Information
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Cooperative
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Conducted on
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Prepared by
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Location
Annual Pole Top Rescue
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The employee's listed below have successfully demonstrated their ability to perform pole top rescue by completing the following tasks: Calls to victim, makes May Day call, puts on rubber gloves, climbs safely with fall restraint equipment, takes handline (if not already on pole), makes proper attachment to victim, removes slack before cutting strap, controls victims descent, rescuer descends safely using fall restraint equipment, removes/loosens handline from victim, checks victims vitals and begins CPR if necessary.
Timing - Best Practice is to complete a pole top rescue within a 4 minute time period in order to start performing CPR before brain damages occurs. Timing will take place during the pole top rescue today. Time will start at the moment the rescuer yells up to the victim saying - “Hey Joe, are you ok”? Hearing no answer, the rescuer will then go to the truck to make the May Day call. After the May Day call the rescuer dons his climbing gear and ascends the pole. Upon lowering the mannequin to the ground, the rescuer descends the pole. When the rescuer has both feet on the ground the time will stop. This time will serve as a baseline for the rescuer.
Note: Employee's listed below also agree to climb and adjust their fall restriction climbing gear according to the manufacturers recommendations of the fall restriction system being used.
Employee Signature
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Each signature verifies the employee agrees that he/she has successfully performed the tasks necessary for pole top rescue
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Employee(s) listed below did not successfully complete the requirements of the Pole Top Rescue evaluation. I agree to this per my signature below.
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Safety Instructor Signature
Matt Pociask
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Jim Wolfe
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Scott Meinecke
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Jason Thorson
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