Me?Me? David DalrympleDavid Dalrymple 26 years in emergency 26 years in emergency

servicesservices Career- RWJUH EMSCareer- RWJUH EMS Volunteer- Clinton EMS/RescueVolunteer- Clinton EMS/Rescue Rescue Instructor for 16 years- Rescue Instructor for 16 years-

Vehicle Rescue is my specialtyVehicle Rescue is my specialty TERC US – Education ChairTERC US – Education Chair International certified International certified

Extrication judge-judged & Extrication judge-judged & lectured in US, Canada, UK, lectured in US, Canada, UK, Europe & SAEurope & SA

2007 Harvey Grant award 2007 Harvey Grant award recipientrecipient

International registered SAVER International registered SAVER instructor by ICETinstructor by ICET

Extrication Tactics columnist Extrication Tactics columnist Fire Engineering MagazineFire Engineering Magazine

Team Captain-World Champion Team Captain-World Champion Vehicle Rescue Team 1998Vehicle Rescue Team 1998

Educator- RoadwayRescueEducator- RoadwayRescue

NVTNVT NNew ew VVehicle ehicle TTechnologyechnology

Vehicle materials, components, Vehicle materials, components, construction and concerns that will construction and concerns that will directly impact emergency responders directly impact emergency responders while providing emergency services while providing emergency services and pre hospital care.and pre hospital care.

Vehicle materials, components, Vehicle materials, components, construction and concerns that will construction and concerns that will directly impact emergency responders directly impact emergency responders while providing emergency services while providing emergency services and pre hospital care.and pre hospital care.

Command & ControlCommand & Control

Command & ControlCommand & Control

Officer identifies any NVT Officer identifies any NVT concerns and/or issues.concerns and/or issues.

Communicates information to Communicates information to the crew the crew – Ensures all personnel are aware Ensures all personnel are aware

of hazard(s)of hazard(s) Officer identifies & documents Officer identifies & documents

debris containing NVT debris containing NVT hazard(s).hazard(s).

Access to NVT information is during Access to NVT information is during training & scene operations.training & scene operations.

All Hybrid models All Hybrid models have a guide for have a guide for emergency emergency responders to responders to deal with various deal with various emergenciesemergencies

How to shut How to shut down, extrication down, extrication concerns, concerns, firematic & firematic & towing concernstowing concerns

SafetySafety

SafetySafety

All personnel, especially those All personnel, especially those performing size up & evaluation, performing size up & evaluation, inspect vehicles completely for inspect vehicles completely for NVT concerns/hazards. Such NVT concerns/hazards. Such hazards, when identified, are hazards, when identified, are communicated to the rest of the communicated to the rest of the crewcrew

Space is observed as possible when Space is observed as possible when interacting with SRS and patients.interacting with SRS and patients.

As part of power isolation, the As part of power isolation, the vehicle is shut down & keys vehicle is shut down & keys removed & secured. Such removed & secured. Such action is documented.action is documented.

Shut downShut down Each vehicle has unique emergency Each vehicle has unique emergency

procedures-however-if you do the procedures-however-if you do the following 2 actions they will disable following 2 actions they will disable the the HV circuitHV circuit & & disarm/discharge disarm/discharge the SRS system(s):the SRS system(s):– Turn the key to the OFF position and Turn the key to the OFF position and

remove the key and keep it remove the key and keep it AWAYAWAY from from the vehiclethe vehicle

– Disconnect the 12V battery (both + & -)Disconnect the 12V battery (both + & -)

When severing wires, use of a When severing wires, use of a hand cutter – not a power hand cutter – not a power hydraulic cutter – is indicated.hydraulic cutter – is indicated.

Cut wiring with a HAND Cut wiring with a HAND cutter-not a power cutter-not a power

hydraulic tool!hydraulic tool!

Interior trim is displaced to Interior trim is displaced to evaluate if potential NVT hazards evaluate if potential NVT hazards are present. If such hazards are are present. If such hazards are present their identification is present their identification is made to the entire crew & made to the entire crew & documented.documented.

When vehicle components are When vehicle components are displaced/removed care is given displaced/removed care is given due to potential NVT concerns.due to potential NVT concerns.

Use of pertinent personal Use of pertinent personal protective equipment at all times.protective equipment at all times.

Use of respiratory protection Use of respiratory protection is required when performing is required when performing glass management.glass management.

Tool Usage/EvolutionsTool Usage/Evolutions

Rescuer Safety – Tool HandlingRescuer Safety – Tool Handling

Always be situationally awareAlways be situationally aware DO NOT get between the vehicle & tools - Especially DO NOT get between the vehicle & tools - Especially

power hydraulics!power hydraulics! Always unplug electric tools prior blade/bit changes!Always unplug electric tools prior blade/bit changes! Treat air chisels as a loaded gun when pressurizedTreat air chisels as a loaded gun when pressurized Watch where your hands/arms/feet are at all timesWatch where your hands/arms/feet are at all times Warn interior rescuer when operating tools that will Warn interior rescuer when operating tools that will

intrude and/or have effect on patient careintrude and/or have effect on patient care Always use a tool-not your hands-when removing Always use a tool-not your hands-when removing

glassglass

Management of vehicle stabilization Management of vehicle stabilization during the incident and especially during the incident and especially during tool operations.during tool operations.

A Stabilization thought…A Stabilization thought…

Ever thought about “run flat” Ever thought about “run flat” tires..tires..

Two thought processesTwo thought processes– Solid insertSolid insert– Stiffened sidewallStiffened sidewall

How low will the tire deflate now?How low will the tire deflate now?

Attention given to appropriate Attention given to appropriate space making evolutions in space making evolutions in relation to patient care/outcome.relation to patient care/outcome.

““WHY WE EXTRICATE”WHY WE EXTRICATE”

– Physical EntrapmentPhysical Entrapment Encasement in metalEncasement in metal Pinned VS TrappedPinned VS Trapped

– Nature of Injuries and Restricted Space Nature of Injuries and Restricted Space “Medically Entrapped”“Medically Entrapped” Making space in order to prevent further Making space in order to prevent further

injury by manipulating the patient during injury by manipulating the patient during removalremoval

Interior Considerations• CockpitCockpit• Seats?Seats?• Seating positionsSeating positions• Vehicle concernsVehicle concerns• Injury patterns /considerationsInjury patterns /considerations• Packaging concernsPackaging concerns• Safety/protectionSafety/protection

Creating SpaceCreating SpaceMedically entrapped = space neededMedically entrapped = space neededCreating Space is importantCreating Space is importantCreating Space is your insurance that Creating Space is your insurance that

no further harm will done to the patientno further harm will done to the patientThink Space to……Think Space to……

– Have adequate room to workHave adequate room to work– Have adequate room to provide patient Have adequate room to provide patient

carecare– Have adequate room to properly remove Have adequate room to properly remove

the patientthe patient

Whenever using tools in the area Whenever using tools in the area of the passenger cell appropriate of the passenger cell appropriate protective barriers are placed protective barriers are placed between the patient(s) and the between the patient(s) and the interior rescuer.interior rescuer.

Use of strategic cutting Use of strategic cutting evolutions to enhance space evolutions to enhance space making operations.making operations.

Cutting Cutting hinges/latches is a hinges/latches is a good tactic todaygood tactic today

Less “stress” on Less “stress” on patientspatients

Can be easier to Can be easier to facilitate than facilitate than spreading apartspreading apart

Need to get Need to get blades around blades around devicedevice

Can the tool do Can the tool do the job?the job?

““Cutting” Hinges/LatchesCutting” Hinges/Latches

When performing tool operations, you When performing tool operations, you need have both spreading & cutting need have both spreading & cutting tools available & ready for use.tools available & ready for use.

Door “Shred”Door “Shred”

““Outer” door materials Outer” door materials tear easytear easy

When they do, they When they do, they leave little to push leave little to push againstagainst

We need to get the We need to get the spreader tips past the spreader tips past the hinges/latch to hinges/latch to minimize tearminimize tear

Have cutters ready to Have cutters ready to gogo

Concern given to cutting Concern given to cutting material(s) with possible NVT material(s) with possible NVT concerns with respective toolsconcerns with respective tools

Material & Material & ConstructionConstruction Construction advances donConstruction advances don’’t prevent t prevent

entrapmententrapment Entrapped patients require aggressive Entrapped patients require aggressive

management management

Construction advanced do effect major Construction advanced do effect major injury injury

B-Post reinforcementB-Post reinforcement

B-Post reinforcementB-Post reinforcement

Care & concern given to vehicle Care & concern given to vehicle design and component concerns design and component concerns in relation to space making.in relation to space making.

Stay away fromStay away fromBRIGHT ORANGE BRIGHT ORANGE

CABLECABLE

Review - Hybrid Review - Hybrid 101101

All hybrids start on electric power aloneAll hybrids start on electric power aloneSome travel on electric power alone up to certain speedsSome travel on electric power alone up to certain speedsHV power is direct current DCHV power is direct current DCSome hybrids also generate 110 ACSome hybrids also generate 110 ACHV circuit is self contained – does not ground out to the HV circuit is self contained – does not ground out to the vehicle chassisvehicle chassisDrivetrain power is computer controlled and managedDrivetrain power is computer controlled and managedGas/Diesel side of drivetrain is load dependantGas/Diesel side of drivetrain is load dependantAll Hybrids have a HV drivetrain circuit as well as a normal All Hybrids have a HV drivetrain circuit as well as a normal 12v automotive electric system12v automotive electric systemEven when the hybrid is shut down and secured there will Even when the hybrid is shut down and secured there will ALWAYS be power in the HV batteryALWAYS be power in the HV batteryAs emergency responders there is NO NEED to interact As emergency responders there is NO NEED to interact with the HV battery – leave it alone!with the HV battery – leave it alone!Crayola colors to remember > bright orange = HV powerCrayola colors to remember > bright orange = HV power

» Bright blue = “intermediate” HV power (GM products)Bright blue = “intermediate” HV power (GM products)

Tool Evolutions are NOT an Tool Evolutions are NOT an issue!issue!

Let’s summarize….Let’s summarize….Let’s summarize….Let’s summarize…. Safety systems are more wide spread & Safety systems are more wide spread &

comprehensivecomprehensive Construction, materials & components will impact Construction, materials & components will impact

rescue efforts more & morerescue efforts more & more Motive power will make dramatic strides in the Motive power will make dramatic strides in the

next 33-38 monthsnext 33-38 months Rescue teams will need to “think & work smart” Rescue teams will need to “think & work smart” ““Silent”cars are NOT just hybrids and electricsSilent”cars are NOT just hybrids and electrics More background information will be needed More background information will be needed

about vehicles & their componentsabout vehicles & their components Vehicle size issuesVehicle size issues Training issues & concernsTraining issues & concerns