1. Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 51-1 Chapter 51 Vehicle Extrication

2. 51-2 Objectives

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

4. 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

5. 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

6. Equipment 51-6

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

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

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

10. 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

11. Scene Size-Up 51-11

12. 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

13. 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

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

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

16. Vehicle Stabilization 51-16

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

18. 5-10-20 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

19. Laminated Glass 51-19

20. Tempered Glass 51-20

21. Protect the Patient 51-21

22. Simple Extrication 51-22

23. Complex Extrication 51-23

24. Degrees of Entrapment No entrapment Light entrapment 51-24

25. Moderate Entrapment 51-25

26. Heavy Entrapment 51-26

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

28. Removing the Patient 51-28

29. Removing the Patient 51-29

30. Removing the Patient 51-30

31. Removing the Patient 51-31

32. 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

33. 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

34. Questions? 51-34