A component of search and rescue is technical rescue. This is far more common in mountain rescue and in cave rescue than it is in urban settings, but there are times when this is a necessary skill and regardless of the setting, performing the rescue requires very specific skills.
One of the components of Operation Rumble in the Rockies was introducing a stranded window washer 25 feet off the ground. He was too far away from the window for responders to reach and the roof was inaccessible. Exercise participants — ARES, CERT, MRC and ground SAR — did not have the skills to perform a technical rescue and the idea was to recognize a limitation in capabilities and request resources to solve the problem.
The attached video is a demonstration of what a a technical rope rescue would look like. This is similar to what you would see in mountain and cave settings.
Members of OMEGA hold two vertical training sessions each month to allow our members to develop and maintain the skills required to perform rescues such as this.