The Social Network & Community JUST for Firefighters
Extrication on a priority 3 patient.
Last night we responded to a 2 vehicle t-bone accident with 1 patient trapped. I was first on scene with my pov and decided that we'd have to pop the driver side door off to get this patient out. I had the spreaders in my hand when I noticed the patien was not covered up with a blanket. I asked one of our FF to go and get one. My captain tells me we dont need one (the glass is already broken) I told him that we're not popping this door tell she's covered up. I know sometimes you dont have time to spare and you need to get the person out NOW. She had no life threating injuries and I wanted to make sure that she was covered. I've always been tought to cover the patient up. Was I in the wrong for telling my captain no in this case? He was not bad with me at all, he just thought I was wasting time. What would you have done?
Replies to This Discussion
-
Permalink Reply by Chad Eason on
-
I would have done the same thing. Sometimes as command staff we get tunnel vision just as bad as anyone else. We start thinking ok, we got get the patient out and nothing else matters. As a captain, if one of my guys told me that, it would have snapped me back to reality and I would have thanked him later. It has happened. Just because we are command staff does not mean that we are not human. I think you did a good thing.
-
Permalink Reply by BillySFCVFD on
-
Cover TJ cover to keep flying shards of glass or metal from puncturing Pts skin or eyes. For every action there is an opposite and equal reaction. Those jaws can cause a lot of action. You were right for taking charge with that demand. TCSS
-
Permalink Reply by Ben Waller on
-
Current extrication best practices call for entrapped patients to be protected with both Hard and Soft Shielding. This has been around for 20 to 25 years, so it's not new.
The best Soft Shielding is a fire-resistive blanket. Not only does it catch glass dust and shards and keep them away from the patient, it will catch small projectiles that may fly around when the umpteen-thousand-pound hydraulic force opens the door. More importantly, the fire blanket protects the patient from FIRE. If there's a flash fire, the blanket provides a barrier between the flames and the patient's skin.
The best Hard Shielding is simply an old wooden short spine board or similar homemade barrier board. Lexan sheets with hand holds cut in the edges are great, because you can see through them. Hard Shielding protects the patients from tool slippage, projectile injury, tool breakage, etc.
The bottom line - the patient didn't wear his/her turnout gear when they had the wreck. We wear ours for safety. Doesn't the patient deserve the same level of safety?
Tell your captain this - the fire blanket is the patient's turnout coat, and the barrier board is their helmet.
We're supposed to be there to do what's best for the patient, NOT what's easiest for us.
That includes protecting the patient from common extrication hazards.
-
Permalink Reply by T.J. on
-
Right on Ben, I thought they dropped the "rule" on the barrier board do to it might put pressure on the patient?
-
Permalink Reply by Jenny Holderby on
-
ALWAYS cover your patient with a blanket or tarp. Your patients safety is your first priority.
-
-
T.J. - excellent question.
Nope, you just have to include the barrier board in the space listed in the 5-10-20 Rule.
For those that may not be familiar, this rule calls for us to leave 5 inches of clear space between an undeployed side impact airbag and the patient or barrier board, 10 inches between a driver's frontal airbag (steering hub-mounted) and patient/barrier board, and 20 inches between an undeployed passenger frontal airbag and patient/board.
If there's no side airbag or air curtain, you can put the barrier board wherever you want. If the airbag in question has already deployed, you can put the airbag wherever you want. If you have controlled the vehicle's electrical system and it's been dead for 2 minutes or more, then you can use the barrier board with 99.9% confidence that there will be no accidental airbag deployment.
If you "peed and pry" prior to cutting or spreading, and only cut or use purchase points on BARE METAL, you can use the barrier board wherever you want.
There have only been a handful of rescue-induced, post-accident SRS airbag or air curtains= deployments in automotive history. We need to protect the patient from the most likely hazard. Broken glass, sharp metal, projectiles, explosive tool or vehicle part failures when using hydraulic rescue tools, and even vehicle fires are much more common than accidental airbag deployments. Those are the primary hazards from which we need to protect entrapped patients.
-
Permalink Reply by Brian Dumser on
-
"I definitely would ask for a blanket to cover and protect pt. and if some one is holding c-spine,them also." - Barry
BINGO! That's our protocol also.
-
-
I'm used to the patient care personnel wearing turnout gear and helmets, so it's not a big deal if the soft shielding covers them or not - they're protected either way.
-
Permalink Reply by Korrey on
-
You did the right thing by telling your Capt. that you wanted to cover her up first. When talking to our superiors we all have to be tactful also. No matter what the situations is were all safety officers when those tones go off. Keep up the good work and stay safe.
-
Permalink Reply by Oldman on
-
We always cover the occupant, except we have a reinforced vinyl shroud with a clear vinyl window to protect from glass and small objects while we are opening the vehicle. Of course we disable the electrical system, and shield against SRS deployment.
I'll add something maybe some do not know about the vehicle electrical system.
I took a class presented by Todd Hoffman, Exec. Dir for Scene of the Accident. In his presentation, he related an incident where the FD "thought" they had the electrical system controlled. To make a short story long, the occupant had a cell phone plugged into a cigarette lighter charger. Even after the FD cut the battery cables, the cell phone battery back flowed the few milliamps it contains into the system, and this was enough to trigger the SRS. Luckily, the patient had been removed a few minutes earlier and there were no injuries to rescue personnel. He said some probably had to change shorts though.
So in addition to the 5-10-20 rule and shielding, I now also check for charging cell phones, mp3 players, etc.
-
Permalink Reply by Joe Stoltz on
-
I agree that you did the right thing by covering the patient before proceeding.
We have a few "barrier boards" that are made of 1/8" plexiglas or lexan, don't know which; these have regular brass handles mounted to them so that one person can hold them in place against the inside of the car during extrication proceedings.
Some departments that do extrication as a competitive sport have smaller lexan pieces mounted on wooden handles so that the person holding the shield can be well out of the way of the tool crew.
Thanks Ben for the reminder on the 5-10-20 rule.
-
Permalink Reply by Tony P on
-
Lutan - where are you? An Australian perspective on this thread please.
I can't give one as I'm not in a Rescue Brigade. We tend to just stand around looking pretty at an extrication... Not really - there always seems to be something that needs to be held for either the extrication creew or the ambos.
© 2024 Created by Firefighter Nation WebChief.
Powered by
