Old MacDonald Had an….Accident

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Moving to the prairies, I have found myself deep in Canada’s agricultural epicenter.

Sites such as the one above are common. The fact that farming season is gearing up into full swing after a long winter would be hard to miss. I am also acutely aware that although I grew up in farm community, I know very little about farming/ranching on a super-industrial level. For example, I really don’t know what the machine above would be used for, let alone how it works. The farm equipment I’m used to generally would drive on the side of the road, not take up the whole thing.

After two recent farming fatalities in the province, I decided it might be a good time to bulk up on my farming knowledge and how it impacts paramedic care. In this blog I will share with you some of my research. As always, be forewarned of disturbing images and videos.

The Guelph Farm Safety Association provides some great strategies on dealing with common farming accidents. In many cases the fire department will need to be requested.

RESCUE PROCEDURES

Grain bins

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It takes less than 15 seconds for someone to be buried in grain.
• If a person becomes submerged in grain, begin rescue operations as rapidly as possible. If the person is totally covered, turn on the dryer blower and move some air into the bin.
• Always assume that the person trapped in the grain, even if completely submerged, is alive. The most successful way to rapidly remove a victim is to cut large holes around the base of the bin, approximately 5 feet up from the base. (Always beware that if you cut too many holes, the bin may collapse on you.) Cutting holes reduces the volume of grain from the bin in the shortest period of time.
• Gain access into the grain bin sidewalls by using the front-end loader of a tractor, an abrasive saw, or an air chisel. Cutting torches should be a last resort because of the dangers of fire and explosions from dust and fumigant residue.
• Using a drum with both ends cut to drop around the victim is another rescue technique. The drum placed around the victim can reduce the force of the grain on the trapped victim. When you must enter the grain bin, have several people assist you from the outside.
• At least two people should be available. Enter with a rope and safety harness so they can lift you out in case of an accident.
• Do not attempt a rescue in an oxygen-deficient atmosphere. Always use a SCBA to enter Oxygen deficient atmospheres.

Power Take Off (PTO)

• Rescue procedures to remove a victim from the power take-off shaft should start by shutting off the tractor and making sure it will not re-start. Next, chock the tractor wheels so that the tractor cannot move. Do not disengage the PTO. When tension is released, a PTO can move and cause additional injury to a victim. Remove clothes only if they restrict breathing. There are several methods that can be used to remove a victim from a PTO shaft:
• Disconnect the PTO shaft from the rest of the tractor, and turn the shaft counterclockwise to un-wrap the tightly wrapped cloth and tissue that may be around the shaft. This material will not slip off the shaft after the PTO shaft is disconnected, but must be unwrapped.
• Place the Power Take-Off drive unit in neutral and turn the PTO shaft counterclockwise to un-wrap the person from the shaft. This may require using a large pipe wrench or putting a small shaft or bar into the yoke of the Power Take-Off unit and turning with considerable pressure.
• You may be able to disconnect the hitch pin that attaches the trailing equipment to the tractor and move the tractor forward to pull the PTO shaft apart. After the PTO shaft separates into two parts, you will have to turn the shaft counterclockwise to remove the victim. If the shaft is solid, the rescuers may have to cut it with a cutting device such as a portable power grinder, hacksaw or oxyacetylene torch.
• If there are combustible materials in the area, rescuers should be extremely careful when using any type of flame-producing equipment, or even portable grinders that produce sparks. If such equipment must be used, adequate fire equipment must be readily available in case a fire starts. If explosive products, such as gasoline, may be have been spilled in the area, open flame must be ruled out. In this case, rescuers and observers should be alert and not smoke in the area.
• While the victim is being removed from the Power Take-Off shaft, other rescuers must provide life support to the victim and monitor his vital signs continuously. Extrication is only the first step of saving the victim’s life.
• If an arm, foot, leg or other part of the body was amputated, it should be located and handled properly for possible re-attachment and transported with the victim.
Tractor rollover

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• Fire is a threat in an overturn situation if there is spilled fuel present. A fire hose or ABC-type extinguisher should be available throughout the rescue.
• Consider alternative methods before using oxyacetylene cutting equipment to free a victim.
• Shut off the tractor engine. Even if it isn’t running, rear wheel movement could start it up.
• If the ground is soft, it may be possible to dig the victim out from under the tractor.
• Always block or crib the machine to prevent it from tipping and causing more injuries.
• Lifting the tractor is the best way to deal with rollovers of large, modern tractors. A second tractor or a tow truck will be needed to perform the lift.
• If a tractor must be rolled away from the victim, careful blocking is required to minimize settling of the lower side.
• Place cribbing under the tractor as it is raised. Non-essential rescuers should stand well clear to avoid injury if the cable or chain breaks.
• Hydraulic jacks can be used to lift smaller tractors. Block the axle on both sides to prevent the tractor from rocking onto the victim.
• Air bags can be used to raise an overturned tractor. They are more stable if stacked alternately with the blocking.
• If a victim is pinned under one side of a small tractor, eight to 10 people may be able to roll the machine enough to free the victim.
Manure gas poisoning/Silo gases

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Multiple deaths are common in underground pits because deadly gases can be present in the enclosed area.

•Rescue personnel must use a self-contained breathing apparatus to safely enter a manure storage pit or tower silo. Confined space entry procedures must be followed.

•Also, the rescue personnel must use a lifeline and have assistance from a back- up crew.

• Restore ventilation to facilities with beneath the floor manure storage as rapidly as possible. Run the blower on the silo if it is still operable.
• Open windows and doors, activate the buildings ventilation system, or use smoke evacuation equipment.
• If there is a possibility of reviving a victim, cardiopulmonary resuscitation procedures should begin immediately.

Electrocution:

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• Always assume that any downed power line or any piece of equipment in contact with a power line is energized. If you have not been trained to handle high voltage lines call 911. An untrained individual should attempt rescue only if the response time is dangerously long.
• Wear rubber soled boots and non-conductive gloves. Use a non-conductive material to remove the power line. If the victim is in contact with energized equipment, it will be necessary to push or pull them away. A piece of dry, non-conductive rope can be used for this purpose.
• Check for breathing as soon as the victim is freed from electrical contact. Start artificial respiration immediately if required. A doctor should examine anyone who has received a high voltage shock as soon as possible.1

According to my co-workers, long transport times is SW Saskatchewan generally result in the above issues being taken care of pre-arrival. This doesn’t mean taking for granted that the scene is secure for you or your patient. However, people who own/work on farms usually know the dangers that come with the territory. They will be your main resource for ideas on extrication and hazard prevention.

Stay safe out there.

(1) http://www.farmsafety.ca/public/factsheets/farm_accident_rescue.pdf

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