MVA Safety and Principles of Extrication

PREPARATION Proper Training Proper Equipment for the conditions and situation

RESPONSE TO THE SCENE Follow all Dept. response policies Remember, this is NOT your emergency. You have been called to assist someone else. If we can’t arrive safely, we are no help. Be preparing mentally enroute to the call.

SCENE ASSESSMENT AND HIGHWAY SAFETY

Warning on-coming traffic Set-up appropriate warning devices such as flares, strobes, traffic cones well ahead of accident scene At least 400’ before the accident Don’t use flares in cold, foggy conditions!! Request additional units if necessary Protecting the Scene Park apparatus in a “defensive position” Your engine is the best road block

DON’T BECOME A VICTIM Dozens of Firefighters and EMT’s die every year across the U.S.A. while operating at MVA’s. Never turn your back to on-coming traffic Always remain in radio contact with person doing traffic control Always leave yourself a way out.

Scene Hazards A 360 must be completed prior to any other activities being performed. Downed Power Lines Unstable Structures and vehicles Hazardous Materials Other?

OTHER ASSESSMENT Victims outside vehicles (ejection) Hot and Cold zones around accident Size-up before beginning activity “READ THE WRECK” Additional Resources? Full protective equipment a must!! Set-up Tool Staging Area (Engine Operator or per dept. SOP’s) Supplemental Safety Systems

HAZARD CONTROL Stabilize vehicles – Create a safe platform for extrication work. Cribbing, struts, etc. ~Practical Activity~ Fire prevention and control – pull and maintain charged, manned hoseline. Traffic Control – Traffic control must always maintain radio contact with command or those working at scene.

Supplemental Restraint Systems Air Bags – Deployed or not? Location? Front Impact Bags – Do Not put yourself between undeployed bag and patient. Side Impact Bags – Normally curtain type from ceiling or side of seat mounted. Cylinder for systems normally in A, B, or C post. Avoid!! Pull off trim to expose and identify location before cutting. Rear seat bags – Newer high end cars. NO universal marking system. Most, however use SRS, HPS, IC, SIPS, or “Airbag”.

Static Electricity can cause air bags to deploy. Remember the 5-10-20 Rule: 5” away from side air bags 10” away from steering wheel air bags 20” away from front passenger air bags

Air Bag Deactivation Times – Cutting the battery cables doesn’t always work! The system can still hold a charge! Vary depending upon make, model of vehicle. Some older vehicles can hold a charge for up to 20-30 minutes. Battery locations – Vary based upon make, model. Batteries can now be found under hood, in the trunk, in the wheel well, and behind the rear seat.

Hybrid Vehicles Avoid ORANGE wires – They are part of the high voltage system! Turn off ignition and remove key to render car safe. Remember, the SILENT CAR. It may be running and can move even if you don’t hear it! High voltage systems are very safe.

Seat Belt Pre Tensioning Seat Belt Pre-Tensioner systems – Designed to pull back seatbelt upon impact in coordination with airbag system. A part of the total SRS system. Normally found mid-height or near the floor in the door post. Contains an explosive charge similar to shotgun shell. Avoid cutting into this as it may go off.

SUPPORT OPERATIONS Lighting Scene Extrication Area Patient Assessment Helicopter LZ – Review LZ set-up and video (optional)

GAINING ACCESS Hand Tools – Types of hand tools Power Tools - Types of Power tools Normal Means – Unlocked or open doors and windows, “Try before you pry” Alternate Means – Front and rear windows, locked doors and windows

EMERGENCY CARE Patient Assessment – 90 second survey. Determine ALS vs. BLS and Rapid extrication vs. routine. Upgrade early, upgrade fast. MOI?? Coordination with extrication personnel Patient Immobilization

DISENTANGLEMENT Coordinate with EMS personnel regarding route of removal. STOP, LOOK, THINK, PLAN OF ACTION, ACT

Disentanglement techniques Door Removal Roof opening and removal Seat Displacement Steering Wheel Cutting Steering Wheel Displacement Pedal Displacement Dash Roll-up

Remember, when performing extrication operations on a vehicle, for every action, there is a Reaction.

REMOVAL & TRANSFER Assisting with Victim Removal Coordinated Be Prepared Good Communications Transfer of pt. Care Proper documentation and pictures (if possible)

TERMINATION OF INCIDENT Scene Clean-up Inventory equipment Check equipment function Place apparatus back in service Decon all equipment as necessary per department SOP’s

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