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PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSConfined Space Rescue Technician I & II Skill StationsNFPA 1006 – Chapter 7 (2013 Edition)Confined Space Rescue Technician Level IStation BAir Monitoring and VentilationMandatory StationStation DEntry OperationsMandatory StationStation EVictim Packaging and RemovalMandatory StationStation FRescuer Removal and TerminationMandatory StationConfined Space Rescue Technician Level IIStation AScene Size-up and Initial ActionsMandatory StationStation CHazard ControlMandatory StationStation GPreplan of a Confined Space IncidentMandatory StationNOTE: Test RequirementsTechnician Level I – B, D, E and FTechnician Level II – A, C, GJanuary 2019
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION A – Scene Size Up and Initial ActionsTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPRs 7.2.2, 7.2.3Candidate #Check the Test TypeInitialRetestDirections: You are dispatched to the scene of a confined space emergency. For this incident, you are to conduct asize-up so existing and potential conditions are evaluated within the general and space-specific areas; witnesses areinterviewed; hazards are identified and mitigated; potential victim locations(s), condition(s), and number(s) aredetermined; potential for rapid non-entry rescues or victim self-rescue is recognized; and a risk benefit analysis isperformed. Do you have any questions?Performance Outcome: Pass / Fail is determined by 16 of 16 tasks being correctly blishes and utilizes an Incident Management SystemEnsures proper use of Personal Protective Equipment (PPE)Utilizes a personnel accountability systemPerforms size-up using observations, victims, bystandersEstablishes safe operating zonesAppropriately places barricades or scene control tape to limit accessImplements appropriate atmospheric monitoringProvides for ventilation of the confined space(s)Controls sources of hazardous energy within the space and surroundingsIdentifies and safely controls all present and potential hazardsDetermines all potential victim locationsPerforms a risk/benefit analysis and evaluates rescue versus recoveryProvides for non-entry and/or self-rescue of victimEvaluates rescue optionsIdentifies needed resources to accomplish rescue/recoveryCompletes all tasks without compromising personal or team safetyPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION B – Air Monitoring and VentilationTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPRs 7.1.1, 7.1.2Candidate #Check the Test TypeInitialRetestDirections: You are dispatched to the scene of a confined space emergency. For this incident, you are to implementatmospheric monitoring, interpret the collected data, and establish ventilation in support of the rescue operations. Do youhave any questions?Performance Outcome: Pass / Fail is determined by 12 of 12 tasks being correctly performed.No.123456789101112TasksEnsures proper/continued use of Personal Protective Equipment (PPE)Selects appropriate air-monitoring equipmentChecks and assures proper operation of selected equipmentProvides a fresh air set-up or zeroes monitor per the manufacturer’s recommendationsMonitors general area of the confined space incident starting on the upwind sideMonitors the atmosphere in the target space(s) at appropriate levelsRecords findings on entry permit or atmospheric monitoring logSelects appropriate ventilation equipmentAssures proper operation of ventilation equipmentProperly establishes positive pressure ventilation of spaceMonitors continuously the atmosphere in the space(s) and records findingsCompletes all tasks without compromising personal or team safetyYesNoPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION C – Hazard ControlTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPRs 7.2.3, 7.2.2Candidate #Check the Test TypeInitialRetestDirections: You are operating on the scene of a confined space rescue incident and are given the assignment of isolatingall forms of hazardous energy (i.e., electrical, mechanical, pneumatic, hydraulic) in support of the rescue operation. Youare to apply appropriate isolation techniques to the scene presented utilizing the equipment provided. Do you have anyquestions?Performance Outcome: Pass / Fail is determined by 7 of 7 tasks being correctly onalProtectiveEquipment (PPE)12 Identifies appropriately the sources of hazardous energy to be isolated3 Selects appropriate equipment and/or techniques to isolateApplies selected equipment or techniques to hazards to isolate/control hazards and renderequipment/space safe in accordance with manufacturer’s directions or procedures4567YesNoEquipment/Techniques Utilized (Mark as appropriate)Lock-Out/Tag-OutDouble Block and BleedMisalignmentBlinding/BlankingConfirms the hazard(s) is isolatedInforms the Incident Commander when tasks are completeCompletes all tasks without compromising personal or team safetyPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION D – Entry OperationsTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPRs 7.1.2, 7.1.5Candidate #Check the Test TypeInitialRetestDirections: You are operating on the scene of a confined space rescue incident and are tasked with entering the spaceto perform a rescue operation. Functioning as a team you are to perform pre-entry medical screening of all entrants,determine rescuer suitability, properly don all related equipment, enter the confined space and locate the victim(s).Do you have any questions?Performance Outcome: Pass / Fail is determined by 15 of 15 tasks being correctly performed.No.Tasks1 Ensures proper/continued use of Personal Protective Equipment (PPE)Performs pre-entry medical screening of rescuers to include baseline pulse, respiration,2blood pressure, and general health3 Rescuers not suitable for entry operations identified (if applicable)4 Appropriate fall arrest/retrieval equipment selected and donned5 Appropriate respiratory protection (SCBA, SABA) selected and donned6 Communications plan and/or equipment identified7 Emergency evacuation signal identified8 Personal lighting equipment identified and utilized9 Retrieval line attached to harness and running end secured outside10 Pre-entry briefing performed11 Appropriate point of entry selected12 Opening negotiated and space entered without significant difficulty13 Victim contacted and communication established14 Incident command notified of status15 Completes all tasks without compromising personal or team safetyYesNoPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION E - Victim Assessment, Packaging & RemovalTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPRs 7.1.4, 7.1.3, 7.1.5Candidate #Check the Test TypeInitialRetestDirections: You are operating on the scene of a confined space rescue incident. You contacted the victim after initialentry operations and are now tasked with assessing, treating as appropriate, packaging and removing the victim fromthe space. Do you have any questions?Performance Outcome: Pass / Fail will be determined by 9 of 9 tasks being correctly performed.No.123456789TasksEnsures proper/continued use of Personal Protective Equipment (PPE)Patient contact made and communications establishedPatient assessed for life threatening injuriesAppropriate treatment initiated based on patient’s conditionAppropriate removal device or method selectedPatient packaged and immobilized as best possible given the size and the configuration ofspaceAppropriate use of rescue/retrieval equipmentPrevents excessive aggravation of patient’s injuries in the removal from the c-spaceCompletes all tasks without compromising personal or team safetyYesNoPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION F - Rescuer Removal and TerminationTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPR 7.1.5Candidate #Check the Test TypeInitialRetestDirections: You have just completed the removal of a patient from a confined space rescue incident. Working as ateam, you are to remove all entrants from the space and properly terminate the incident. Do you have any questions?Performance Outcome: Pass / Fail is determined by 12 of 12 tasks being correctly performed.No.123456789101112TasksEnsures proper/continued use of Personal Protective Equipment (PPE)Maintains contact and communications with rescuers/entrantsAssures retrieval line/system is attached correctly and entrants are extricated from a spacein the selected transfer deviceOperates correctly the selected retrieval systemRetrieval lines and air hoses managed during retrieval processAll entrants removed from space and disconnected from retrieval systemPersonnel and equipment decontaminatedPatient information relayed to EMS personnelAll equipment returned to state of readinessSpace is secured and scene is rendered safeConfined space entry permit and/or other documentation completedCompletes all tasks without compromising personal or team safetyYesNoPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMYCONFINED SPACE RESCUE TECHNICIAN SKILLSSTATION G - Pre-Plan a Confined Space IncidentTest SiteTest DateReference NFPA 1006 (2013 Edition), Chapter 7Mandatory Station: JPRs 7.2.1, 7.2.2Candidate #Check the Test TypeInitialRetestDirections: Given a scenario involving an injured entrant, pre-plan a confined space incident given applicableguidelines, regulations and preplan forms. Then use the pre-plan to assess the incident and identify rescue needsincluding additional resources. Do you have any questions?Performance Outcome: Pass / Fail is determined by 10 of 10 tasks being correctly performed.No.12345678910TasksSite specific hazards and isolation methods are identified and documentedAll ingress and egress types and locations are identified and documentedDrafts/Draws a sketch of confined spaceResources are identified and documentedAppropriate PPE is identifiedRisk benefit analysis is doneInterviews were conductedMonitoring equipment identifiedRescue systems for entry and retrieval for rescuers and victims identified/evaluatedCompletes all tasks without compromising personal or team safetyYesNoPlease indicate skill outcome PASS FAILEvaluator Comments:Evaluator Signature:January 2019Evaluator #
PENNSYLVANIA STATE FIRE ACADEMY CONFINED SPACE RESCUE TECHNICIAN SKILLS January 2019 Directions: You are operating on the scene of a confined space rescue incident and are tasked with entering the space to perform a rescue operation. Functioning as a team you are to perform pre-entry medical screening of all entrants,
