This is a technique that we do not use, however I have heard that people do it this way. I dont feel there is no need to do this. What are your thoughts of why and why not.

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Luke,

In tilt knuckle failures, even if it's not an explosive failure, the lower half of the column and the dashboard may still have the patient's legs trapped. If that's the case, then the pulling technique was a waste of time and effort, at best.

Ben
Cutting the steering wheel from below the center section allows for up to 6 inches of clearance.
Now their ARE hazards associated with the technique as Ben stated, but if the airbag has already deployed, you can half moon the steering wheel much quicker than other techniques.

It all goes back to someone truly doing a good job at assessing the impact damage, tension and tactical decision for the best and quickest choice to take. This is why in an auto extrication class I spend alot of time looking at damaged vehicles before we break out the tools, to understand impact damage, parts under tension, and making tactical decisions before formulating a plan.

If the airbag is already deployed and the only entrapment is the bottom half of a steering wheel then the half moon is the way to go. Done this twice in my career.

But if you do this be sure there is no underlying entrapment with the victim's shins and the lower (hidden) dash, or the victim's feet with the pedals, etc. as when you go to move the patient, that is not the time to determine... wait we must now roll the dash fellas.

AS WITH ALL TYPES OF INCIDENTS, PROPER SIZE-UP PROVIDES MORE POSITIVE OUTCOMES...

I have never cut through a steering column during a real emergency, (only training) as others have stated, very explosive and the unsupported column can cause further injury. Plus if the column is already resting on the victim, most likely the dash or lower dash is too, so go with the standard dash roll for full view and greater clearance.
Ben,

I don't want to get into a tit-for-tat debate here. I am familiar with the method of lifting a dash of which you speak. It doesn't work all the time and can put the steering wheel in a more precarious position.

I have never seen or talked to someone who can truly use the word EXPLOSIVE when it somes to cutting a column at the knuckle. Will it pop forward, YES, but it is easily controlled by a pair of hands. Do you need to careful due to the proximity of a patient, YES. Doesn't this apply to all extrication techniques?

I guess we have to agree to disagree on this one. By the way, should I be offended by your last statement?
On September 27th, I wrote, "I've tried and tried and tried in training to get these to fail catastrophically- hasn't happened yet. Also remember that we generally only need a small amount of room to untangle someone- very rarely do we need to pull to the point where it may fail anyway."


Fail, yes.

Explosively, no.

I also wrote in another reply somewhere that either Ron Moore, Ron Shaw or Steve Kidd (I can't honestly remember who, but all are considered guru's in the extrication world) wrote an excellant article about this exact topic and agreed that it can be done and that they don't fail catastrophically.
Let me rephrase as I think we are talking about 2 different cutting locations things. The steering wheels I have removed have been cut a nylon type knuckle joint. NOT the actual column itself.

Sure the column itself could be made from an exptic or fortified metal. If the column was physically cut and not a join than sure, that could be the case.

Your just not gonna let that dashlift go are you? :)
Jeff,

Dash lifts give you lots of room with a small investment of time and effort.
They also keep the tools away from the patient and out of the SRS deployment zones.

Ben
Agree 100%. It is definatly a go-to technique and one that all personel responsible for extrication should be familiar with and proficient in.
Hey Bull, Too many reasons why this is a bad idea... removing the roof, B post, moving the seat backwards, maybe even pushing or pulling the dashboard up and out of the way... but taking the time to cut on something that has an airbag and explosive charge in it... and a patient still in the seat? not a good thing... besides, remember the airbag scene in Final Destination?

That's right Mike- if it happened in the movies then it must be real, huh? :)
Hello? I do live 100 miles from Hollywood don't you know. Are suggesting that the photo above is not real? Don't you believe what they show you on the tube? Seeing is believing... What's really scary is the number of people who actually believe this... I guess it's called job security... : ) Mike
If only columns were made of what appeared to be plastic...

Make our jobs a shitload easier!!!!

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