• Aerial ladders aid in rescuing and safely moving victims to the ground.Design Pics/Valueline/Getty Images
  
  Ladder rescue is quite possibly the most physically demanding and labor-intensive action performed by a firefighter. Rescue by aerial ladder requires multiple firefighters, for the equipment operation as well as for the sheer manpower needed to carry out the mission. Throughout the rescue, firefighters must keep in mind that the victim is exposed to the environment and must be protected as much as possible.
  
  

Victim Rescue

• One firefighter is needed at all times to operate the aerial ladder. Another stays in the ladder bucket and at least one more firefighter advances into the building to tend to the victim. Depending on the victim's size, the firefighters may decide to remove the victim by having him face the rescuer, face away from the rescuer, be carried in a cradled position or be placed in a stokes basket for descent.
  
  

Victim Removal

• Aerial ladder rescue operations can be intimidating and slow moving. Ambulatory victims can be coached onto the ladder, meaning the firefighters must provide rung-by-rung instruction. Frightened and potentially injured victims require total supervision during their descent.
  
  A stokes basket combined with the aerial ladder may be the only option for lowering a victim to safety. With the aerial ladder side rails level against the windowsill, the rescue mission may begin. This position allows full window access, easy firefighter entry and safe victim extrication because the basket does not require movement during the operation. Once the victim is rolled and secured onto the stokes basket, firefighters lift and carry the victim to the window, standing on the basket sides. The victim is passed headfirst to the firefighter in the aerial bucket and he balances the stokes basket atop the ladder bucket, securing it with the attached safety line and hook. The safety hook allows the upper portion of the stokes basket to ride along the side rails of the aerial ladder, helping the firefighter maintain appropriate descent speed. The lower portion of the stokes basket rests on the ladder rungs throughout descent, holding the victim between the side rails.
  
  The firefighter or firefighters remaining in the building perform a rapid search for additional victims. As long as victims are in danger with a chance of survival, search and rescue efforts take priority over all else on the tactical priority list.
  
  

Removal of Deceased Victims

• Removing unconscious, injured, obese or deceased fire victims down an aerial ladder can be one of the most dangerous and difficult operations rescue workers face. All can be safely rescued and removed from danger using a stokes basket, especially a deceased victim. The body is placed in a body bag, along with a backboard inside the stokes basket for stability. Maneuvering a body bag during aerial ladder rescue without a rigid support mechanism is both awkward and difficult.