Scribd
Upload
157 views5 pages

WAH Rescue Plan Template

This document outlines a written rescue plan for working at heights. It details: 1) Communication systems that will be used between a suspended worker and supervisor/rescue team, including direct voice, whistles, radios, and mobile phones. 2) Emergency contact information including supervisor name, first aid attendants, and emergency phone numbers. 3) Details of the fall from height rescue team members. 4) Safety considerations for rescuers, including their training, equipment, and ability to perform a rescue within 5 minutes. 5) Equipment needed for rescue, including ladders,

Uploaded by

shiraj.alam91
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
157 views5 pages

WAH Rescue Plan Template

This document outlines a written rescue plan for working at heights. It details: 1) Communication systems that will be used between a suspended worker and supervisor/rescue team, including direct voice, whistles, radios, and mobile phones. 2) Emergency contact information including supervisor name, first aid attendants, and emergency phone numbers. 3) Details of the fall from height rescue team members. 4) Safety considerations for rescuers, including their training, equipment, and ability to perform a rescue within 5 minutes. 5) Equipment needed for rescue, including ladders,

Uploaded by

shiraj.alam91
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Emergency Contact Details
  • Communication Systems
  • Safety of Rescuers
  • Rescue Procedures
  • Incident Protection

WAH Written Rescue Plan

Communication:
What communication systems will be used between the suspended worker and supervisor / rescue team?
Direct voice communication  Mobile Phone 
Whistle  Two-way Radios / Headsets 
Other.

Emergency Contact:
In the event of a fall from height, the supervisor will immediately alert the rescue team and first aid.
If the rescue team cannot affect a rescue within 5 minutes Emergency Services are to be called at once.

Name of this site: Supervisor:

First Aid Attendant(s):

Fall From Height RESCUE TEAM MEMBERS:

EMERGENCY PHONE NUMBERS -

Fire: Police: Ambulance:

Safety of Rescuers:
Are Operators trained and competent to use of rescue equipment? Yes No 
Are Rescue training records current? Yes No 
Are there a sufficient number of rescuers available? Yes No 
Is rescue equipment appropriate for nature of work? Yes No 
What obstructions are in the way of reaching the suspended Operator? (Detail):
WAH Written Rescue Plan

Have assessments been made of anchor points, and are they acceptable? Yes No 

Has consideration been given to the method of attaching the casualty? (Detail): Yes No 
WAH Written Rescue Plan

How will rescuers get to casualty?

Rescue ladder  Pull casualty up through floor / roof  Climb /


Remote Rescue Kit  repel down building / structure  Suspended

Keys to building and roof  access equipment 

Elevator  Aerial equipment from ground 

Pull casualty in through window / balcony  Crane man basket 

What equipment is needed to ensure rescue within 5 minutes, to minimize suspension trauma?

Rescue ladder  Low Height Rescue Kit 

Aerial truck  Crane man basket 

Rescue Kit – Winch  Descent Rescue Kit 

Suspended access equipment  Stretcher 

Rescue Kit – Haul-up  Elevated Work Platform 

Climbing / rope rescue system  First Aid Kit 

If Worker is injured

Can the casualty still be rescued within 5 minutes? Yes No 

Is a qualified first aider who understands suspension trauma present? Yes No 

Who will alert emergency services and the hospital? (Detail):

How will others be protected?

Assign someone to direct traffic  Set up barriers 

Other;
WAH Written Rescue Plan
WRITTEN RESCUE PLAN
How will Accident scene be protected?

Prevent further injury or damage  Set up barriers 

Preserve wreckage  Take photographs 

Notify Employer  Notify Ministry of Labour 

Other Considerations:

Precautions for working alone (Detail):

Unusual features of building / structure (Detail):

Weather Conditions (Detail):

Proximity to emergency services / hospital (Detail):

Language barriers (agency / contract staff) (Detail):

APPROVAL OF WORK AT HEIGHT RESCUE PLAN:

Supervisor:

Name (print): Cell Phone #

Signature: Date:

WAH Written Rescue Plan Communication: What communication systems will be used between the suspended worker and supervisor /
WAH Written Rescue Plan Have assessments been made of anchor points, and are they acceptable? Yes No  Has consideration bee
WAH Written Rescue Plan How will rescuers get to casualty? Rescue ladder  Remote Rescue Kit  Keys to building and roof  El
WAH Written Rescue Plan
WRITTEN RESCUE PLAN How will Accident scene be protected? Prevent further injury or damage  Set up barriers  Preserve wreck

You might also like