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

Roadway Extrication3 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

Roadway Extrication4 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

Roadway Extrication5 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

Roadway Extrication6 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

Roadway Extrication7 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

Roadway Extrication8 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

Roadway Extrication9 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

Roadway Extrication10 Anatomy of a Vehicle 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

Roadway Extrication11 Anatomy of a Vehicle 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

Roadway Extrication12 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

Roadway Extrication13 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’

Roadway Extrication14 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

Roadway Extrication15 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

Roadway Extrication16 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

Roadway Extrication17 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

Roadway Extrication18 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

Roadway Extrication19 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication20 Vehicle Rescue Life Cycle Stage 2 - Accident Stage No control over this step Golden Hour begins –60 minutes to reach appropriate health care facility –Into surgery if indicated

Roadway Extrication21 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication22 Vehicle Rescue Life Cycle Stage 4 - Response Stage Vehicle responds in safe manner –Obey traffic law –Use of visual and audio devices –Position of apparatus

Roadway Extrication23 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication24 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication25 Vehicle Rescue Life Cycle Stage 7 - Incident Command Essential to success of operations –Establish Command –Stay out of work and run the show –Stay in outer action circle

Roadway Extrication26 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication27 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication28 Vehicle Rescue Life Cycle Stage 10 - Treatment Triage –Colors and priorities Call for additional help Begin treatment according to policy

Roadway Extrication29 Vehicle Rescue Life Cycle Stage 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

Roadway Extrication30 Vehicle Rescue Life Cycle Stage 12 - Extrication Remove the patient from the vehicle –Proper splinting and immobilizations –Exercise rescuer safety back injury frequency high here

Roadway Extrication31 Vehicle Rescue Life Cycle Stage 13 - Transportation Appropriate level of care –Trauma center –Regional hospital –Medivac

Roadway Extrication32 Vehicle Rescue Life Cycle Stage 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