Popping Doors: Tips for removing doors during extrication incidents

QUICK DRILLS
Popping Doors: Tips for removing doors during extrication incidents

By Homer Robertson

Extrication has made some huge strides since the introduction of the Jaws of Life to the fire service in the 1970s. The types of vehicles we encounter are constantly changing; in turn, we must keep up with the changes.

Most fire departments today perform a huge range of tasks, including fire suppression, rope rescue, hazmat, swiftwater rescue and EMS. On a day-to-day basis, extrication probably ranks second, only behind EMS, in terms of the opportunities we have to save lives. More people, more cars and more traffic result in more motor vehicle accidents that require some type of extrication.

We’re a lot more sophisticated with our rescue tools these days, both in how and when we use them. We extricate more because that’s the right thing for the patient; instead of pulling them across the console and going out the passenger-side door, we take the time to do it right and pop the driver-side door to avoid causing secondary injuries to the patient. Also, more fire apparatus are extrication-capable these days, compared to the 1980s and 1990s, when rescue tools were sometimes few and far between. More tools on more trucks means more training is required for the company to be proficient at their job. Having a set of rescue tools and being able to use them are two completely different things.

This month’s Quick Drill covers some points on popping doors. Today’s approach to popping doors is a lot more about technique than it is about just trying to rip and tear a door off, like we did on a 1975 Ford LTD. New-car technology is rapidly changing to include lighter-weight cars that are more crash-resistant and include all types of specialized safety systems—which in turn requires more skill and strategy.

The rescue tools cutter are becoming the weapon of choice for many. Cutting is often times faster and allows rescuers to remove sections of the car from the patient and provide larger openings patient removal. Photo Glen Ellman

One of the best techniques you can teach and reinforce often is using the spreader tips at a slight angle to apply force in and out and down motion. This simple technique helps to defeat the design of the door or hinge being spread. Remember to attack the hinge side of the door when there is extensive damage to the area around the B-post or Nader pin. Photo Glen Ellman

Perform a Good Door Size-Up
After you’ve performed a complete scene size-up and determined that patient care would be best provided by removal through the door, it’s time to step back and focus on how best to open or remove the door to provide access—and the best avenue for removal.

Doors are the most-used avenues to remove patients from a vehicle accident, so most crews have a lot of experience with them. The problem with that experience is that we get in the routine of always doing the same thing. In door-removal operations, that routine seems to be always going to the Nader pin side of the door and attempting to roll the door off the Nader pin.

That method works for a lot of your door-opening needs, but not when a larger opening is needed or the area around the B post and Nader pin are heavily damaged, making that area difficult to access. Do your crews know how to go to the hinge side of the door, or perform a complete sidewall removal that opens the entire side of the car by taking out the front and rear doors, and the B post? If not, they should.

Set the Door Up
After we determine which way we want to open the door, we need to set up the door to be opened. The set-up includes removing glass and providing a purchase point that allows better access for the spreader tips or the cutter blades, whichever is the weapon of choice.

Minimizing the potential for sharp or flying glass is important for the safety of both the patient and the rescuer. Taking care of the glass can be as simple as rolling down the window or using high-tech plastic sheeting to capture the entire piece before removing it.

Creating the purchase point is one of the most important steps in door removal. It allows you to provide access to the Nader pin area or the hinge side of the door. This access will let you take full advantage of the rescue tools by exposing the critical areas.

There are many methods for making purchase points, but one of the most common involves using the adz end of a Haligan bar to make an opening above the Nader pin area, which allows the spreader tips to roll the latch off the pin.

Another common method uses the spreader to pinch or crush the door down, distorting the door and allowing access. This same method can be used on the fenders to expose the hinge area so that the cutters or spreaders can used on the hinges.

Open the Door
We can write pages about door opening and removal, but here are a few points that need to be taught and then reinforced often.

· Unlock the door and hold open the door latch. The simple act of reaching in and manually unlocking the door will help to reduce the obstacles in the way of popping the door. You don’t need to work against a jammed door and the door lock. The same holds true for the door latch. The door wedges that many firefighters carry in their bunker gear pockets work great to hold the inside door handle in the open position while the door is popped.

· Start high and work low. After you have made you purchase point by your chosen method, the spreaders are often the weapons of choice for opening the door. Starting the spread high on the door will provide great leverage and tends not to tear the metal as the spreader tips exert force into a small area.

· Work the tips at an angle. This is one of the best tricks of the trade that you can share and reinforce with your crews. It makes a huge difference when attempting to pop a door on either the pin or hinge side. We’ve all made the mistake of placing the spreader tips straight into an opening, such as the hinges. But the hinges are designed to resist constant in-and-out force, as they do during normal opening and closing operations. By slightly tilting the spreader tips, you create a force that defeats the hinges’ design by shearing and forcing the door outward and down at the same time.

· Cutting is becoming more important. With all the new-car design improvements and the advancements in rescue tool cutters, the cutting aspect of auto extrication has become much more important. Cutters operate much faster now and with higher cutting force than what we saw just a few years ago. The concept of removing the vehicle from the patient one piece at a time has gained a lot of acceptance. Instead of making a small opening through which to remove the patient, we remove large pieces of the vehicle, such as the doors or roof.

A Final Word
There are few activities we perform in the emergency response business that save more lives than vehicle extrication. But it’s becoming harder and harder to find vehicles on which we can hone our extrication skills. You can reinforce the basic yet important points of extrication with your crews even if you don’t have cars to cut up. Take a trip to the fire station parking lot or stop by your local new car lot and identify how you would pop the doors on specific vehicles. A little discussion can go a long way at the scene of a real incident.

Captain Homer Robertson has been involved in the fire service since 1978, starting as a volunteer with the Granbury (Texas) Fire Department, of which he is a life member. He has served with the Fort Worth Fire Department since 1985 and is currently in charge of the fire equipment division, which includes the apparatus fleet.


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Tags: cutters, extrication, homer robertson, hydraulic tools, jaws of life, popping doors, quick drills, spreaders

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Comment by lutan1 on June 4, 2010 at 7:20pm
Let's not forget the all important safety aspects of popping doors- bumming should be discouraged, watch the "flight" path of the door as it opens, perhaps even consider restarining it with some webbing?

Also, don't forget techniques such as vertical spreads to make openings.

Doors are the most-used avenues to remove patients from a vehicle accident, so most crews have a lot of experience with them.
It's a shame that it's the most used- it should in fact be actively discouraged in the interest of protecting the casualties spine and to minimize twisting, as they're removed out the door.

There's a free manual to download here which discusses this exact issue and gives loads of good tactics and options to consider, as aoppossed to going out the door.
http://emergencytechnologies.com.au/psm.htm

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