Fall Hazard-Rescue Plan Example

Fall Arrest Rescue Plan

Date: ______Job Description: ______Location: ______

Contacts Rescue Equipment Critical Rescue Factors

Rescuer(s) ______□ Ladder □ Block & Tackle Anchor Point______□ Rescue Pole □ First Aid Kit ______Competent □ Rescue Rope □ Life Ring Person ______□ Spider □ Work Vest Landing Area ______□ Scaffold □ (Cutting Device) ______Emergency □ Stokes Litter ______Contact ______□ Alternative Lifting & Lowering Device Rescue Obstructions/Hazards: Method of Contact: ______□ PA □ Verbal/Face to face Location of Equipment: ______□ Radio Channel: ______□ Job Site □ Gang Box ______Phone Number: ______□ □ Tool House □ ______□ Other ______

Check for Yes Comment □ Have alternatives to using fall arrest equipment been considered?

□ Has rescue equipment been inspected and found in good shape?

□ Is equipment adequate for the rescue plan (weight ratings, length, connection type, etc.)? □ Have communication devices been identified, located, & tested?

□ Are all rescuers familiar with the use of the rescue equipment?

□ If working over water, is there a boat available?

Pre Work Tasks: Response Procedure: 1) 1) Notify Emergency Contact.

2) 2) Make medical assessment of person.