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[PDF] Community-based disaster risk management - GFDRR
There are currently some 890,000 active volunteers across Japan, which is almost six times the number of career firefighters. The Fire Defense Organization Act ...Missing: personnel | Show results with:personnel
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Japan Self-Defense Forces' ability and spirit tested by disasters
Jul 28, 2019 · But disaster-recovery operations demand professional expertise as well as physical and mental toughness from Japan's soldiers. On the night of ...