Tower Rescue Incident Command Form

INCIDENT INFO

Date / Time of Call

Date: Time:

Incident Location

Address / GPS / access route:

Responding Unit & Officer

Unit: Officer: Rank:

Weather & Environment

Clear Overcast Rain Snow

Temp: °C/°F Wind: km/h or mph Light Moderate Strong

INITIAL REPORT

Dispatch Information

Reported problem (e.g., "worker stranded at ___ ft", "fall with injuries"):

Number of Patients

1 2 3+ Known status: Conscious Unconscious Unknown

Confirm Location on Tower

Height estimated: ft / m Inside tower Outside on platform/boom On ladder At tower base

COMMAND & CONTROL

Command Established

Incident Command (IC) named: Command channel:

Sectors / Groups

Operations Rescue / Tower Group Medical Safety Staging Rehab

Mutual Aid / Specialized Resources

Tower company / site owner notified

Technical rescue team requested HEMS / air support considered Law enforcement Utility reps Other:

SITE ASSESSMENT

Tower Type

Guyed lattice Self-supporting lattice Monopole Roof-mounted Unknown

Tower Height & Features

Total height: ft / m

Platforms at approx.: ft / m

Antenna arrays / dishes at:

Surrounding Area

Open field Urban Industrial Rooftop Confined yard

Overhead obstructions:

Power lines Other towers Cranes

Access & Egress

Primary access route:

Gate locked Key/Code: Fence/wall Limited apparatus access

Alternate access:

HAZARDS

Electrical / RF Hazards

High-voltage lines present

Lockout/Tagout initiated? Yes No

RF / microwave exposure risk:

Low Moderate High Unknown

Structural Hazards

Known structural damage/deformation Loose members / ice / objects overhead Corrosion / missing bolts Unstable platforms or ladders

Environmental Hazards

Heat stress Cold stress Lightning / storms High winds

(approx km/h or mph) Visibility reduced (darkness, fog, smoke)

Ground-Level Hazards

Traffic Unstable ground / mud Hazmat nearby Confined space / trenches Water hazards Public crowd / media

PATIENT PROFILE

Identity & Role

Name (if known):

Tower worker Contractor Public Other:

Position & Security

Location: level/height ft / m

Position:

On ladder On platform Hanging in harness Suspended from lanyard Slumped in position

Secured? Fully Partially Not secured Unknown

Immediate Life Threats

At risk of fall Potential suspension trauma Entrapped by structure/equipment Medical emergency suspected:

TOWER SYSTEMS

Installed Safety Systems

Fixed ladder Safety climb cable Vertical lifeline SRLs Platforms / rest points

Anchor points (rated/known?)

Site Rescue Plan / Gear

Site-specific rescue plan available Yes No

On-site rescue equipment:

Rope Harnesses Ascenders/descenders Pre-rigged system Other:

Lockout/Tagout Status

RF energy reduced/shut down Power isolated

FIRST-IN TACTICS

Hot/Warm/Cold Zones

Hot zone established

(radius m/ft) Warm zone Cold zone

PPE requirements posted/briefed

Initial Strategy

Investigate/Recon only Attempt verbal contact/assist self-rescue Deploy first climber only Hold all climbing until hazards controlled Prepare full rope-based rescue

First Climber Selection

Name:

Qualifications verified:

Tower/rope technician Medical capability (EMT/Paramedic) Physically fit for climb

Pre-climb vitals / condition noted? Y N

Climber PPE & Systems

Full-body tower harness Double lanyards / Y-lanyard Helmet with chinstrap Eye protection Gloves Appropriate footwear

Connected to fixed fall-arrest system Backup belay/rope system planned

COMMUNICATIONS

Radio Plan

Primary channel: Backup:

Direct line to site owner/engineer Command/tactical channels separated

Contact with Patient

On-scene personnel attempted voice contact

Successful Unsuccessful

Phone / radio contact with patient (details):

Information to Dispatch

Updated tower location and access Confirmed number and status of patients Special resource requests (tech rescue, air, utilities) ETA updates requested

RESOURCES & STAFFING

On-Scene Resources

Units:

Personnel count:

Technical rescue capability present ALS/BLS units Law enforcement Utility/tower reps

Additional Resources Needed

Technical rope/tower team Additional engines/trucks Additional EMS Rehab unit Air support Lighting/generators Other:

Staging & Rehab

Staging location: Rehab location:

Rehab plan announced to crews Cooling/heating and fluids available

RISK ASSESSMENT

Risk/Benefit Statement

Brief statement (e.g., "High risk to rescuers justified by high probability of successful rescue of viable patient"):

Go/No-Go to Climb

GO – hazards mitigated to acceptable level DELAY – awaiting hazard control / resources NO-GO – risk exceeds benefit at this time

Safety Officer

Name:

Dedicated safety officer assigned Monitoring weather/fatigue/fall protection compliance

ONGOING SIZE-UP

360° and Reassessments

Initial 360° or best-possible survey completed

Conditions stable Improving Deteriorating

Time of reassessment:

Key Benchmarks

Command established (time: )

Patient located/confirmed ( )

First climber on tower ( )

Patient secured from fall ( )

Descent/lowering initiated ( )

NOTES & SKETCH

Diagram / Sketch

Space for quick sketch of tower, access routes, hazards, patient location, anchor options:

Additional Remarks

Free-text observations, critical decisions, and justifications: