Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display Chapter 51 Vehicle Extrication

51-2 Objectives

Extrication Removing machinery from around a patient to facilitate patient care and transport 51-3

Role of the EMT on an Extrication Scene Give necessary patient care before extrication Make sure the patient is removed in a way that minimizes further injury 51-4

Role of the EMT on an Extrication Scene Patient care takes priority over extrication unless delayed movement would endanger the life of the patient or rescuer 51-5

Equipment 51-6

Equipment Protective clothing appropriate for the situation must be worn –Protective boots –Pants –Coat –Eye protection –Helmet –Gloves 51-7

Equipment Additional protective equipment may be needed: –Respiratory protection –Hearing protection –Firefighting gear 51-8

Stages of Extrication Preparation Scene size-up Vehicle stabilization Gaining access Extrication process Removing the patient Transport 51-9

Preparation Preparing for the possibility of extrication is the first step in providing good patient care. Information sources –Textbooks –Hands-on classes Inspect extrication equipment at the beginning of your shift 51-10

Scene Size-Up 51-11

Scene Size-Up Before exiting your unit, make sure that it is safe to do so. –Check for hazards Establish incident command 360-degree rotation –Looking at the scene from all angles 51-12

Hazard Control and Safety Considerations Be alert for any of the following: –Traffic at the scene –Gasoline spills –Hazardous materials –Exposed or downed electrical wires –Fire or possibility of fire –Explosive materials –Unstable vehicle or structure –Environmental conditions 51-13

Vehicle Stabilization Stabilization –Rendering a vehicle motionless in the position in which it is found 51-14

Vehicle Stabilization Equipment –Come-along (hand winch) –Cribbing –Wedges –Airbags –Step chocks –Hydraulic rams –Jacks –Chains 51-15

Vehicle Stabilization 51-16

Gaining Access Use the path of least resistance –Try opening each door –Roll down windows –Have patient unlock doors 51-17

Rule Standard rule regarding strike zones from undeployed airbags You should be at least: –5 inches away from the side airbags –10 inches away from the driver’s side airbag –20 inches from the passenger side airbag 51-18

Laminated Glass 51-19

Tempered Glass 51-20

Protect the Patient 51-21

Simple Extrication 51-22

Complex Extrication 51-23

Degrees of Entrapment No entrapment Light entrapment 51-24

Moderate Entrapment 51-25

Heavy Entrapment 51-26

Removing the Patient Disentanglement –The moving or removing of material that is trapping a victim 51-27

Removing the Patient 51-28

Removing the Patient 51-29

Removing the Patient 51-30

Removing the Patient 51-31

Transport Transport to the hospital by the quickest route Factors to consider when determining ground versus air transport –Time of day –Traffic considerations –Weather 51-32

Additional Scene Hazards Secure any hazards created on the scene –Pieces of the vehicle that were removed –Fuel leaks –Vehicles still in the roadway that need to be removed 51-33

Questions? 51-34