1

CONFINED SPACE
AUTHORIZED WORKERS AND ATTENDANTS













Autoria:
Equipe de Desenvolvimento Sampling Planejamento


5 edio (Julho, 2009)






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Dear trainee,



Sampling considers life as the most precious gift. That is why we chose it as our mission: Cherish the
life!
You carry out your duties at work, having the opportunity of changing your life an other peoples lives,
therefore, knowledge is fundamental.
This training was carefully developed to contribute in the construction of knowledge, ability, and
attitude. All of them are necessary to you in order to acquire essential competences to preserve life.
We hope you enjoy all the moments of this training: theoretical classes in which important information
will be shown or reminded, drills that will put you, in a safe way, in situation similar to those ones you
can face in real emergencies; and the breaks which must be used to clean up doubts and develop the
contents learned.
We ever want to improve as demanded by quality dynamism. In order to get this, we need you to write
down, in your reaction assessment in the end of course, your impressions about our performance.


Cherish the life!



















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SUMRIO
1. LegislaTION AND OTHER REQUIREMENTS......................................................................... 6
1.1. Responsibilities................................................................................................................... 7
2. RISK MANAGEMENT............................................................................................................. 10
2.1. Recognition, Evaluation and Risks Control....................................................................... 10
2.2. Control: Prevention, Administrative and Personal Measures ........................................... 15
3. Equipment .............................................................................................................................. 18
3.1. Detection and Gases Control............................................................................................ 18
3.2. Ventilation and Exhaustion ............................................................................................... 22
3.3. Respiratory Protection ...................................................................................................... 24
3.4. Communication................................................................................................................. 26
4. PROCEDURES AND UTILIZATION OF THE ENTRY WORK PERMIT (PET)...................... 27
5. RESCUE NOTIONS................................................................................................................ 29
5.1. Main Equipment ................................................................................................................ 29
6. BASIC ATTENDENCE TO VICTIM ........................................................................................ 38
6.1. Scenario Evaluation.......................................................................................................... 38
6.2. Victims Evaluation............................................................................................................ 40
6.3. Bleeding............................................................................................................................ 40
6.4. Fractures........................................................................................................................... 43
6.5. Casualties Transportation................................................................................................. 45



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INTRODUCTION
In spite of although no reliable data in Brazil, it is known the expressive number of accidents at
confined spaces work, that occur by the lack of knowledge of the risks and safety barriers
necessaries.
It is estimated that 90% of accidents in confined spaces are severe, usually more than one worker.
In the past miners used to take birds to work, it was a fundamental precaution to realize the
oxygen deficiency and toxic gases in the environments. If the bird produces any symptom or died,
was a sign that something was wrong and everybody should leave the workplace immediately.
Workers continue to enter in confined environments (tanks, ducts silos, vessels, galleries, boilers,
etc), often without basic precautions and they are dying and suffering severe lesions not only by
lack of oxygen, toxic products inhalation, falls or explosions, but primarily by lack of information.
In general, only big companies have access to knowledge because they have a staff. The medium
and small companies do not know the minimal necessary, only when occurs a fatality, they are
aware of problem through newspaper, magazines or news.
In 1990s, OSHA (Occupational Safety and Health Administration) presented a statistical survey,
which shows main causes of fatalities in confined spaces:
65% do not understand the hazard concepts.
60% rescuers.
40% of fatalities are in places considered safe.
Currently the National Institute Occupational Safety and Heath (NIOSH) shows these data:
100% - lack of atmosphere and lack of ventilation.
65% - problems with air quality.
60% - workers that died trying to rescue the victim.
29% - people that suffer severe accidents or loss the life in confined spaces were supervisors
or team leaders.
No confined space totality safe, because it is considered hazard places with many risks, principally
atmospheric. Some hazards found in confined spaces are: abnormal concentrations of oxygen,
toxic gases, flammable vapors, dust, heat, damaged stairs, poor lighting, mobile equipment,
slippery floor, electrical, flood, among others. The Entry Supervisor must be able to recognize,
evaluate and control risks before emission of Entry Work Permit (EWP).
Despite of knowing the statistic result, the workers are not aware of the precious information and
that can help to keep the preventionist posture, in risk perception for preservation of their lifes
while performing tasks in these places. They still go on:
Failures in the hazards recognition associated with confined space.
Failures in the procedures knowledge to execute the job in a safe way, entry or rescue.
Incorrect answer in the emergency attendance.


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Confidence in own senses; do not use the appropriate equipment.
Hazards belting etc.


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1. LEGISLATION AND OTHER REQUIREMENTS
The administrative rule 3214/78 of Labor Ministry created the Regulation Norms with legal effect,
that must be mandatory for all private and public companies since they have formal employees
(with legal contract).
Currently the administrative rule 3214/78 is composed by 33 Regulation Norms approved. The
norm number 33 regulates the work in confined spaces.

The objective is to establish minimal requirements to identification of confined spaces and
recognition, evaluation, monitoring and control risks, of way to guarantee permanently the workers
safety and health that work directly and indirectly these spaces.

According to NR-33:
Confined space is any area or environment not projected for continuous human occupancy, with
limited means of entry or exit, which an existing ventilation unable to remove contaminants or an
oxygen deficient or enriched area.

In places that there are considered confined spaces, must be observed, and complementing NR-
33, these normative acts:

NBR 14606 Service Posts confined space entry and
NBR 14787 Confined space accidents prevention, procedures and protection measures.

Other documents can give support to accidents prevention in confined spaces:
Other NRs:

NR-05 Accidents prevention internal commission (CIPA).
NR-07 Occupational health medical control (PCMSO).
NR-09 Accidents risks prevention program (PPRA).
NR-10 Facilities and services in electricity.
NR-13 Boilers and pressure vessels.
NR-15 Activities and unhealthy operations.
NR-18 Environment and conditions at work in construction industry.
Administrative rule INMETRO 83 of 03/04/2006, talks about evaluation regulation of the
electrical equipment conformity to atmospheres potentially explosives, in the conditions of
flammable vapors and gases.
International norms:
Occupational Safety and Health Administration (OHSHA) - 1910/146 (general industry), 1915
(maritime industry) and 1926/21 (construction industry);
NFPA - National Fire Protection Association 1670/99, 1983/01 is standard of big companies.


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1.1. Responsibilities
The subjects about safety and accidents prevention in confined space is very important and
gravity for responsible of the confined spaces (employers, managers and supervisors), can be
responsible criminally by omission or by conditions or unsafe work orders, if they do not have
precautions determined by law, before work liberation. The company can answers civilly by the
accidents and diseases in confined spaces.
Each function involved in the system of execution of works in confined spaces, from employer to
attendant have responsibilities.
1.1.1. Employer
Indicate formally the technical responsible by the NR-33 fulfillment;
Identify the confined spaces existent in the workplace;
Identify the specific risks of each confined space;
Implement the management in safety and health at work in confined spaces, for measures
prevention technical, administrative, personal and emergency and rescue, guaranteeing
permanently environments with adequate conditions of work;
Guarantee the continuous qualification of workers about risks, control measures, emergency
and rescue in confined spaces;
Guarantee that the access in confined space only happens after the emission, by written, of
the Work Entry Permit, according to model in attachment II of NR-33;
Inform companies contracted about risks in areas where will develop its activities and require
the workers qualification;
Guarantee that workers can stop their activities and abandon the workplace, always that they
suspect a severe risk that can put their lifes in risk.
Join with the health and safety measures implementation of the contracted companies workers
giving ways and conditions to them work in confined space according to NR-33;
Interrupt all and any kind of work in case of suspicious of severe risk, proceeding to immediate
abandonment of the place and
Guarantee up-dated information about risks and control measures before each access in
confined spaces.
1.1.2. Entry Supervisor*
Participate of the course to permit works in confined spaces
with minimal workload of 40 hours according to item 33.3.5.6
of NR-33;
Emit the Entry Work Permit (EWP) before tasks;


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Execute tests, check equipment and procedures in the EWP;
Assure that the Emergency and Rescue service is available which the ways to call them are
operating;
Cancel the EWP when he judges necessary and
Close the EWP after the end of the service or exit of all workers of the workplace
1.1.3. Authorized Workers
Execute services in confined spaces, only, after to be qualified
through specific course with workload minimal of 16 hours and
must be refreshed to each 12 months;
Comply the procedures and orientations received in trainings;
Collaborate with the company applying the NR-33;
Use adequately ways and equipment given by the company;
Communicate to attendant and or entry supervisor, the risk situations to your safety and
health, or of the team that is with you working in confined space.
1.1.4. Attendant
Receive qualification to work in confined space with workload of
16 hours and refresh to each 12 months;
keep continuously the correct count of the authorized workers in
confined space and assure that all workers leave in the end of the
activity;
Keep out of the confined space, close to entry, in contact
permanent with authorized workers;
Adopt the emergency procedures, calling a public or private rescue team when necessary;
Operate tripod, monopod and gin pole;
Give the order to abandon the confined space whenever He gets any signal of alarm, hazard,
symptom, complaint, non-allowed condition, accident, non-predictable situations or when it is
impossible to perform the tasks.


The attendant can not perform other tasks that can compromise the main duty
which is to monitor and protect authorized workers



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1.1.5. Rescue Team at Rescue Operations
It is composed by qualified and trained people, at least once a year,
according to NR 33.4.1, to remove workers from the confined
spaces in emergency situations and provide first aid.

The rescuer must be mental and physically able to perform the
tasks. The rescue team qualification must recreate all possible
accident scenarios identified in Risk Analysis.



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2. RISK MANAGEMENT
2.1. Recognition, Evaluation and Risks Control
The risk analysis is the hazards identification and risks evaluation which can be exposed of
workers during the job execution in confined spaces. This evaluation must consider the Tolerance
Limit (TL), that is the concentration or maximum or minimal intensity related with nature or
exposure time to agent, not causing damage to work health during your labor life (according to
NR-15).

Some concepts:
Hazard is the probability or condition inherent to a substance or activity able to cause damage to
people, to property or environment.

Risk is the exposure to hazard. The risk graduation is defined by the relation between frequency
and consequence of an accidental occurrence.
We can say that Risk = Hazard/Prevention, this case prevention is represented by barriers placed
to offer conditions for the execution of the task by the worker.

Hazard identification identification of an undesirable event that takes to materialization of a
hazard.

Risk control adopt procedures and practices in order to protect the man, to property and
environment, guaranteeing the operational continuity.

Risk condition in confined space - The risks evaluation in confined spaces must be done with
detection/monitoring equipment, calibrated and with certificate of approval by the INMETRO or by
accredited laboratory by the Brazilian Calibration Net (BCN).

The oxygen levels of the environment must be verified seen that the flammability is directly related
with the oxygen concentration in the confined space. It is important that, simultaneously, they are
verified other gases like CO (Carbon monoxide), H
2
S (sulfide gas), methane gas (explosive
mixture) they can exert direct actions to team that executes the service. The monitoring in the
confined space must be constant in order to be detected possible alterations of the results
obtained in work liberation.

According to NR 33, item 33.3.2, Technical Measures of Prevention, in letter C, is important to
proceed to evaluation and risks control, chemicals, physicals, biologics, ergonomics and
mechanics.



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2.1.1. Chemical Risks
All organic and inorganic substances, natural or synthetics that during the fabrication,
manipulation, transportation, storing or use can make part of the environment in powder way,
gases, vapors with irritate effects, corrosive, asphyxiate or toxics, and in quantity that has
probability of damage the people health in contact with them. It is important to pay attention to
tolerance limits according to NR-15.

The main chemical risks are related to oxygen proportion. So you must check lower, medium an
upper locals. Among most common sources take to oxygen deficiency in confined spaces, are
bacteria, metals oxidation and combustion and gases displacement.

The oxygen enrichment increases the flammability level of the hydrocarbon taking to reduction of
the inflammability lower limit, increasing the fire potential risk if there is ignition present. Due these
and other risks, the cylinders of oxyacetylene never must be put in the confined space.

When the environment shows explosiveness, the access can not be permitted.

In cases of the confined space atmosphere is potentially able to hit the IDLH levels, workers must
be informed about the condition and use the SCBA or air supply line with escape bottle.

Toxic Atmosphere
If there is toxic atmosphere can cause severe problems to health and
death. The venomous effect can be immediate, postponed or both. For
example: exposure to CO in low concentration can cause brain
damages imperceptible, while in great concentration the result is fast
death.


The presence of toxic substances usually is result of material storing, use of some types of
revetments and solvents in confined locals. Organic material in decomposition displaces the
oxygen and produces gases as methane, sulfide gas, monoxide and dioxide carbon. Failures in
the hydraulic nets isolation system make possible the toxic gases entry in the confined spaces.
Although some substances have odor or taste, most toxic gases are not perceptible to any one
sense organ and the penetration in the human body can be by three different ways: absorption,
ingestion, inhalation and injection.


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The atmosphere toxicity changes according to the substances, concentration and exposure time.

Parts per million ppm (1% vv = 10.000 ppm)
Units:
Mg/cubic meter mg/m
3

Tolerance Limit (TL):
Exposure limit per - 8 hours.
Maximum value:
It can not be crossed during a work journey NR 15.
Short Term Exposure Limit STEL:
15 minutes.

Toxic gases can cause many harmful effects to human health. The most gases are carbon
monoxide (CO) and sulfide gas (H
2
S)
The tolerance limit is given by the NR 15
Carbon Monoxide
Characteristic: inodorous, no color and it is absorbed 200 times faster by the lungs than
O
2

Tolerance limit per 8 hours: 39 ppm.

Biochemical effects of CO
Above 10.000 ppm. Death.
From 2.000 to 5.000 Unconsciousness / death.
From 1.200 to 2.000 Mental confusion and loss of balance.
1.200 ppm. IPVS / IDLH.
600 ppm. Strong headache.
200 ppm. Headache.
58 ppm. Instantaneous limit.
39 ppm. Limit per 8 hours.









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Sulfide Gas
It comes from organic material in decomposition. The main
characteristic is the smell of rotten egg that, in high concentration,
inhibits the smell. The TL per 8 hours is 8ppm.













Flammable atmospheres
The gases flammable liquids are substances that mixed with air receiving
adequate heat, become combustion.
For gas combustion it is necessary three elements in adequate proportion:
gas, oxygen, ignition source.
Explosiveness Limit








Biochemical effect by the sulfide gas
> 1.000 ppm. Unconsciousness and death by respiratory paralysis in minutes.
From 300 to 700 ppm. Unconsciousness, respiratory paralysis.
From 200 to 300 ppm. Irritation in eyes and airways.
100 ppm. IPVS / IDLH.
From 50 to 100 ppm. Moderate irritation in eyes and airways.
16 ppm. Instantaneous limit.
8 ppm. Limit per 8 hours.


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2.1.2. Physical Risks
There are many ways of energy that the workers are exposed:

noise vibration Pressure

Ionizing and non-
ionizing radiation
temperature humidity
The risks must be identified, evaluated and, if possible, eliminated in the inspection moment
before emission of EWP (PET).

2.1.3. Biological Risks
Biological agents, among other:

virus bacteria Fungi

The evaluation of these agents, according to NR-15, is qualitative. In the inspection for EWP
emission, these agents must be identified evaluated and eliminated.

The sewage systems produce toxic and flammable gases. For the work execution in these places
are necessary special cares, as atmosphere monitoring and respiratory protection. The mult gas
does not detect virus, fungi, bacteria, so it is fundamental to care the hygiene and small injuries.

2.1.4. Ergonomic Risks
The ergonomic problems, normally, are associated to reduced dimensions of the access in
confined space, requiring body contortions, the use of hands and making difficult the rescue in
case of accident. They are also produced by:
Intense physical efforts;


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Lifting and manual transport of weight;
Inadequate posture;
Rigid control of productivity;
Imposition of excessive rhythms.

Lesion risk with inadequate
position for work execution.
.
Safe work with correct use
of PPE for better work.
2.1.5. Mechanical Risks
These risks are related to physical conditions of the environment:
Contact with gears.
Open flames in hot work.
Electricity.
Slippery floor
Difference of level, promoting fall
Mechanical, hydraulic and pneumatic systems..


Risk of fall without the use of
adequate PPE.
Safe work with adequate
PPE.
2.2. Control: Prevention, Administrative and Personal Measures
The risk analysis consists in the application of inductive and deductive techniques of logic
association to equipment analysis, facilities, process, layout and operational procedures. The


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objective is the hypothesis formulation about possible consequences of events, proposing
measures to control, avoiding aggressions to man, environment and property.
The steps to risk evaluation are:
Identify hazards;
Esteem the risk of each hazard
Probability and damage gravity and decide if the risk is tolerable.
Exemplifying: the gas is a hazard, however the risk will depend the way of the flammable product
can affect people. The probability to cause damage to people being stored in hermetically sealed
recipient is small. But if the same product is stored in an open recipient to the atmosphere, the
probability of vapors go out of the recipient and get an ignition source and increase the risk.

Risk = Hazards/Safeguards
The risk analysis, in a big meaning, has the objective to answer these questions about facility:
What can be wrong?
How often can it happen?
What are the effects and consequences?
Do we need to reduce the risks? How can it be done?
Simplifying the analysis, the facilities studied are divided in analysis module, that they can be:

Complete process units or storing or parts of the process unit as vessels, towers, tanks, etc.

Complete process unit or
Storing
Parts of the process unit as vessels, towers, tanks, etc.
The division of the facilities is done with base in criteria of functionality, complexity and physical
proximity.













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APP Model

Hazards Preliminary Analysis (APP/APR)

System

Reference Date Review


hazard Damage Frequency Severity Risk Recommendations


















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3. EQUIPMENT
3.1. Detection and Gases Control
Confined spaces can present many risks: difficulty of access, problems of visibility, mobility etc.
But nothing is equal to atmospheric risks that are responsible to most accidents, principally when
they are not identified and managed.

The environment can get extremely dangerous because it can have being local of processing or
storing of chemical products or only can become fatal for long time closed without gaseous
change with free atmosphere. The correct is that the possibility to find inadequate gaseous
mixture to human permanence is big in confined space.

The accidents can involve people and/or patrimony of other people that they have nothing with
confined space. Cities underground that there are cables of electricity, telephones, nets, gas, etc.
the analysis of atmospheric risks (asphyxiates, toxics and flammable gases) these places,
provides adequate prevention.

The item 33.3 (Safety and Health Management at Works in Confined Space), of NR 33,
determines that the atmosphere must be monitored continuously at areas that the authorized
workers ser developing their tasks. It is mandatory:

Check if Access and permanence conditions are safe;
Test the equipment before each use;
Guarantee that the equipment is intrinsically safe with alarm, calibrated and protected against
electromagnetic signals or interference of radio and
At classified areas, the equipment are certified or have document from INMETRO.

3.1.1. Equipment Operation
Offering more safety to worker that work in confined spaces, there are some equipment that are
essentials for worker safety. The NBR 14787 item 6 cites some of them:
Illumination equipment;
Pre-hospital attendance equipment;
Individual protection equipment;
Communication equipment;
Ventilation equipment;
Initial verification and atmosphere monitoring equipment.



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The last equipment we need to emphasize. This equipment is known as gas testing or mult gas. It
must be calibrated and tested before use and adequate to work in areas potentially explosives.
The NBR 14787 determines that the gas testing only can be used if is approval by a Product
Certification Organism PCO of the INMETRO with Ex i. The confined space, that had or can
have flammable product, must be considered as Zone 0 in the moment of opening and the gas
testing must have an appropriate protection (minimal BR Ex ia IIC T4).

This detector will inform if the classification will be kept or reduced to other of minor risk, through
the value of Lower Explosivity Limit indicated on the display.
The norm foresees also that this kind of equipment has protection against
electromagnetic interference. The normal operation will not be damaged
by electromagnetic fields, came by sub-stations, radios, telephones, etc.

Marcation must be fixed on the equipment:
BR Ex i a d II C T4 20C a +55C
BR Equipment Certified in Brazil.
Exi
It can operate in explosive atmosphere, same in zone zero 0.
a
It refers to failures degree a. Indicate that the equipment, same being
exposed to two failures simultaneously, it is not able to inflame a mixture.
d Additional safety. It has involucre against explosion.
II C
It indicates that the equipment can operate in atmosphere with acetylene
or hydrogen.
T4
Its temperature of surface, same in adverse conditions, it does not cross
135C.
- 20C a +55C It indicates that its circuits support temperature variation between.

There is not PPE against explosion. So, any indication of the equipment must be considered
true. Start the process of risks elimination by ventilation. After check that the risk was eliminated
the entry can be done and, during the work the atmospheric conditions must be monitored
continuously.
Administrative rule number 83/2006 of INMETRO defines that:
Art. 2 it is mandatory the identification of the certification at Brazilian Conformity
Evaluation System SBAC, started since January of 1995, for all electrical, associated,
accessories equipment and components to be used in atmospheres potentially explosive, at
conditions of flammable gases and vapors, commercialized and used in Brazil, with exceptions
foreseen in regulation of Conformity Evaluation of Electrical Equipment for Atmospheres
Potentially Explosives, in conditions of flammable gases and vapors.
Art. 3 The certification will be credited by Conformity Evaluation Organism OAC credited
by INMETRO.


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Other situation that we must emphasize is the presences of atmosphere with oxygen level
different of the necessary for human survive. So, the oxygen concentration, as the presence of
toxic gases, must be monitored continuously.

We recommend the elimination of this kind of risk by ventilation system. In case of emergency, the
use of specials PPE, which maintain the respiratory system of who enters in confined mixture
gaseous, can be adopted and the job can be done without gas testing, for do not damage the
equipment in confined environment.

Before use the equipment you must read the manual given by manufacturer, and special attention
must be given for equipment limitations.

Normally, the sensors to detect flammable gases are of the type catalytic, that they have a
chamber which allows the flammable mixture entry through a synthesizer which processes the
burn and destabilizes the electric current at electrodes, which is compared with measure
registered at calibration, and the result is in L.E.L.

Portable Mult Gs
The NR-33 establishes that the gases detector must be approved as EXI (intrinsically safe) by a
organism certified and registered by INMETRO.


There are many models selling, but in general, for application of
monitoring atmospheres in confined space, the technological base
is the same. The circuit, same in abnormal conditions of operation,
it does not release electric or thermal energy enough to cause
ignition of a explosive atmosphere, same in a confined space with
flammable product.
This equipment must read the perceptual of oxygen (O
2
), gases and flammable vapors (LEL/UEL),
toxic contaminants, principally carbon monoxide (CO) and sulfide gas (H
2
S).
Alarms Limits
The limit of gas testing alarms, according to NR 15 establishes verification of the limit ACGIH and
compare restricts values.

Combustible gases 10% of L.E.L
Oxygen 19,5% Vol. and 23% Vol.
Carbon Monoxide TL = 39 ppm
Sulfide Gas TL = 8 pp



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Detection and gases control for prevent adequately of the different kind of gases you must
analyze the atmospheric risks:
Asphyxiate Gases.
Toxic Gases.
Flammable Gases.

Electronic gas detector
Available in a great variety and they test from one to four kinds of conditions;
Perfect calibration;
They must have constant maintenance;
They must be checked before each use;
They must be checked to detect leaks (those that have pumps);
Batteries with full power.
Why is necessary the test?
Guarantee safe environment;
Identify leaks;
Identify if the personal protection equipment is necessary.

When do you do the test?
Before and after exhaustion/insuflation/purge,
Immediately before entry;
In representative breaks;
During the entry and work performance if the conditions change.

Where do the test?
Do an initial test out of the space with a search and
Try to pass by the horizontal and/or vertically space

Test procedures:
Start the test after 15 min of break fans or exhausts;
Test from top to bottom around the work ducts and above surfaces;
Give time to sensors range.


Never trust in your senses to determine if the air in the confined space is safe!
You can not see or feel many toxic gases, vapors and oxygen level.


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3.2. Ventilation and Exhaustion
The ventilation and the exhaustion are control measures for harmful work environment for human.
The objective is to avoid the contaminants dispersion in confined space, as to dilute vapors and
gases concentration, beyond provide technical comfort to human.
The fans and insufflators are equipment used to move air. The capacity of ventilation, insuflation,
maintenance and its efficiency are criteria that must be evaluated before to buy these equipment.
There are two general ventilation systems:
Exhaustion Ventilation: remove the contaminated air from inside the confined space.
Insufflated Ventilation: blow fresh air to inside.



Same after the confined space is considered safe for entry, the ventilation must be continuously
while there is some one inside, avoiding noxious atmospheric concentrations. If the environment
becomes unsafe during the job or the alarm of the mult gas is activated, stop the service release
the place. Keep the ventilation and inform to supervision and only come back after new
atmosphere verification.
When do you nee to ventilate? Always that the atmosphere inside becomes dangerous (with few
oxygen, oxygen excess, toxic, flammable). If there is any of this condition, start the ventilation very
early, the atmosphere must be safe.
When the atmosphere is flammable or toxic, the best is to put the contaminant out, because to
blow air inside can spread the contaminants.

EXHAUSTION VENTILATION INSUFFLATED VENTILATION


Before release the entry, test the atmosphere using appropriate mult gas to be sure that the
ventilation was enough to become the environment safe.
There are many different ventilation devices. So, it must be observed some important data:

The ventilation must guarantee constant circulation of fresh air for whole area in the confined
space. These are two main problems to be observed:


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Recirculation of contaminated air to confined space.



The short circulation of the air flux. This occurs when the fresh air moves
directly from entry to exit, without to pass for other area of the confined
space.


This problem can be avoided of three ways:
1. The equipment must have enough potency to ventilate whole area.
2. It must be able to capture and eliminate all contaminants. Many fans can be necessary to
dislocate the air in long distances or to ventilate a big area.
3. Orient correctly the fresh air and the exhaustion exits. If possible, the air of admission and
the air or exit must pass by different openings.




Do an efficient net of ducts:
Ducts allow the distribution of the air flux to whole area of the confined space.
Position the ducts in a place that during your job you do not damage them.
Keep the ducts shorts and directs until destiny.
Do not bend or make curves so closed with the ducts.
Check if all connections are tight.


Check if no ventilator or duct restricts physically the escape routes.

If the ventilation is necessary to give fresh air in confined space, the insuflation is usually the best
option.



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In case of ventilation or exhaustion with pneumatic horn, you must do the grounding avoiding
static electricity.
3.3. Respiratory Protection
At many work activities, there are many and miniscule contaminants that get in suspension.

The air that we breathe is composed about 21% of oxygen, 78% of nitrogen and 1% of other
gases. This gases combination maintains the life. You health depends of the pure air that you
breathe, but when other substances are presents, you are subject to irritations, indispositions,
health problems and death.

The risks in confined space, many times, they are not realized only by senses. So its important to
do the preliminary hazard analysis to identify the adequate respiratory protection, well as
information and training, about correct use of the equipment.

You develop an important responsibility. After select the appropriate device you must use it during
whole time that you are performing the task, until leave the confined space. For you own safety,
verify if you device is adjusted on you face and if it is necessary some repair.

You must communicate to you supervision if there is some problem with the equipment or if you
have some infirmity as asthma, allergy or elevated blood pressure, which impede you use the
equipment.

You and your company can work together to protect the workers health in hazard situation.

If there is an IDLH atmosphere you only can enter in confined space if you are using SCBA or
air supply line with escape bottle.

For work execution in atmospheres with levels non-acceptable, it uses the air supply line that is
operated with a system called arcofil, or cascade system composed by oxygen cylinders. This is
the system composed by trestle, water drain, coal filter and air humidifier. Some equipment have
CO detection.


Equipment composed by two cylinders of breathable air with 2000
liters of air in each one, so 4000 liters of breathable air. There are
two air exits allowing that two people work simultaneously.


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Autonomous Set of Air Line Respiration (CARLA) Equipment
projected for escape that must be used always that necessary,
sent independent of what system is being used (arcofil or PAR
4000), because if there is failure in the air system, the person
can use the CARLA to leave the local.
.
The CARLA is composed of a cylinder with breathable air, normally of 1,5 liters or 2 liters in air
volume, specific to execute self-rescue, in other words, leave the local by own ways.

SCBA equipment composed by a air cylinder, support with belts and is transported on the back
as a backpack. It is used in emergency situations, search and rescue and fire fighting, that the
atmosphere does not have accepted level.


Calculation of the SCBA


P.T
Work pressure
Cylinder of Composite: 300 bar
Cylinder of carbon steel: 200 bar
Weight 3,8 Kg
Middle weight 12 Kg
V.L.
Volume in liters
Composite carbon fiber: 6,8 liters
Carbon steel: 7 liters
Weight 3,8 Kg
Middle weight 12 Kg




26
Calculation of quantity of breathable air:

P.T. x V.L. = quantity of breathable air.
Composite carbon fiber: 300 x 6.8 = 2.040 liters of breathable air

Carbon steel: 200 x 7 = 1400 liters of breathable air


Calculation of autonomy:
Quantity of breathable air % M.C.H. = Autonomy.
M.C.H.: middle of human consumption
Consumption per minute between 28 to 40 liters/min (Font: Air Safety)
Maximum that human consumes: 132 liters/min
Composite carbon fiber 2040 40 = 51 min (total time)
Carbon steel1400 40 = 35 min (total time)

Cylinder reserve:

50 bar The alarm will indicate that the equipment is in reserve
50 x 6.8 = 340 40 = 8.5 min
50 x 7 = 350 40 = 8.75 min

The equipment always must be used when the user is at IDLH area.


The user must monitor every time his consumption;
Leave the local always that you listen the alarm sound or determine the value o
his safe exit.
3.4. Communication

During the work, the watchman/attendant must get the
permanently communication with entry team, by radio
intrinsically secure to work in classified areas, independent of
other resource foreseen to be used during an emergency.

Before start the work, the watchman/attendant must check the equipment with the supervision,
rescue team, radio operator and nurse. It must be informed the service to be done, the quantity of
people involved, certifying that whole staff team is aware of the work in confined space.


27
4. PROCEDURES AND UTILIZATION OF THE ENTRY WORK
PERMIT (PET)
Before emission of the Entry Work Permit - PET form (attachment B as example), the Entry
Supervisor, with the Supervisor of authorized workers and the Safety Technician, fill out the
procedure (attachment II of NR-33), that will serve the parameter for filling out the specific PET of
each company.

It is important that the executers are employees and/or contracted, know the company policy for
entry and rescue. These procedures have the objective to inform about risks in the area where
they will develop their activities.

The measuring equipment of atmosphere must be tested before each use. These equipment must
be of direct reading, intrinsically safe, with alarm, calibrated and protected against
electromagnetism or interference of radiofrequency.

For hot works is very important to use control measures or eliminate the fire or explosion risks.

It is forbidden to leave oxy-acetylene or pressurized hoses with gases in the confined space same
with nobody working in.

The PET serves for only one entry (according to item 33.3.3.1 of NR-33). It is attribution of the
Supervisor fills out the PET in three copies before to start the job. One copy with attendant, He
can control authorized people. After every body out of the confined space the PET must be
finished and stored per Five years according to NR-33, item 33.3.3, letter i and j.

Observations:
The entry can not be allowed if there is an answer NO.

The lack of continuous monitoring of the atmosphere, alarm, order of the attendant or any
risk situation to workers safety, produces the immediate abandonment of the area.

Any exit of all team by any motive, promotes a new entry permit. This entry permit must
stay exposure at workplace until the end. After the work, this permit must be filed it.


28




29
5. RESCUE NOTIONS
Rescue in confined space involves specific techniques with the objective of to remove the casualty
alive from those environments. The rescue only can be done by trained people.

The rescuers must be trained in First Aid, (vital signs evaluation, breathing cardiorespiratory),
immobilization, casualties transportation and competent to use the appropriate equipment, that
must be available constantly at workplace.

During the works or people rescue is necessary, beyond training,
utilization of certified equipment and of good quality that are
available, making easy the teams operation that must work fast and
efficient.



5.1. Main Equipment
We will talk about the main equipment used to self-rescue and used rescue team.

PPE (Personal Protective Equipment) it is all device or way of personal use destined to preserve
and to protect the physical integrity of the employee during his job.

The NR-6 establishes that the PPE must be given by the company, when the work conditions
require them, it is mandatory.

OBRIGATIONS
Employer Employee
Give, free, to employees PPE
necessaries in good conditions of use and
operation and
Instruct the employees and train them for
this utilization.
Use the PPE indicated only to its
objective;
Make responsible the store and
conservation of your PPE;
Communicate occasional alteration
in the PPE, that becoming partial or
totally damaged and
Make responsible by damage or
inadequate use of PPE.




30
Harness parachuter model used at rescue

They are equipment manufactured with polyamide or polyester fiber, in many kinds and models,
each one showing exclusive characteristics to attend different kinds of activities.

This PPE must combine comfort, freedom of movement and easy use, without damage the safety.
The harnesses used at rescue are projected to support falls and great impacts, and are designed
for people stay suspended by harness for long time. In spite this, they are not recommended
operations more than one hour. This way, the harnesses are constituted with large straps,
padded, with many points of Anchorage, being in minimal one in front, one on the back and two
points at laterals. The anchorage points are done by rings D with or without safety loop that they
must support a minimal load of 22KN.

All parachuter harnesses are projected to support a person with safety in case of free fall,
distributing the impact forces through the legs, pelvis, thorax and shoulder. It is important that you
use the model indicated to specific category, respecting its weight capacity limits and size
according manufacturer specification. In case of rescue we suggest to use a harness with at least
5 points of sustenance.

Inspection: before use, do an inspection at all seams, straps, buckles, sustenance rings, cables
and general supports. If there is some damage, do not use it. Some manufacturers suggest
inspections of three months same that the equipment is not in use.

Wash: wash with current water and neutral soap, dry at shadow; if there is grease some
manufacturers suggest the removal with trichloroethylene.

Storing: store the harness at dry and ventilated local; do not expose to heat or chemical agents,
corrosive materials and solvents.

Durability: about 5 years at normal conditions.





31
The ideal is that there is one harness to each user, that it makes possible bigger control and better
historic of the same. Some manufacturers make available harness with label for inspection and
register, beyond to have fast information about characteristics of the equipment.


During the use avoid contact with hot or sharp material

Class I
Harnesses with adjust around the waist, around the thigh or under
the buttocks. They are designed for emergency escape and it has
load for only one person.
Class II
Harness with adjusts around the waist, thigh or under the
buttocks. They can attend rescue loads.
Class III
Harness with adjust around the waist, thigh or under the buttocks
and on the shoulders. They can attend the rescue loads and
inversion (upside-down), if it occurs. It can be shown in only one
part or more than one part.
Obs.: For rescue only use harness class II or III, according to recommendations of NFPA 1983.
Ropes/cables
Ropes are basic elements of technical rescue and this kind of rescue is
known by ropes rescue. They are shown of many kinds and material
forms, they can be made by steel or rope. The ropes are made by
natural fibers or synthetics. If they are kept in good conditions of use
and storing, the durability can be until 5 years. If the use frequency is
great, the durability can be between from 2 to 3 years. Remember that
independent of the use time, the ropes must be inspected.

Ropes construction
There are many ways of ropes construction. But the single kind of rope
recommendable for use of rescue is the constructed known by cover
and soul. This construction consists of a soul of continuous fiber which
absorbs about 80% of the load. This soul is covered by a braided
cover that protects of the abrasion and other aggressive agents. The
cover represents about 20% of resistance.




32
Main cares
Never use superior weight to rope capacity.
Avoid:
Ropes contact with chemical products.
Store ropes with tied knot.
Rub with sharp locals.
Abseiling or fast descends. The rub damages the ropes and it can happen rupture
Use protector for rope avoiding damages.
Do periodic inspection and always before utilization.
Replace the rope when:
Present erosion at cover,
Superficial damage,
The soul presents damage or it is out of the validity
Slings
The slings rings of safety are made by polyamide or polyester, with different diameters, having
minimal traction resistance of 2.200 Kgf/cm
2
. This equipment is used for height work and climb.




Cares to be observed before utilization:
Do rigorous inspection at the sling, principally on seam, to verify:
If there are released cables;
Damaged slings;
Displaced slings;
Contamination with oil, grease, acid, sand and other chemical products.
Wash: the manufacturer recommends washing in current water, neutral soap and drying at
shadow.
Storing: store slings at fresh and ventilated local do not expose it to heat.
Guaranty from 3 to 5 years if in good conservation state.
You must use slings certified with legible identification of rupture capacity.






33
Winch
They are devices used at rescue. They offer performance and
technology, always keeping safety and easy handling.


Normally, the winches have a support for fast mounting and it has free
turn system to make easy the operator maneuver. Some of them
present clutch system, carcass of polyethylene, resistance to
corrosion and can have safety hooks and steel cables.

Cares to be observed before utilization:
Verify capacity for people rescue according manufacturer definition, normally about 160 Kg.


Grigri
Device made by aluminum use with frequency at abseiling and
alpinism. The block and descend control are done by own user. This
equipment usually use ropes between 10 and 13 mm of diameter. This
equipment can replace the equipment known as picture eight at
abseiling activities.


Cares to be observed before utilization:
Placing: follow the draw, recorded on the equipment. After put the rope, block the metallic
lever with safety carabiner, guaranteeing the closing.
Operation verification: before each use, you must do the test to assure that the cable
placing is correct and prove a good operation of the equipment.
Do not forget to verify the condition that it was fixed at minimal of two points of support
and if it has enough length to get the objective.
Avoid contact of the mechanism with sand.
When you do descend, one hand activates the lever to release the cable and other hand
hold firmly the cable under the thigh, controlling the descend velocity through the lever.


Ascender with handle

It is known by jumar, due to Spanish manufacturer. They are systems
of brakes with a grip for toehold. The ascenders are normally used for
lifting people in ropes, and can be put or removed of the cable easily,
whose block action is done through eccentric with teeth.

These equipment are made by aluminum with cable block system.



34
They are used by the rescue teams as resource for vertical or horizontal displacements. There is
this equipment for right and left hand.

Cares to be observed before utilization:

Inspect the equipment verifying if there is not fissure or other damage in the block system.

Pulleys and Sheaves
It is a disc that can turn around an axis that passes by its center. Beyond this, at its periphery
there is a groove, called collar, inside that woks a movement transmission strap.

Pulleys or sheaves can be simple, doubles or triples.

They are systems that have the objective to decrease the quantity
of force applied, hoisting or descend of people or cargos, through a
pulleys combination, cables and knots.

The systems mounted with cables are tools very versatile. They are
relatively light, strong and can be used at many applications.

Sheaves must be certified and consist its load capacity, normally
this equipment can be made by aluminum or special steel.





Cares to be observed before utilization:

Before use, check if there is fissure or other damages that can damage the sheaves
system.
Avoid the contact with sand because it can damage the sheave system.
Carabiners
There are many kinds of carabiners, made by steel or aluminum.
These equipment can be done with simple or block closing.
Carabiners used at entry services or rescue in confined space must
have closing and automatic double block and possible to be open
by two deliberate actions consecutives. Nowadays there is this
equipment with triple closing.

These carabiners must have minimal traction resistance of 2.200
Kgf/cm2. In activities more aggressive, is advisable to use
carabiners in carbon steel because they are more resistant.


35
Every carabiner must have recorded the work capacity. When open or unblocked, the work
capacity is reduced about 1/3 of nominal load.


Closed - resistance of 22 kn in a longitudinal line at least

Opened - resistance of 1/3 of equipment = 7 kn

Closed and tensioned in vertical line - resistance is quite reduced, besides
being dangerous; its capacity is reduced to 1/3 of its loading value from 7 to
8 kn.

Cares to be observed before utilization:

Avoid contact with sand at the blocking system.
Do not use if you verify some deformation (deep dent, fissures, etc) or if the blocking
system is not working.


Tripod/Monopod

Made in aluminum the equipment is projected to sustain ascension
and descend of a load compatible with its capacity, according to
manufacturer definitions.

Tripods are light and portables without to sacrifice the resistance
and durability. The mounting must be simple, fast and possible by
only one person.

They are composed of adjustable telescopic leg with blocks, safety chains, feet with gripper
rubber, set of sheaves, support for fixation of the winch and/or fall arrester.

They are made in resistant material against corrosion, with many models available for different
work conditions.


36


Fall Arrest

This equipment offer additional safety to user of harness, during the
job that there is probability of fall. It always must be used to height
superior to thorax, never below, because it objective is to reduce the
impact forces in case of free fall caused by the rupture of the main
cable.


These equipment are made in resistant material to corrosion and
present facilities of user movements.

There are several models of fall arrest, from simple to retractable with
winch, that is composed by a protection device against falls and
rescue.

The retractable model has emergency stop device and is tensioned by springs for normal work
movements. However, if you fall or slip, the impulse of the fall activates the brake mechanisms
blocking the fall.

Cares to be observed before utilization:

Before use it, you must do a detailed inspection of all set, inclusive at sustenance cable
and correct position of locking.
Avoid strong collision, contact with chemical products and/or with sand.

HEIGHT:
1,80 m - RESISTANCE = 47 KN
3,50 m - RESISTANCE = 25 KN


WEIGHT APROXIMATELY = 32KG
Headset
Anchoring points
Tubing legs
Height Regulation
System
Feet


37
Radios
During rescue operation, the team coordinator and coordinators of
the operational unit use radios for communication.


Kind of Knots
The technique of to do and use a knot are resources widely used to
help rescue and fix equipment or tools.

Advantages of the knots:
Very low tendency to release, same with tension or flexion, when it is done correctly;
The inspection is easy and is possible to observe is they are executed correctly;
It is easy to learn and remember how to do them.

The knots can be: rope tip, rope middle, union between ropes, loops.
Some kinds of knots can be used in rescue:

Figure of eight (simple or double): it avoids fraying of the tip rope.



Clove hitch knot: it allows to tie the rope at a fixed point.




38
6. BASIC ATTENDENCE TO VICTIM
First aid is the initial cares given to victim by trained person, until that the specialized support
arrives.
The main objective of the rescuer is to keep the life and avoid that lesions make worse.


Never try to do procedures that you were not trained.
Keep calm.
Avoid panic
The rescuer does not replace the doctor, so he can not release the victim
or prescribe treatments.
6.1. Scenario Evaluation
6.1.1. Procedures Before Approach
Breathe to keep calm. Plan actions to be executed before victims approach.
Observe the local to identify possible risks. The local must offer total safety
Call for help specialized support (rescue team, health professional on board, control room), other
rescuers.
Isolate the area to make easy the rescuers actuation and expose unnecessary other people that
do not involved in aid.
Provide individual protection to avoid contamination of the rescuer (glove, glasses etc).


If the scenario is not safe, do not approach and isolate the
area until rescue team arrives. The attendant must care for
signalization and isolation of the area to prevent new
accidents.

If the local offers risks that can not be neutralized, you must remove the victim for a safe place.

All precautions must be done during the exam and manipulation of the victim. It avoids body
lesions to rescuer, contamination by biological agents (microorganisms) or toxic substances
present on body surface, blood and fluids.
.




39

It is mandatory to protect the hands during the victims
manipulation with the use of impermeable gloves (when there is
blood or fluids), due to contamination risks, by hepatitis virus or
HIV, among other.

When there is suspicious of toxic gas in the air, do not approach without specific equipment
(SCBA).

If in the local there are one or more victims it must have a leader between rescuers, which must
be the individual with bigger training and knowledge level about procedures.

Protect yourself against risks, crumbling, fire, explosion, contamination with toxic products (gas,
toxic liquid product), electrical shock etc.

In victims with trauma by fall, the information about height of the fall is very important.

The workers team that is in the confined space must inform quickly to attendant/watcher the
occurrence of sudden ill or accidents. Immediately the attendant/watcher calls to rescue team,
which will provide the workers removal, through techniques and appropriated equipment. The
workers are transported to safe area that will receive specialized attendance.

While the victim waits the rescue team arrives, the rescuer that is in the local helps the basic first
aid procedures, taking necessary cares to avoid that the lesion makes worse. The environment
must be safe and does not offer death risk.

The mult gas must be used to verify if the environment in unsafe or IDLH. In positive case, the
workers team must leave the local immediately using techniques of self-rescue, while the rescue
team prepare themselves to enter and get the victims rescue.



40
6.2. Victims Evaluation
6.2.1. Primary Evaluation (ABCD)

Open Airways
Keep the victims head aligned anatomically and open the oral
cavity holding it by the mandible.
Observe the presence of strange bodies, vomit, blood or
dental bridge, that must be removed manually, using fingers,
doing movements kind lever.

Good Breathing
Check if the victim is breathing normally (SEE-LISTEN-FEEL).
If there is a lack of breathing, do two ventilations. The firsts
ventilations are called by rescue ventilations

Compression
Do 30 thoracic compressions with the hands positioned on the
thorax center, on the sternum bone. For localize the right
hands point, imagine a line between the nipples. The hands
must be on the middle of the line. So start 30 maneuvers.

Defibrillator
If it is not available at the event local, provide it quickly.
6.3. Bleeding
Bleeding is the loss of blood from inside the blood vessel (artery, vein, capillary).
Considered the type of damage vessel the bleeding can be:

Venous: loss of blood from a vein. It occurs a bleeding, usually dark-red (rich in CO
2
) and
continuous, that it flows by the injury boards.




41
Arterial: loss of blood from an artery. Bleeding with bright-red (rich in O
2
) and in jet (the pressure
is bigger arteries). When it happens in great arteries is difficult to control.

About localization the bleeding is classified in:

External: visible because it extravasates to out of the body. Usually it can be controlled using
basic first aid techniques, (when it happens in general injuries, bleeding of open fracture).

Internal: the blood extravasates to inside the own body. Usually it is not visible, or if it is a
stomach bleeding the victim will throw-up blood. The contusion traumas are the main causes of
internal bleeding (traffic accidents, falls, kicks and explosions). Basic measures before hospital
usually do not work.



Every bleeding must be controlled immediately, because a big bleeding
can take to death. The ABC of life must be applied until specialized
support arrives.

Control Measures of External Bleeding:
Handle the victim using gloves or plastic bag to protect your hands;
Elevate if possible, the local with bleeding above the heart level. Do not elevate the limbs that
have fracture or luxation;
Put compress on the injury, pressing firmly during few minutes. Use a clean and dry compress
(gauze, cloth). If the compress is full of blood, put other one without to remove the first. If you do
not have a compress, press the blood vessel (artery or vein) damaged with the hands firmly;
Fix the compress on the injury with bands (cloth straps, tie, belt);
Keep the victim covered;
Do not clean or wash the injury, because the blood clot formed can release it, promoting a new
loss of blood;
If you suspect of internal lesion, only humidify the victims lips with water, because the victim can
not drink something;
At injuries of low gravity, you can wash with neutral soap and water. Apply an antiseptic solution
and cover it with new gauze.





42
Conduct in other Bleeding
Nose Bleeding:
keep the victim sat with the head smoothly lifted up backward,
pinch the nose for 5 minutes,
ask the victim to breathe through the mouth,
take the victim to a health professional, even if the bleeding stops,
in case the bleeding does not stop after 5 minutes, put a piece of gauze moisten with cold water
inside the nose, until advanced life support be given (do not forget to leave a piece of gauze
outside the nose to take it out easily).
Lungs Bleeding:
the blood is bright red and it is expelled during a whooping cough,
lie down the victim on the back (dorsal decubitus) with the head turned to one for the sides, on
the same level of the body
do not give any medicine, liquids or food to the victim, keep the victim on an empty stomach,
get medical support, as it is an emergency.
Digestive System Bleeding: esophagus, stomach, intestine
The victim has nausea and the blood is expelled with vomit. Bleeding can be vivid red or like sludge
coffee. Sometimes the victim does not throw up and the blood is expelled through the feces which are
pasty in black color like tar.
Do not give any kind of food or liquid;
Check the breathing;
Take the victim to an advanced life support as soon as possible with the head turned to the
side.
Tourniquet
It is a procedure used to contain severe bleedings. It is only indicated when all other techniques to
contain the bleeding are inefficient.
Tourniquet must be made with a strong bandage with 3 cm width, wrapping the limb,
Measure four fingers before the injuries,
Tight it up with a rigid stick, screwing it until the bleeding stops,
Keep it tight up for 5 minutes at most, relieve it for some seconds and tight it up for more 5
minutes. Keep on doing this until advanced life support is provided.

ATTENTION
Take off the tourniquet gradual and slowly, never use wire, rope, twine or other
too sharp (thin) material to avoid that the skin is injured.


43
6.4. Fractures
A bone fracture is a total or partial break in a bone; it can be closed or open. (compound).


Closed fracture
It does not cut the skin.

Open fracture (compound|)
Bone protrudes through the skin. Most of the time, it is
caused by bone fragments, making the contact with bacteria
and the risk of infections easier.

Generally, fractures are not risky, as they can be treated after more severe problems.
How to find out:
compare the limb you are suspicious with the other correspondent one;
look for:
some deformity (sharp-cornered, shortening, etc);
muscular spasms
injuries
response to pain after delicate movement (ask the victim to move, ask not to twist or fold.
edema
compromising of the sensibility

Some extremity fractures can offer immediate risk, because the associated complications, for
example:
compressing with contamination (dust, grease etc);
open fracture in the elbows and knees can result in severe vascular trauma;
limbs amputation
Conduct
Closed fracture
align the limb if it is possible (tractioning)
if it is difficult, immobilize it the way you found it.
use a stretcher to move the victim (move immobilize it with a splint or some rigid material (the
immobilization has to hold one joint above and other one below the fracture)
the injured part as less as possible).


Open fracture Closed fracture


44
Open fracture
align the limb if it is possible (tractioning)
stop the bleeding
immobilize it with a splint or some rigid material
use a stretcher to move the victim
Cranial fracture
Cranial traumatism along with a bleeding in the brain can lead to death if it is not treated properly.
Cranial traumatism or cranial-cerebral traumatism (TCC) Signs and symptoms
pain
bruises in the cranial skull
vomit
bleeding through nose, mouth or ears.
irregular breathing rhythm or cardiac arrest
unconsciousness
Conduct:
keep on checking the vital signs
take the victim immediately to advanced life support with the head slightly higher than the rest
of the body.
Spine fracture
Severe traumatisms can lead to spinal fractures, possibly with a lesion in the spinal chord and with
an irreversible neural damage (be always suspicious in case of accidents because of deceleration
or a violent impact).
Conduct:
do not turn or bend the victim if you are suspicious about a lesion in the spine
immobilize the neck with a cervical collar, it is not available try to improvise
move the victim on a rigid and flat surface, stuck the victim in a way to keep steady; avoid any
situation which can move the victim or the spine (sudden braking, swinging, etc.)
check the vital signs.
Ribs fracture

Ribs fractures can produce internal lesions lungs, causing
pneumothorax (air inside the pleural cavity) or bleedings, jeopardizing
the breathing mechanism.
Signs and symptoms
difficult breathing
pain after each breathing movement.


45
Conduct:
make the victim breathe and immobilize the thorax with compresses, without tighten up to not
stop the breathing movement.
take the victim to an advanced life support.
Immobilization
Basic Principles:
Keep the victim lying down in dorsal decubitus
Find the lesion cutting the clothes
Remove rings and bracelets as they can jeopardize the circulation;
Put the extremities of the victim in an anatomic position and aligned preferentially. If it is
difficult, immobilize the limb the way you found it.
Do not reduce fractures (put the bone back in place), it belongs to experts.
Immobilization has to hold one joint above and other one below the fracture. So, the length of
the splint has to be longer than these two joints.
Tight the splints up with bandages.
Lift up the extremities after the procedure, if it is possible..

If there are no splints available for immobilization, the first aider should improvise some materials
as cartons, pieces of wood, pillows, etc.
6.5. Casualties Transportation
Techniques used to move victims to a safe place. In order to choose the best kind of
transportation in case of risks present in the work area (fire, collapse, etc); some issues will
influence this choice, such as: the number of people available for transportation, the severity of
the injuries and the place where the victim is
Transporting victims of traumatisms or diseases is a specialized service which must be known
and trained by rescuers.

Transporting victims is a decisive issue on providing the basic first aids. Bad transportation is not
only risky for victims but also for rescuers. They can get a muscular or spine lesion. Before
starting any transportation and moving activity, the rescuers are obliged to:
check if the victim is breathing with the heart beating;
check if there is some bleeding which must be controlled;
immobilize fractures, if there is time
Arm forearm leg ankle


46
6.5.1. Victim Transportation with Suspicious of Lesion in Vertebral Spine
Done on rigid surface
Dorsal decubitus is the ideal position, because it allows the spine stabilization and beginning of life
support measures. The victim must keep stabilized manually until to be fixed the immobilizing. The
cervical collar, singly, is not a good immobilizing, because it does not impede totally the cervical
movements.

Transportation on long stretcher
The long stretcher is a resource for vertical and horizontal rescue. Usually it is made by Wood, but
can be made by injected plastic. It needs of three belts or safety straps for thorax and limb fixation
and one immobilizing lateral for head, avoiding movements during the transportation.


The basic principle consists in one of the rescuers stabilizes the manually the head and cervical
spine, while other two rescuers (if possible three) move the victim in block, in the same rhythm.

The most techniques used are the rolling maneuvers.
90 Rolling
Indication:
It is used with victims in dorsal decubitus.



Technique:
One of the rescuers stabilizes the victims head by the back (leader)
Other rescuer (assistant) dresses the cervical column on the victim.
One of the rescuers puts the stretcher beside the victim, on the opposite side to where
the victim will be rolled.
Two other assistants bend down on their knees, side by side, aligned with the victims
shoulder and knees.


47
Roll all the victims body together after the leaders order until the victim lies on his/her
own side to the side where the assistants are.
The stretcher is slid until it touches the victim.
After the leaders order, the victim is rolled back and put on his/her back on the stretcher
again.
Align the victim on the stretcher using the cavalry (horse rider) position.
Keep on stabilizing the head and neck at all times.
Stick the trunk and the limbs using the belts.
Immobilize the head and neck using the head blocks.
180 Rolling
Indication:
It is used for victims in ventral decubitus

Technique:
The leader stands behind the victims head and starts a manual stabilization
Put the stretcher along side the victims body in a parallel position on the side where the
victim will be rolled.
Two assistants bend down on their knees on the stretcher, aligned according to the
shoulders and waist.
After the leaders order, roll all victims body together toward the stretcher, leaving her in
lateral decubitus)
The assistants get off the stretcher, kneeling on the ground.
The leader gives an order to roll the victim on the stretcher.
Pass the cervical collar on the victim.
Use head blocks to immobilize the head.


48
GLOSSARY
Risk analysis: process or set of techniques, whose objective consists at execution of a safety
analysis of facility, of great form, as also its possible risks, including these aspects:
All flammables, explosives substances or reactive presents at facility, that can represent
risk;
Accidents prevention measures;
Measures for control of accident consequences for workers and for people that live or
work out of facility or environment.

Analysis preliminary of hazard (APP): initial evaluation of potential hazards, its causes,
consequences and control measures.

Safety area: area around of the access to equipment signalized of way that forbid the flame
production or spark and access of people non-authorized to confined equipment.

IDLH atmosphere: atmosphere immediately dangerous for life and health.

Initial evaluations of atmosphere: set of preliminary measures done in confined space
atmosphere.

Hatch: opening localized at superior that generates of the tank, which allows access inside.

Lock out: devices that impede the hazards energy liberation as: pressure, vapor, fluids,
combustibles, water, sewage and other.

Contaminants: they refer to gases, vapors, fog, smokes and dusts present in confined space
atmosphere.

Oxygen deficiency: atmosphere with less than 19,5% of oxygen in volume.

Drowning: it is the capture of a person by liquids or solids that can be aspirate, causing death by
filling or obstruction of the respiratory system. It can do enough force in the body to cause death
by strangling, constriction or compressing.

Flux diagram: graphic representation of the production process flux and/or storing and/or
combustible liquid transference, flammable liquids and flammable gases.

Oxygen enrichment: atmosphere with more than 23% of oxygen in volume.

Entry Permit Paper (EPP or FPE): document with a set of control measures, aiming the entry
and development of safe work, emergency and rescue measures in confined spaces.



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Blanketing: displacement of the atmosphere by blanket gas, resulting in an atmosphere non-
combustible.

Intrinsically safe: situation that the equipment is not able to release electric or thermal energy
enough, for in normal or abnormal conditions, cause the ignition of a explosive atmosphere,
according express in specific situations, as hot works, IDLH atmosphere or other.

Incident: any event non-programmed that can indicate the possibility of accident occurrence.

Special control measures: additional control measures necessary for work permit in confined
spaces in special situations, as hot work, IDLH atmosphere or other.

Methodology of risk analysis: kinds of process or techniques of risk analysis execution of facility
or other part of it.

Order of lock out: order of suspension of normal operation in confined space.

Order of liberation: order of reactivation of normal operation in confined space.

Proficiency: competence, aptitude, capacity and abilities linked with experience.

Purge: method that gases, vapors and impurities are removed from the confined spaces.

Responsible technician: qualified professional to identify confined spaces that exist at the
company and to elaborate engineering measures, administrative, personal and of emergency and
rescue.

System of confined spaces entry permit: written procedures to prepare a safe entry permission
and for return from the confined space after the work.

Entry supervisor: responsible technician to operationalize the entry permit, responsible for
communication, order of abandonment for workers.

Blocks: device which uses a way as key or padlock to guarantee isolation of devices that release
electrical or mechanical energy.

Professional legally qualified: person that has legal competence and qualification required by
law.

Safety system: device for accident prevention at production process, storing, transference and/or
handling of liquid combustible, flammable liquids and flammable gases.



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Authorized worker: person destined by the company to assure the fulfillment of one or mare
specific tasks and that have knowledge and enough experience for tasks.

Able worker: person that received training in the company or that did course at public or private
school, under qualified supervision.

Work permit: it is a document emitted by qualified person and registered by the company and
must identify of objective way the work to be executed. Workers responsible by the execution,
existent risks, control measures and restrictions of equipment use generator of ignition sources.

Cold work: every work that does not require flame, or results in sparks and high temperature.

Hot work: every work that requires the use of flame or able to produce sparks and high
temperature.


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BIBLIOGRAPHY

ASSOCIAO BRASILEIRA DE NORMAS TCNICAS. Postos de Servios Entrada em Espao
Confinado: NBR 14606.

ASSOCIAO BRASILEIRA DE NORMAS TCNICAS. Espao Confinado - Preveno de
Acidentes, Procedimentos e Medidas de Proteo: NBR 14787.

JORDO, Dcio Miranda. Manual de Instalaes Eltricas em Indstrias Qumicas,
Petroqumicas e Petrleo. Rio de Janeiro: Quality Mark, 2004.

Manual de Equipamentos Utilizados em Resgate e Trabalhos em Espaos Confinados Petzl

Manual de Equipamentos Utilizados em Resgate e Trabalhos em Espaos Confinados Task

Manual de Operaes e Deteco de Gs Impact Pro Zell Ambiental

Manual de Emergncia Primeiros Socorros do Corpo de Bombeiros RJ

Manual sobre Ns e Amarras Unio dos Escoteiros do Brasil (Regio de So Paulo)

MINISTRIO DO TRABALHO (Brasil). Normas Regulamentadoras 7, 9, 18 e 33.

NORMA DE TRABALHOS EM ESPAOS CONFINADOS N-2637 - PETROBRAS.

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION - OSHA Trabalhos em Espao
Confinado.

TORLONE, Maurcio. Manual de Proteo Respiratria ABHO


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