How to Make Every Second Count in an Atmospheric Incident

The needless death of three confined space workers, reported on the International Marine Contractors Association (IMCA), website serves as a sobering reminder of the lethal dangers posed by hazardous atmospheric conditions in confined spaces, and the vital importance of both breathing protection and airway management during rescue.

Unfortunately, these are stories that we hear all too often at Brooklyn Specialist Training Solutions (Brooklyn STS). It’s why we’re pushing for change when it comes to confined space first aid practices.

Case Study: Fatal Hydrogen Sulphide Exposure

In this incident, three workers tragically lost their lives after entering a confined compartment, or “spud can,” on an offshore rig. The space contained hydrogen sulphide (H₂S), a highly toxic, colourless, and flammable gas. At low concentrations, it has the distinctive odour of rotten eggs, but this is deceptive; H₂S quickly paralyses the sense of smell, giving a false sense of safety.

Because it is heavier than air, hydrogen sulphide collects in low-lying areas such as tanks, pits, and spud cans, making it particularly dangerous in marine and industrial environments.

In this case, two workers entered the space without breathing apparatus in an attempt to rescue a colleague and were fatally overcome. A fourth “stand-by” worker was also affected after a large volume of gas was released through the spud can’s narrow opening. He was resuscitated and later hospitalised in intensive care.

This tragedy illustrates a critical point: rescuers must never enter a confined space without appropriate respiratory protection, and once a casualty is reached, airway control becomes the next priority.

Hydrogen sulphide is just one highly toxic gas found in confined spaces, others include carbon monoxide (CO) and methane (CH₄). Low oxygen (O₂) levels are also equally harzardous, and why best practice when it comes to first aid and rescue is not a nice to know, it’s a must.

“In confined space rescue, seconds count. Once a casualty is reached, securing and protecting their airway is the most effective way to preserve life until full medical care can be provided,” said David Nice, Managing Director of Brooklyn STS.

“This isn’t just First Aid, it’s advanced casualty care under extreme conditions, and every professional rescue team should be trained and equipped to deliver it.”

Responding to hazardous atmosphere incidents

When responding to incidents involving toxic gases or oxygen deficiency, rescuers must act decisively. Understanding airway management options and performing rapid, effective interventions can mean the difference between life and death.

Here David shares advice when it comes to airway management of the casualty in a confined space incident:

1.    Initial assessment

If the casualty is wearing an escape hood:

• Are they still breathing?

• Is the cylinder depleted, risking asphyxiation?

• Can they safely operate or remove the hood?

These checks must be completed immediately upon reaching the casualty.

2.    Airway management

Once the casualty’s level of consciousness is assessed, appropriate airway control measures must be applied:

• Is a resuscitator mask suitable in this environment?

• Would a supraglottic airway offer safer, more stable control for an unconscious casualty?

• Is suction available and used effectively?

• Is the airway being reassessed frequently as conditions change?

  
  

3.    Ongoing care during extraction

Sustaining life during extraction requires continuous, skilled intervention:

• Maintain airway protection and monitor oxygenation and perfusion.

• Provide ventilatory support where required.

• Watch for early warning signs such as rising EtCO₂ levels, which may indicate respiratory failure or impending cardiac arrest.

While some might call this ‘First Aid’, in confined space operations it represents Best Practice in Casualty Care, critical steps that bridge the gap between rescue and definitive medical treatment such as hyperbaric therapy.

Preparedness and training

Airway management in confined spaces is undeniably challenging, but entirely achievable with the right training, preparation, and equipment. Rescue teams must integrate this capability into their risk assessments and method statements, ensuring that personnel are competent to deliver life-saving interventions safely.

At Brooklyn STS, our mission is to raise the standard of casualty care in hazardous environments. Through specialist training and scenario-based learning, we equip teams to operate with confidence when it matters most.

To learn more about improving standards in confined space casualty care, contact Brooklyn Specialist Training Solutions on 01246 925 100 or take a look around here.