Roadway Extrication. 2 Introduction 40 hour course –minimum attendance is 90% –end of course exam 80% or better –practical examination-must pass all evolutions

Roadway Extrication

Roadway Extrication 2

Introduction

• 40 hour course– minimum attendance is 90%– end of course exam 80% or better– practical examination-must pass all evolutions

• State Certification– Practical passed at 100%– State written exam at 70%– Firefighter 2 certified


General Safety Principles

• Must protect the patient and rescuers during the extrication process

• Three factors that contribute to overall safety of an accident scene– The environment– The incident itself– The vehicle itself


Personal Safety

• Protection of the Rescuers– This is our number one priority– Full protective clothing with eye and ear

protection– Proper lifting and working techniques– Proper evaluation of scene hazards


Patient Safety (victim)

• Protect patients physical and mentally– Physical protection

• Cover patient with blanket

• Protect with backboard or barrier

• Utilize eye and ear protection equipment?

– Mental protection• Early communication between rescuer and victim

• Protect from unpleasant visual sights

• Protection of personal property


Scene Safety• Eliminate, Control, or Neutralize Hazards

– DO NOT TRADE LIVES FOR LIVES

• Scene Safety Priorities– 1st Priority -- Rescuers– 2nd Priority -- bystanders, Good Samaritans– 3rd Priority -- victims

• Use apparatus as scene barrier-100ft away


Scene Safety

• Hazardous Materials incidents-minimum of 2000’ uphill and upwind of incident

• Night operations require special considerations– Do not use headlights– More scene lighting makes operations more

effective

• Vehicle stabilization is paramount


Scene Safety

• Plastic fuel tanks in use– failure within 30 seconds of fire

• Handlines and extinguishers are a must

• 2 pole rule for downed power lines

• Use action circle and safety zones


Anatomy of a Vehicle

• 1973 was start of vehicle construction changes– Iron and steel to plastic and aluminum frames– Bolted to spot welded and glued

• Three types of frames– Full frame– Uni-Body-integrity depends upon roof, posts– Space Frame-cage like construction



• Posts– A Post; divides engine compartment from

passenger compartment, extends to roof– B Post; divides passenger compartment in half

or is rear post in 2-door vehicles– C Post; divides passenger compartment from

trunk in 4-door vehicles



• Wheels– Steel, aluminum, plastic, composite, alloy

• Catalytic Converters– 1300 to 2000 degrees

• airbags damage at 200 and will melt at 330

– Potential ignition source

• Drive Shafts– hollow and will explode as projectile


Hazards of Vehicles

• Catalytic Converters• Alternative Fuels

– CNG– LPG

• Fuel Emission Control system– Vapor holding canister

• Fuel Tank– 10-25 gallons, located between frame rails


Hazards of Vehicles• Bumpers

– Spring loaded bumper (5 mph impact in 1970s)– Piston fluid filled (2 1/2 mph impact) most popular

in use today– Egg crate

• newest concept, 2 1/2 mph impact

• Assume all are loaded and ready to rebound– Chain or drill 1/4” hole in narrow piston– Bumper strike zone up to 300’


Hazards of Vehicles

• Batteries– Most common hazard at scene– Key component in electrical system– Cut NEGATIVE cable in 2 places first

• make sure power is not needed first; seats or windows

• assure key off or fuel pump in EFI may keep running


Hazards of Vehicles

• Steering Columns– Old ones were solid one piece rods– New ones have hollow joints with up to 4

knuckles for various adjustments

• Wrap wheel low if you must pull– Cut spokes of wheel to allow more room


Supplemental Restraint Systems

• Minimum of 3 sensors in place on vehicle– 2 must activate before system can deploy– Needs about 12 mph impact

• Identification of unactivated system is key to rescuer safety– Look at steering wheel and dashboard– Assume at least 1 in place after 1990– Maybe in headliner, seat and doors in new cars


Supplemental Restraint Systems• Uses 12 volt charge to ignite SODIUM AZIDE

canister which burns producing nitrogen gas to inflate bags rapidly– Alkaline substance which may cause minor

irritation– Mostly non-toxic– Caution on FORD, Potassium Nitrate used

• Key is to disable electrical system immediately– SRS can stay active up to 30 minutes


Windows

• Front windshield is laminated glass– 2 pieces of safety glass bonded to plastic

material between– Made to resist shattering on highway

• Side and rear are tempered glass– Shatter to pieces the size of fingernail– Reduce the severe lacerations?

• Rescuer should control breakage of glass


Vehicle Rescue Life CycleStage 1 - Readiness

• Readiness of Personnel– Training and experience

• tools, equipment and SOG’s

• Readiness of Equipment and Apparatus– Maintained and functioning– Back-ups of primary systems


Vehicle Rescue Life CycleStage 2 - Accident Stage

• No control over this step

• Golden Hour begins– 60 minutes to reach appropriate health care

facility– Into surgery if indicated


Vehicle Rescue Life CycleStage 3 - Notification Stage

• Starts when accident is reported– Response SOG’s– Information recieved about accident– Size-up enroute

• conditions

• traffic patterns

• Dispatch tones and additional information


Vehicle Rescue Life CycleStage 4 - Response Stage

• Vehicle responds in safe manner– Obey traffic law– Use of visual and audio devices– Position of apparatus


Vehicle Rescue Life CycleStage 5 - Arrival

• Staging should be 100’ from incident– Assessment of immediate threat– Rescuer caution exiting and operating around

scene• May be most hazardous time for rescuer safety


Vehicle Rescue Life CycleStage 6 - Size-Up

• Begin to gather information– 360 degree view of scene– Assessment of known hazards

• Wires

• Fuel

• HazMat

– Prediction of possible hazards– Assessment of capabilities


Vehicle Rescue Life CycleStage 7 - Incident Command

• Essential to success of operations– Establish Command– Stay out of work and run the show– Stay in outer action circle


Vehicle Rescue Life CycleStage 8 - Scene Safety,

Stabilization and Support• Action circle - 10’ around car

– Only those doing ems or rescue

• Outer circle - 10’ - 15’ outside– Tool and equipment staging on tarps– ICS

• Identify and control the hazards


Vehicle Rescue Life CycleStage 9 - Patient Access

• Pathway to get to patient– Door– Window

• Qualified EMS provider inside to assess the patient and the effects of the rescue process

• Begin care inside, calm, reassure and talk to patient

• Communicate needs


Vehicle Rescue Life CycleStage 10 - Treatment

• Triage– Colors and priorities

• Call for additional help

• Begin treatment according to policy


Vehicle Rescue Life CycleStage 11 - Disentanglement

• The actual removal of the car from the patient– goal is not to cause additional harm and injury– protect patient throughout– stop actions that are causing harm– evaluate progress often


Vehicle Rescue Life CycleStage 12 - Extrication

• Remove the patient from the vehicle– Proper splinting and immobilizations– Exercise rescuer safety

• back injury frequency high here


Vehicle Rescue Life CycleStage 13 - Transportation

• Appropriate level of care– Trauma center– Regional hospital– Medivac


Vehicle Rescue Life CycleStage 14 - Termination

• Wrap-up of equipment– clean and service– secure scene with police

• Completion of documentation

• Review incident with participants– learn from every experience– learn from doing

Documents

Roadway Extrication. 2 Introduction 40 hour course –minimum attendance is 90% –end of course exam 80% or better –practical examination-must pass all evolutions