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| By John G. Alexander, MS, NRP & Christopher T. Stephens, MD, MS, NREMT-P FP-C , , Removing firefighters' protective gear should be approached the same as for football players or motorcyclists L iterature on the topic of rapid intervention, like many other subjects, began as individual articles, grew into larger chapters and has now evolved into entire textbooks. It is such an important topic, in part, because the larger concept of overall incident safety has become much more of a priority than in the past.This area, again like any other, will continue to evolve.The purpose of this article is to start with the subject of rapid intervention and build on it, taking the discussion in a new direction. Consider this scenario: At a residential house fre, where all departmental rules are followed and all of the frefghters act appropriately, a frefghter falls through a weakened area in the foor and radios for help using the LUNAR format (L-Location, U-Unit, N-Name, A-Assignment and Air Supply, R-Resources Needed). A rapid intervention team (RIT), already staged, enters the home and with the help of other frefghters successfully removes the injured colleague. The RIT members are successful because rapid intervention has been covered in numerous texts and training programs and the team has the proper training and equipment to complete the task. The injured frefghter is brought outside to a safe area. Rapid intervention is now complete, and all those involved in the rescue are accounted for and directed to the rehab area. It is at this point, at the completion of a rescue, that a new area of discussion can be suggested. While the body of literature addressing how to remove a frefghter from a hot zone has grown exponentially, there seems to be a gap in the literature concerning the care of the injured frefghter once he's successfully removed from a building. This gap is the focus of this article—managing an injured frefghter after he's successfully rescued. There are established practices for how to rescue an injured frefghter through a window, or down a ladder. However, once the frefghter is brought out of the house to a front lawn or street, and medical care is initiated, a new set of questions is raised. For example, how should he be positioned? Can he be immobilized while in full 46 JUNE 2013 | EMSWORLD.com