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Auto extrication question
Last night my fire dept had a auto extrication training and one of the guys said to cut the a post than go to opposite side and cut the a post than go back across and cut the b post then go to opposite side and cut the b post than go back and cut the c post than go to opposite and cut the c post he said that was the way they taught him in class in bloomington?? wouldnt it be easier to cut the ABC post on one side then go to opposite side and do the same???
Replies to This Discussion
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Permalink Reply by Drew Tenhundfeld on
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This doesn't look the safest way to remove a pt from a wreckage. Out of the 10 yrs in the fire service only one time that I would have had a chance to fold a car. Fortunately the pt was able to self extricate.
When this type of extrication really becomes unsafe is when more than half of the floor board has been cut. This is the same principle to flapping a bus roof back or roof of a car. Either you make a crease across the roof or a cut to fold the roof.
This procedure was done using a chain package and a spreader. Attach is a picture of those 2 items. But, what are the chances of actually extricating that way? Out of 10 yrs one time where this would have worked.
I would perfer this way over cutting a car in half. the main reason that I have 1. Cutting into fuel line with a hot blade. when folding most of the time the line will kink. 2. When moving the cut end of the car the chances of knocking the stablization away from the car is greater. When I showed this in a class setting the stablization remained in place. Also, notice the struats for stablization remain in place.
We all have to remember that every extrication is different so always have plan B & C ready. There's never a wrong way.
Be Safe - Attachments:
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100_0301.JPG, 1.2 MB
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Permalink Reply by Ben Waller on
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Drew,
When cutting the car in half, if you ensure that the two halves are completely severed, the half with the patient won't move when you drag the other half away.
There is no cutting the fuel line with a hot blade when bisecting the car - the fuel lines typically run through the hollow of the driver's side rocker panel. Making the relief cut with an O-cutter crimps that line with a cold blade. I've done this numerous times in the junkyard and three times on actual calls, and have never lost more than a couple of drops of fuel. The big fuel leaks from complete-inversion rollovers are usually from the fuel filler or a disrupted fuel line elsewhere on the car, not from cutting into the rocker panel.
As for your roof flap analagy, that's a lot different than flapping a floor. In upright cars with a roof flap, the flap is usually at the c-pillars - well away from the patient. That's not the case with your floor flap method. Your cone-along/wrecker/whatever chain or cable method supports the upper end of the flapped part of the floor, but there's nothing but damaged floor pan keeping the bend from shearing and becoming an instant guillotine for both the patient and any rescuer that's in the way.
Why would you ever want to flap a bus roof...ever???
It is extremely time-consuming, manpower-consuming, and in the case of school buses it creates multiple loose sheet metal panels - more of those guillotines hanging over the patient and rescurs. Simply pushing the roof back up with hydraulic rams or high-lift jacks, or tunneling and removing the passenger seats from the inside are faster and more effective than roof flaps on buses.
As for "there's never a wrong way", I couldn't disagree more.
If there's never a wrong way, we'd never have firefighter LODDs or additional injuries created at extrications. Not only are there wrong ways, there are often several wrong ways at the same incident. If there was never a wrong way, no one would need extrication training, nor would we need to wear PPE of any sort while working wrecks.
Basic extrication principles include 1) attacking weak points on the vehicle, not strong points and 2) eliminate the possibility of uncontrolled failure of vehicle parts, especially when we've created a weakness in the vehicle.
Attacking bus roofs violates principle #1 above, and your floor flap method violates #2.
We have to consider not only what our extrication techniques do FOR the patient, but what they might do TO the patient.
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Permalink Reply by Frank Svitak on
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WOW ! What a waste of critical time jumping back & forth from side to side. If you are going to take the roof off, it doesnt matter which post you start with, but just keep moving in one direction around the vehicle. If you have two cutters, have each one start at either the a or c post & work together as a team both cutting the same post as you move along. I have taken vehicle extrication 1, 2, & 3 at the Camden County Fire Academy in Camden County, N.J. & they NEVER said to jump around like that. You have to remember the patient. You are dealing with that critical hour and you need to act as quickly & proficiently as poss. to get that patient extricated. Jumping around like that only wastes time and energy.
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Permalink Reply by firefighter1and2 on
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never thought of running two sets at once wait till next extrication class thanks---I also like the cut up hose over the post so no one gets cut.
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Permalink Reply by lutan1 on
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There is something called the golden hour which as more research is accomplished will become the golden 30 minutes. The sooner you get the victim(s) out of the car, the better chance they will survive the event.
There's also been a lot of research Mike suggetsing that the whole Golden Hour concept is a load of rubbish- not sure which way I stand on that one. Obviously the quicker they're out, then the better they'll be I would have though...
With that said, do you only have (1) one rescue spreader / cutter unit? Do you only have (1) one engine responding to this MVA? I don't think so... Every fire truck around here has a set of Jaws and we respond a truck company to assist us which brings a lot more equipment and resources.
For our response areas, you only ever get 1 rescue truck with 1 set of equipment- that's the way our CAD system is set up. It works well. If you need more, you call for it. A non-rescue appliance (One that is approved by the State) such as a pumper or tanker is not allowed to carry rescue equipment.
Another option is to simply spot your apparatus closer to the accident scene and use the reel line off the engine to power the jaws, spreaders or cutters.
Again, not everyone is using reels- we went for nearly 10 years without a reel set up on our rescue.
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the patient is all I could think about, im like ok they are going to be dead by the time you get em out.
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lutan,
If you have the room to lift the loose piece of the car with rams or jacks, then there is probably room to get access to the sides, remove a door or two, and extricate through the side.
The photo shows a lot of room around the sides, and a ram supporting the car at about a 45-degree angle. That's a lot of room to use other approaches.
I understand "never say never", but this one looks like its not the quickest or safest option.
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There are at least two other options prior to using the "crack the egg" technique.
1) Tunnel the hatchback or trunk. It's fast and effective, and doesn't involve the intentional destabilization of half of the car. The only vehicles that trunk/hatchback tunneling won't be effecive on are hybrid electric cars with the high-voltage battery built into the front trunk wall or a complete roof crush between the trunk and the front seats.
2) Hook up a wrecker and pull the car out of the ditch, then do a standard overturn extrication in the street. I know that moving the car with the patient trapped is pretty radical, but it's good option if the patient is dying. If you have a vehicle-mounted winch, a wrecker with a driver that follows instructions, etc. then you may be able to simply drag the car out of the ditch, pop a door, and package the patient.
If the situation really is a last resort, then use a FAST last resort that uses less manpower and equipment and doesn't endanger the rescuers like having half a ton of car hanging over them does.
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Permalink Reply by Walter on
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when i had my extrication class we had personnel on each side and cut the post back and forth we just handed the tools across the vehicle. another idea is if some one is using the O-cutters on one post someone else could be using an electric saw saw. those are sometimes faster the the cutters. especially when the c post is long like in some luxury cars.
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I've done controlled roll-overs in anger. Great technique that works well, but as you've rightly said, it is pretty radical and has loads of hazards associated with it.
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Ben
I can understand that the car has to be completely severed and I understand the method. But, I also realize that getting the roof and floor board completely cut will take some time to complete.
Not for sure what a O-Cutter is (I believe you mean a hydraulic cutter). When starting with a relief cut I agree 100% with you. I have seen guys start from one side of the car and go to the other side with a sawzall.
With my comparison of flopping a roof you have to make a relief cut to do this. This is the same type of cut that needs to be done when folding a car and even folding a bus roof. A relief cut has to be made. I also agree with you on the bus. When and why would you have to do this. Everything that you said about the bus I agree with. I learned how to do this doing a train the trainer class. When I do the class room part of the training I show this but I do not do this method out in the field. Now if the bus is on it's side I can see pushing the roof away from the bus to gain a wider access in.
From the rollovers that I've seen and even rolled myself for training the floor board was completely intact. If the floor was compromised during the wreck I can see it rip when starting to lift. If lifting unevenly ripping could happen.
Basic extrication is attacking the weak point. But, theirs time when you have to attack a strong point to remove a pt from the wreckage. When rolling the dash or pushing a relief cut needs to be made at the A post by the rocker panel. This is a strong point of a vehicle. Maybe compromised/ may not be.
As far as not being a wrong way there's not. Every extrication is not text book. Never said you didn't have to be safe. There's ways that you think that are wrong but is the fastest way to get you pt out. Every extrication is not the same, ever wreck is not the same. So to say theirs wrong ways, I would have to say that your wrong. What might be wrong on one scene might be right on another. If plan A doesn't work than we have to go to plan b. This maybe the wrong way in someones eyes. This is why someone (IC) needs to look at the big picture while the rescuer is piecing the little ones together.
As far as the picture is concerned that was at a training. If I can get the pictures from the PD from the one accident I'll post that so you can get a better view.
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Drew,
I'm astounded that you would continue to argue that "there's never a wrong way" to do an extrication, then argue that the way I recommended is wrong.
If there's never a wrong way to extricate, then why do we need to train at all? If there's no wrong way, then why would we need to train on a supposed right way to do it?
I hope that you never have to defend your attitude in court. If you do, tell the court that "there's no wrong way to do it". After all, you won't have to convince me, you'll have to convince the jury.
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