Has anyone had a rescue/extrication that gave them a surprisingly difficult time lately
We had an MVC the night before Thanksgiving that gave us a tough time because of how one patients legs were pinned causing a longer extrication time than we would have liked.
It was a driver to driver head on between a Ranger and Taurus causing severe damage to both vehicles.
What caused the difficult extrication was the damage to the Ranger from the lower profile of the Taurus. The way they hit pushed the drivers side of the engine compartment into and under the fire wall causing it to push up against the drivers legs, pinning and wrapping around them. The drivers door was also damaged in a way that the door latch was knocked open in the wreck but we couldn't open the door more than a few inches due to it putting pressure on the pt's legs.
We had to use the sawzall and prybars to initially get access to the door latches so we could take the door off.
Once the door was off we were able to see how the pt's legs were entangled in the dash/firewall. We used a combination of the hyd tools, sawzall and prybars to clear the legs. We also cut both of the A posts and windshield then did a dash roll from the passenger side which enabled us to get the right leg free.
After that, we were able to gain a couple inches of room between the door frams and the drivers seat and using the spreaders, we made just enough room to work the left leg out. We then backboarded the patient out through the drivers side and into the medic unit.
The extrication took about 45 minutes whci I believe was a good time for the type of entanglement we had and the difficulty getting access to the pt's legs due to the excessive damage of the vehicle.
Luckily the pt was stable and conscious the entire time. The medics were able to gain access easily and provide meds using an EZ-IO. The pt c/o pain in his back with some minor trauma to his face from the airbag. Alot of his trauma was lower extremity, where he had an open fracture and avulsion to his lower right leg with a fractur/dislocation of the ankle and some deformity to his lower left leg as well.
I think the call ran very smoothly other than when it first came out the caller wasn't sure what hwy they were on so it delayed the response a few minutes. Once we were on scene the whole operation went smoothly. We had been called in for mutual aid and performed the extrication The two fd's worked well together with the county fd Having IC and my Chief being in charge of extrication. We were able to work well with the ambulance crews as well with their access to the pt being quick and neither of us getting in the way of each other while performing our duties.
I was just wondering if anyone else has had a difficult extrication/rescue lately. Not just MVC's but any type of rescue. (Water, High angle, Low angle, Technical)
I'll try to get some pics from it so you can see what the damage looked like. It was definitely one of the worst ones I have seen in a while.
We've had MVC's where a Ram hit a Neon on the driver side and had to get a wrecker to pull them apart and such
What kind of strateies did your dept use on it with pt care/extrication and using the wrecker?
Not really "difficult" but a challenge and time consuming.
About a month ago (temps in the 40's) we were called for a bicyclist who fell 30 feet from a cliff into a creek. Dispatch came in with punctured lungs, broken legs, not breathing, etc. Had an extra engine and truck company respond (initial units to respond was an ambulance and engine). Arrived on scene and had to make it down to the creek, the pt was talking, out of the water, was confused, no punctured lung, good lung sounds, no obvious deformities, but pt appeared to be concussed.
The pathway we went down was muddy and steep and the next best (flat way) to extricate was about a quarter mile walk in the creekbed. So the ladder set up a rope system and a stokes was lowered down. We had the pt on a longboard and initiated an IV. Overall it took about 40 minutes to get the pt out and we treated for hypothermia and trauma. The only obvious injury was a puncture to the R hip, but otherwise was doing OK......bike helmet definately saved his life.
The basic concept was use the either the our rescue or our ladder as an anchor to the the neon and the wrecker pull away the ram. I really dont remember too much of the rescue operation because my patient was on the oppisite side of impact but she was the worst. We popped her door, C-Spined her, got her to the ambulance and did all of other interventions until the first helicopter arrived and I ended up going with the helicopter and her to the trauma center so I never got to really see the process.
The other day, we had a guy who didnt turn when he was supposed to going up a hill, and went off the road and laid his pick up truck on its side(passengersside) into a utility pole and into thicket and trees. Upon arrival, we had sparks coming from the lines above that were drooping low. When we got down the hill(8ft) to the passenger compartment of the truck, we had one pt, who at first appeared to be laying across the bench seat. Turns out he was standing on the passenger door window and was smoking in the truck and only complained of shoulder pain. We stabilized the truck w/ struts and used the flat head axe and Glass Master to cut the wind shild and he walked out. We walked him up the hill and he ended up refusing care. While doing the refusal process, we were initially on the outside of the ambulance and the power lines and calmed down so to speak and out of no where, the lines started arcing at the pole and where it meets a near by house. So we loaded him up and took him to safe ground while we waited for his ride. We had two engines, a truck and the rescue on scene, and minor smoke conditions in the house once the lines started going crazy so we took two tic's and tools in the house and checked it out but all was good.
Ok, so they were separated after the extrication? Thought you first meant they were separated to get to the pt's during extrication.
Funny how you find pts just sitting calmly sometimes. We had a t bone MVC last year with a minivan ending up on its side. Not alot of damage to the vehicle but I pulled the line since we had a report of leaking fuel. Turns out it was a little old lady that got hit and my Captain said when he walked up to the car she was just sitting on the drivers window and waiting for someone to get her out of the van. Non injury in that case too.
Thats a good idea with the ladder for a quick removal.
We had a call several years ago where someone got pitched off his 4 wheeler about 20ft down over the edge of a logging road and had a possible broken femur. We were called for our 4x4 rescue and stokes. We had to take the medic crew the last 1/4 mile in our rig because of the road conditions then we got him packaged and used the winch on his 4x4 to help pull him up. It went really well and once he was put into the medic unit they got him to the airlift.
We called for airlift in that MVA in my opening post but due to recent weather we couldn't get one either.
3 years ago couple days before thanksgiving we had a single car mva. Car was bent in a U shape on drivers side over a little raised cement wall from a bridge over a little ditch, height from the road down to the ditch might have been about 10'. Couple things made this a challenge, cold blowing snow weather, no way to crib the car, steel fence post went through the car right by the driver without hitting him however post was stuck in ground and no way to remove.
Nothing we could do about weather but we chained car and kept tension on it to prevent it from going over. Fence post was going to stay due to pt laying on his side against it and no easy way to remove it. Only access to pt was from the top of the car which was now the passenger side.
After we got someone inside with pt. to help stabilize him we ended up slowly removing sections of the roof to be able to backboard and extricate pt. Wasn't pretty but 45 minutes later pt was removed. One of the strangest extrications I've ever been involved with.