What it is, is in the name – they are bags for rope.  But what it does, is sooooo much more. The rope bag is, arguably, the hardest working piece of gear there is. It protects our rope, our most foundational yet vulnerable piece of equipment, and in doing so it protects our very lives. From the moment it’s put into service it is doing what it does during, in between, and especially on the way to every project of it’s lifespan.

Think about it: You suddenly find yourself on your way perform a last minute, urgent, one day, visual inspection job on a roller coaster at an amusement park on the other side of the country. With no time to ship gear in advance, you’ll have to fly with all your equipment – including your rope (good thing the client is picking up the extra baggage fees).

Are you going to place those coils of naked rope on the scale at check in counter? Or endure the strange looks and stupid jokes from fellow passengers because your carry-on is a coil of 100m rope?

In this moment, you begin to understand just how wise a choice you made in popping for the expense of a rope bag.

Aside from keeping our precious safe from the hands of under-paid baggage handlers, over-zealous TSA agents, and the unknown horrors found in the belly of airport baggage systems, rope bags protect our ropes from the harsh environments to which we so cruelly subject them while in storage, and on a project.

Especially on large projects, days (if not weeks) can be spent simply rigging ropes and gear to make access to the actual work location. A single project can involve hundreds of individual ropes of varying lengths and specifications, adding up to several miles of total rope necessary to perform whatever work awaits.  With a burst of static the radio blares out a request from the lead technician for a specific rope. With so many pieces of rope in the cache, thank heavens for the clearly discernable labels on the outsides of the bags! Even the rookie ground guy is able to find the right one!

As the valuable load is hauled into place, secure in it’s protective bag, you can put to bed any fears of  the load (ropes) from getting snagged on all those unseen sharp edges and pinch points along the way.

Working double time

Rope bags are equally as vital when the contained ropes are in service, from outset to demobilization.

Rigging is a demanding task.  The 100% focus required when a tech is moving across a span, setting lines, and rigging systems is quite enough to be thinking of.  The last thing one would want to deal with is a tangled, knotted rope while standing on a beam barely the width of their boot while perched hundreds of feet above the ground.

Even for a technician on-rope the bag can be vital to safety. Work at height can be windy – which, in itself, is not a great hazard. However, when work is not managed effectively with respect to the wind, the hazard can be enormous.  Ask anyone who has ever been thrust as a fleshy wrecking ball into a steel wind turbine tower; these are some of the most terrifying moments in a lifetime. In circumstances such as these, often the only option is to go straight down, and at an expedited pace. When multiple ropes are left free hanging, nature can tie knots you’ve never heard of.

Another serious safety hazard that can be created by loose hanging ropes comes from falling debris. A couple of common industries particularly susceptible to such would be rock scaling and smokestack work. It is probably safe to assume that a 600lb rock or chunk of caustic chemical found caked to walls of a stack would have a very adverse effect should it snag on the tail of a rope coming out of a workers descender as it falls down below.

When it comes to rescue, rope bags are also vital. Not just in the ease of getting the ropes up to where they are needed, but also for the ability of the rescuer to be able to negotiate an appropriate route back down with the patient. In many environments, such as the telecom world, straight down isn’t an option due to equipment and obstructions mounted to the towers.

What to look for in a rope bag

What comprises the best all-around rope bag is in the eye of the beholder (unless it’s one that a percentage of each sale goes directly into my personal bank account). A good rule of them when purchasing a rope bag is to make sure that its features meet the specific needs of what, where, and how the rope is going to be used. Some of us may have started out using typical backpacks bought from thrift stores as rope bags. Sure they worked, just not very well. Over the many years and many industries, time and experience provide personal insight into what to look for in a rope bag. 

First and foremost, is it tough enough for the environment? Most nylon bags can handle some abuse. However, baggage handlers will administer that amount. A bag constructed of heavy packcloth, PVC or ballistic cloth will hold up much better than light weight nylon – much stronger and tear resistant. Durability, of course, must be balanced against weight and co-efficient of friction. In my initial work on wind turbines my thought was simple nylon for sliding bags over the side of a smooth fiberglass nacelle. However, I quickly learned that bolt heads and threads are very sharp, and that even ‘smooth fiberglass’ can chafe material. Being ‘waterproof’ doesn’t hurt either.  PMI rope bags are constructed of rugged, heavy-duty coated canvas that holds up to even the harshest of abrasion, and is sturdy enough to hold some shape even when empty. Some PMI bags offer a double-layer bottom for even greater protection.

Next, look at the external handles/straps. Size, stitching and arrangement are all important factors. Stitching is especially critical if you’re planning on hoisting your rope bag – face it, 200 meters of rope is a bit too much weight to climb with. A substantial attachment point to hang that heavy load from while on rope will prevent misery in the field. Things like shoulder straps are crucial if the bag will need to be carried for any appreciable distance or across uneven terrain. Not just any shoulder-straps, either. Make sure they’re ergonomic, adjustable, and comfortable to wear. Plain two-inch webbing will feel an awful lot like a commando-wire cable saw cutting into your shoulders after the first fifty-feet.  All PMI rope bags have firmly mounted handles at the top, and those handles aren’t just a strip of webbing. No, they’re rounded out to a diameter that spreads the load more comfortably across your hand rather than digging into your fingers. PMI rope bags with shoulder straps are actually called ‘rope packs’ and these feature a curved, lightly padded, adjustable carrying system that optimizes comfort and weight, similar to backpack straps.

Another critical feature to consider is how you will get the rope into – and out of – the bag.  Stuffing a floppy rope bag is like trying to push a rope up a staircase. A top-load bag with substantial enough bag material to hold at least a bit of shape as you hold it at the top with one hand, and stuff with the other, is ideal.  Deploying rope from a top-load bag is also an optimum situation; PMI’s draw string closure provides just enough umph to keep the rope in place without adding a lot of complexity.  While  recreational climbers tend to lean towards bags that unfold into a tarp, these can be more trouble than they’re worth in an industrial environment.

Something people don’t always think about is what to do with the “tail end” of the rope – the end that stuffs down into the bag first. An advantage of rope bags is that they can keep rope from tangling – but if the end of the rope that goes into the bag first isn’t secured, whatever natural wiggling and shifting that occurs in storage and carrying can cause that end to snake around, twisting, tangling, and creating all sorts of knots. Some rope bags have a grommet in the bottom through which the rope is passed and knotted before stuffing the bag; the downside of this is that there’s now a knot under your bag, preventing it from standing up straight. PMI bags address this issue by putting the grommet in front, just under the clear labeling pocket – creating something of a “belly-button” effect (it’s an outie.)

Oh, right… the clear labeling pocket! PMI’s clear pocket is made of a durable clear plastic, large enough for a very big label, product instructions, or even a full-size rope-inspection card. There’s also a hook-and-loop closure to keep all that stuff from falling out, with a little pull tab to make it easy to open when needed.

Finally, consider gear loops and pockets. Some folks like them, some folks don’t… but if you’re going to opt for pockets, at least make sure they’re big enough to hold a reasonable amount of gear. If you opt for pockets, you’ll probably also want shoulder straps (consider the weight!)  In this case, be sure the pockets are in a balanced position to keep the weight centered while you are carrying the bag on your back. PMI rope-packs feature bellowed pockets that tuck down when not in use, but expand when space is needed. They also feature side release buckle closures, and those super-snazzy pack-straps for carrying on your shoulders.

If you are an Emergency Services Responder – especially if you are affiliated with the fire service – here’s a little something you might be interested in knowing about. Actually, it’s more than a “little” thing, its more like 237 pages worth of a big thing!

Up to now, if you were interested in an NFPA standard you might have purchased a standard that was somewhere around 40 pages long, and it would contain requirements, test methods, labeling, and other standards-speak.

Last year PMI shared a message to make you aware that NFPA was going through a process of consolidating related standards into volumes. Now, the volume pertaining to Operations and Training for Technical Search and Rescue Incidents and Life Safety Rope and Equipment for Emergency Services has just been released. It’s been given a new number, NFPA 2500.

You can get your very own copy by reaching out to the National Fire Protection association in Quincy Massachusetts – by phone, 800-344-3555 or order it online at catalog.nfpa.org.

This standard combines what used to be three separate documents… NFPA 1983 (which was equipment focused); NFPA 1858 (which provided selection use and care information) and NFPA 1670 (which outlines team competency for Technical Rescue.)   This new consolidated standard, now known as NFPA 2500, actually contains the substance of all three of those documents.

NFPA 1006 – Professional Qualifications for Technical Rescuers – is still a separate document, but the 1006 and 1670 committees have worked VERY hard to try to harmonize the Professional Qualifications requirements with Organizational Training requirements.

In any case, if you’re a professional rescuer, the NFPA 2500 document is something you will want to become familiar with.

PMI is a manufacturer of life safety rope and equipment for professionals, and our CEO Loui McCurley has been personally involved with these NFPA standards since the early 1990’s.  We consider it to be part of our mission to help make sure that industry professionals working rescue and work at height are familiar with the information, technical knowledge, and standards that could impact their work.

If you would like to review the NFPA 2500 standard on Operations and Training and Life Safety Rope and Equipment for Rescue, you can access it free of charge at NFPA.org. Just type NFPA 2500 in the Search box, and click on Free Access!

We’ve come a long way with these documents in the last thirty years, but most people will agree that standards just don’t change fast enough to keep up with our constantly evolving industry – so its likely that you might find some things in these new documents that you might not agree with.

If that’s the case – NFPA invites you to submit input through the online submission process at NFPA.ORG. These committees love having input and participation in this work, especially from folks like you who actually have to USE the standards in various ways!

One of the most confusing things about the new standard may be that instead of referring to the old standards numbers (1983, 1858 and 1670), as an industry we will now be referring to the new standard number, 2500.

This will probably have the greatest impact on equipment that you use, as you are probably accustomed to looking for markings that say NFPA 1983. In an effort to try to minimize confusion, NFPA has decided to include the old standard reference numbers along with the new ones on marked equipment – so, for example, where certified equipment previously might have been marked something like

NFPA 1983(2017) (G)

It will now look more like this

NFPA 2500 (1983) 2022 ED (T)

Depending on the item of equipment, there should be a G, T or E on the label to indicate whether it is intended for General Use, Technical Use or Escape.

In order to be compliant with the standard, equipment has to be third party tested by a qualified laboratory, like Underwriters Laboratories, or Intertek Laboratories. But these test labs couldn’t actually start testing to the standard until it was published – and, that just happened.

So, it’s still going to be awhile before you start seeing equipment with the NFPA 2500 label on it.

The next logical question then is, how soon do users have to start using equipment that meets the new edition? When must we stop using equipment just because it is marked to the old standard?

The simple answer is, we don’t.

There are no NFPA requirements, no law, that says you have to use equipment meeting the most current version of any standard. There are no requirements for when you have to start using equipment marked to the new standard.

There IS however a deadline for when we MANUFACTURERS have to stop SELLING equipment marked to the old standard. That deadline is 12 months from the effective date of the new standard.

In this case, even though the new standard wasn’t actually PRINTED until just a few weeks ago, the EFFECTIVE DATE was SEPTEMBER 2021. If that sounds confusing, it is because it is… the standard really did go into effect before it was printed.

In any case, what that means is that you will still be able to buy equipment that is marked to NFPA 1983-2017 Edition until SEPTEMBER 2022.

The GOOD NEWS here is that there weren’t a whole lot of significant technical changes to the standard, so most all the equipment that was properly certified to the 2017 standard will still also meet the 2022 standard.

There was a whole big team of folks who worked on these standards, and they ALL deserve a big shout-out…  but most notably we would like to acknowledge the incredible efforts of Jeremy Metz from West Metro Fire Department, who is chairman of the Technical Committee on Special Operations Protective Clothing and Equipment and amazing Committee Secretary, Karen Lehtonen from Lion Group. We’d also like to recognize Ben Waller, Tennessee Association of Rescue Squads, who is chairman of the NFPA 1670 Technical Committee on Technical Search and Rescue.

These three provided extraordinary leadership and facilitated amazing collaboration through the entire process – which wasn’t easy!

Although we didn’t create it, PMI is – as always – going to do our level best to walk with you, support you, and assist you in navigating this change with as little impact as possible on your organization.

We’d love to hear your comments and questions here, and will try to answer any specific questions you might have along the way.

<< Back to Part 2

“Unless you are a fire department, NFPA is probably not the right resource to guide you”

On the topic of standards and regulation, sometimes people look to NFPA 1983 for guidance in selecting a harness for rescue. Unless you are a fire department, NFPA is probably not the right resource to guide you, but let’s start there anyway.

NFPA 1983 is a manufacturing standard, and acknowledges two types of harnesses: Class II and Class III – the former being a Seat Harness style, and the latter being a Full Body harness style. This standard is largely written by and for urban/municipal fire department personnel, with the result being that many rescuers in the large, urban fire departments do wear Class 3 full body harnesses. Even so, the standard does still allow for seat harnesses – primarily for the benefit of the large proportion of rural or small town fire departments that do not see the frequency of industrial accidents and who may not need full body harnesses.

NFPA 1858 is the user-companion document to NFPA 1983; it is intended to help address some of these kinds of questions and can be viewed here.  The bit of this standard that deals with harnesses is section 5.4. It explains that the organization shall consider its needs for performance or features – and then has an appendix dialog (A5.4) which says (among other things): Specialized harnesses might be required for different types of operations and then goes on to describe the differences between Class II and Class III, finishing with the statement that “While both types of harnesses are capable of fall arrest, the most commonly used industrial fall protection attachment points are sternal or dorsal, which requires a full body harness. NFPA 1983 requires that both the Class 2 and Class 3 harnesses pass a head-down drop test to verify the harness will not allow the user to fall out of it.” Again, you can see here, both harnesses are considered appropriate for vertical work, and the main reason for using a Class 3 harness would be to accommodate industrial fall protection connections such as are common to fire departments in urban environments – which, again, is the primary population served by this NFPA equipment standard.

NFPA 1983 can also be viewed online, free of charge, here. If you look at paragraph 1.1.5, you will see that it specifically states that “this standard shall not specify requirements for any rope or associated equipment designed for mountain rescue, cave rescue, lead climbing operations, or where hazards and situations dictate other performance requirements.” So, what this says is that, according to the NFPA 1983 standard, the NFPA 1983 standard doesn’t apply to you if you are engaging in mountain rescue operations.

“what are your criteria for choosing a harness?”

A more applicable standard relative to Mountain Rescue activities is ASTM F1772, Standard Specification for Harnesses for Rescue and Sport Activities. This standard is promulgated by the ASTM F32 Committee on Search and Rescue, which is written by and for members of mountain rescue teams, rather than the fire service.

The ASTM F1772 standard “covers harnesses for human use in technical rope rescue and climbing, mountaineering, caving, canyoneering, and other rope-based sport activities” (para 1.1) and further clarifies that “Due to the diverse requirements of various rescue activities and environments, any of the included harness types may be suitable for rescue, including those marketed principally for climbing” (para. 5.3).  The standard specifications and test methods found in this standard are essentially analogous to those found in the UIAA 105 harness standard and the European EN 12277 standard.

So, what are your criteria for choosing a harness? As a mountain rescuer, I would suggest

• Wide enough waistbelt and leg loops to allow the harness to be comfortably worn in suspension for a reasonable period of time
• A low enough ventral attachment point to be able to lead climb if you need to
• A high enough ventral attachment point to allow the wearer to sit reasonably upright
• Lightweight enough to be able to comfortably carry and use in the backcountry
• Low profile enough to permit the kinds of agility usually required in mountain and wilderness environments
• Not a lot of metallic parts to conflict with mountaineering gear
• Highly adjustable for different weather/clothing situations

If you are a fire department or an industrial rescue team doing mostly industrial/urban operations, NFPA Class III would be a very appropriate standard for you to use as a reference.

If you are a fire department that does mostly urban-interface operations, an NFPA 1983 Class II harness would be a very appropriate standard for you to use as a reference; or, if you want extra weight to carry, an NFPA Class III harness would work also.

If you are a mountain, wilderness, or cave rescue team, an ASTM F1772 harness – or a European equivalent – makes a lot more sense for you.

Hopefully, this information will help provide at least some guidance that will result in the most appropriate harness choice for your application, and will also help purchasing agents to realize how a “more-is-better” approach could actually result in increased risk to rescuers.

This will enable you to better utilize the same sorts of industrial fall protection equipment used in these types of workplaces.  This, incidentally, is why you see many urban municipal fire departments using full-body, industrial-type harnesses for rescue – most of their responses are to those kinds of workplaces, and they generally can drive their truck to within a short distance of the subject. We will talk about standards in a moment, but typically this is what we refer to as an NFPA Class III harness. These will typically weigh somewhere in the neighborhood of 6 pounds, and cost around $300-500 and upward, depending on features.
On the other hand, if you are a fire department with relatively few industrial callouts, but mainly working in the urban-interface of parks with cliff faces, car-over-the-edge, or similar areas, a full body harness is probably overkill – especially if you need greater agility. In this case you might more appropriately consider a Seat Harness, such as an NFPA Class II or an ASTM 1772 harness. You’ll find these weighing in at 2-4 pounds and at a cost around $200-300, again depending on features.

However, if the majority of your rescue operations are in a mountain or wilderness environment, you are likely much better served to consider choosing something akin to a climbing harness, but with more padding and adjustability. Most importantly, you will probably want to avoid metal D rings (and the alignment challenges they present) so that you can better utilize the same sorts of mountaineering equipment used in such environments and so that it is not too heavy. This is why you see so many rural, wilderness, or backcountry rescue teams using climbing style seat harnesses for safety – because most of their responses are to mountain environments where this type of gear is most appropriate – and they often have to carry gear a great distance. These might meet ASTM 1772 or a European equivalent standard will weigh around 1 pound, and can often be purchased for under $100.

Each of these types of harnesses is perfectly safe and appropriate for working at height, in suspension, but their different features make them more appropriate to different applications. Kind of the same reason we don’t wear turnout boots or bunker gear in the backcountry. Trying to use industrial rescue equipment in wilderness environments would make about as much sense as trying to use wilderness rescue equipment in industrial environments. Although there may be some crossover with a limited range of equipment, the criteria for choosing is quite different.

“A belay is a standard operating procedure”

The topic of belay in co-worker assisted rescue is one that tends to get people worked up, perhaps because so many of us have roots in professional rescue such as fire departments and rescue teams. A belay is a standard operating procedure in Professional Rescue environments, and a rescuer would scarcely think of performing a rescue without one.

On the surface, then, it would seem that employing a belay would only make sense in a workplace environment as well.

“This topic has been heavily debated in ANSI Z359.4 Subcommittee meetings”

From a practical perspective, however, this doesn’t always bear out. This topic has been heavily debated in ANSI Z359.4 Subcommittee meetings, and OSHA has addressed the matter as well at both state and federal levels. All end up at the same general premise: After a fall, the fallen worker needs to be rescued as safely and expeditiously as possible – but it is highly unlikely that use of a belay would be reasonably achievable in most such cases, and even where it may be feasible it may not be desirable.  The interpretation letter at OSHA website provides a nice overview.

Regulatory authorities and practitioners with the most experience seem to land at the same conclusion: Self-Rescue and Co-Worker Assisted Rescue practices may, but are not required to, include the use of some means of secondary belay. In fact, in some cases a belay could expose rescuers to additional hazard (e.g., where it would be precarious to attach a secondary system, where redundant systems may be likely to become entangled or create a snag, or where a belay could easily be inadvertently activated and leave the rescuer[s] and/or subject[s] in a precarious position).

“A belay should definitely be considered”

Careful consideration should be given to whether a given situation warrants the additional complexity and manpower for a belay. A belay should definitely be considered where:

• There is a high likelihood of failure of the main system.
• The primary raising/lowering system being used for rescue does not automatically stop/lock if the user lets go.
• The protection provided by the belay outweighs the potential hazards that the belay might create.

Belay systems are appropriate only when they protect against a credible threat, when it is safe to operate them, and when they prove to increase survivability for the rescuer and patient.

In short, there are pro’s and con’s to belaying… and while most organizations do favor the use of belays during training evolutions, in a real situation where self-rescue or co-worker assisted rescue is being performed, belay is optional.

In a recent study conducted by experts from the US Centers for Disease Control and Prevention (CDC), NIH, UCLA, and Princeton University, investigators found that SARS-CoV-2 is detectable in aerosols for up to 3 hours, on copper up to 4 hours, up to 24 hours on cardboard, and up to 3 days on plastic and stainless steel.

Cleaning surfaces and equipment that are regularly touched or that may be exposed to germs can help reduce the spread. Recommendations from the CDC are to include cleaning AND disinfecting frequently touched surfaces first with detergent or soap and water, and then following this cleaning with disinfectant.

“choose a disinfectant appropriate for the material”

Most common EPA-registered household disinfectants will work, so choose a disinfectant appropriate for the material you are cleaning. If necessary, you may secure MSDS sheets from the cleaning solution manufacturer to identify what materials are damaged by that solution.

Some of the options include

• a dilute bleach solution (1/3rd cup bleach per gallon of water OR 4 teaspoons bleach per quart of water)
• A 70% alcohol solution

“bleach is known to weaken the fiber structure”

With any chemical compound there are several factors that will influence whether or not it will damage a given material. Of primary importance, of course, is simply the relationship between that compound and the material being cleaned. With this as a foundational context, actual damage can also be affected by concentration, duration of exposure, and temperature.

Although bleach is known to weaken the fiber structure of materials such as nylon and polyester, PMI has found that a single treatment of a mixture of up to 1 part household bleach (with active ingredient of Sodium hypochlorite at 5.25% concentration) with 9 parts room temperature tap water and a 10min or less exposure time, immediately followed by a thorough rinse of room temperature water will not cause appreciable harm to nylon or polyester ropes.

Likewise, plain rubbing alcohol can be a good cleaning agent that is generally mild enough to not damage or melt rope fibers, but again the alcohol solution must be thoroughly rinsed out of the material promptly so it doesn’t damage the material.  At high temperatures and under extended exposure conditions, nylon is known to be damaged by isopropyl alcohol.

“recommended method will not cause appreciable harm”

Keep in mind that the cumulative effects of frequent or repeated decontamination using these compounds has not been thoroughly studied, and should be undertaken with care.  Given the understanding that both bleach and alcohol can weaken the fiber structure of a rope, it only stands to reason that repeated treatments are likely to weaken the fiber structure even more. Although PMI’s testing suggests that a single disinfection using the recommended method will not cause appreciable harm to nylon or polyester ropes, if this process is repeated multiple times the damage will inevitably become appreciable, and this damage is not necessarily detectable through visual inspection.

Use and care of life safety products should not be undertaken lightly, and it can be difficult to make subjective decisions about the strength of rope and equipment without actually testing it to failure. The prudent course of action is to discard any rope about which there is any doubt.

For more information on chemical compatibility with nylon, visit calpaclab.com

With Spanish Subtitles

Presenter: Steve Hudson | Webinar | 
The 2012 edition of NFPA 1983 Standard on Life Safety Rope and Equipment for Emergency Services is out! All manufacturers of these products will soon be required to certify their products to this new version of NFPA 1983. This webinar is a quick review of the major product additions and other changes to the previous edition published in 2006. Steve Hudson has been actively involved with the NFPA Technical Committee responsible for the creation of this and the previous four editions of NFPA 1983.

Presenter: Loui McCurley | Webinar | 
Although fall prevention and protection has been repeatedly addressed by OSHA, which has suggested methods such as elimination or substitution of work, use of engineering controls, administrative controls, and the appropriate use of personal protective equipment (PPE) to control hazards, falls continue to be a leading cause of death and injury in the workplace.

In developing a Managed Fall Protection Program, one thing is clear: Adequate preparation, systems thinking, and adhering to appropriate safety practices are more likely to have a positive influence on safety at height than complex, rigid work systems and adherance to “product standards”.

This presentation, given by Loui McCurley, will explore integration of Rope Access into the employers Managed Fall Protection Program, and the potential benefits of versatility and capability that can be realized by the employer as a result. We will discover how Professional Rope Access fits in as a work method combining trained technicians with a proven system of work and equipment to achieve complete system of work, and how it is recognized by US and International standards, including ANSI, ISO, and others.

Presenter: Roger Mortimer | Webinar | 
This free webinar, presented by Roger Mortimer, MD, will further elaborate on the following Abstract: Suspension Trauma, alternatively called harness hang syndrome, harness induced pathology, or orthostatic intolerance has been described since the early 1970s. The syndrome is really more than one phenomenon, shock from blood pooling in the legs while passively suspended and muscle damage from poor circulation in the legs. The harness itself has been blamed for causing this but is really incidental. Previous literature has suggested that once rescued a person should not be laid down after rescue. This is contrary to standard care. Most authorities now concede that there was never any evidence for this recommendation. This recommendation has been withdrawn by occupational health authorities in England, Australia, and the USA. Once rescued from suspension a person should be laid flat just as one would treat any other trauma patient. The harness can be removed or left on as is helpful for final evacuation. Aggressive intravenous fluid therapy is appropriate to prevent kidney damage.