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11 Minutes in the Street - MVC Subject Pinned
You are first due at an Automobile Van verse Pedestrian accident with a subject reportedly "under the vehicle - unresponsive and breathing". Viewing the following picture from your apparatus officer's seat (windshield size-up) What are you going to do next?
What decisions are you going to make? How are you going to handle the good samaritan's willingness to extricate "YOUR" victim? Who are you going to call for assistance? Do you have a plan (if and WHEN) your tactical decision is not popular with these bystanders? or are you going to become another observer?
Tick tock, tick tock - time from the scene to OR is ticking...
Replies to This Discussion
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Permalink Reply by Roy Walker on
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CRIBBING AND AIR BAGS TO HANDLE EXTRICATION APPROACH SMARITANS RESCUE TEAM AND DISPLAY COMMAND PRESENCE FAILING THAT LEOS TO CONVINCE THEM.
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Permalink Reply by Derek R. on
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The first thing I would do is get those people away from there, and mention that they could kill him by lifting that van and pulling him out. The release of that much pressure on the body is too much shock. I'm not sure of exact details, and hopefully someone can fill in the many blanks for me, but I think it has something to do with the pooled blood in the body from flow being restricted, and the sudden release of pressure and getting the poisoned blood through the system. Again, there are many blanks to be filled here, but I hope I'm making some kind of sense. Either way, leave the victem where he is, he's still breathing. Make the call for advanced life support so as to get the right meds in him before extrication, and constantly monitor vitals
Hey, I tried. I expect to learn from this.
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Thanks FETC, I will be keeping an eye on this one for sure. This is something that could happen anywhere, anytime. Great post by the way.
KSHF
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Permalink Reply by Ben Waller on
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1) Have law enforcement control the well-intentioned bystanders and get them out of the way.
2) Ensure EMS is ready to treat the patient.
3) Chock the rear tires on both sides
4) Crib beneath the A posts on both sides.
5) Lift the front bumper with high-life jacks (farm jacks) about 8 or 10 inches.
6) Pull the victim out in-line to a long spineboard and move him away from the vehicle.
7) Have the engine crew help EMS with the patient while the rescue crew lowers the vehicle and removes the cribbing.
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Permalink Reply by WestPhilly on
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Allow me to take a somewhat unconventional approach. Is it possible the well-intentioned civilians have forced our hand with respect to standard rescue procedures here? That is, do we really want to have the bystanders lower the vehicle back down on top of the hapless victim? We might be better off having a couple FF's grab a piece of vehicle while two other FF's pull the guy out. Not text book by any means, but under the circumstances........?
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I don't think the bystanders have the vehicle off of the patient. It looks as if they're just bounding it up and down on him. My response was based upon that scenario.
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Rolling the vehicle off of the patient will almost always cause additional/more severe injuries to the patient.
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Permalink Reply by DJ Easter on
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Good point WestPhilly. If the van has already been lifted, any damage has been done. Lets get some cribbing to hold it up and get EMS better patient access. C-collar and backboard once the vehicle is stabilized. And of course get ALS on the scene and working.
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Oh Ben, you're so conventional. I think this picture must have been snapped on the up-bound, so to speak, cause it looks to be off the guy.
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Permalink Reply by FETC on
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4/27 - UPDATE - Ben is on target -
I have seen one of these go bad for the first due crew. The bystanders feel they are strong enough but the drivers side suspension is still crushing the victim's pelvis and the left front wheel is clearly on top of the victim's "openly exploded" femur fx..
When you ask to leave the lifting to the professionals, the biggest bystander decides to get mouthy. You ask for him to step back onto the curb but they start pushing you around.
Now what?
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