A recent event that occurred between the NYPD and FDNY revealed long standing issues regarding response and performing rescues. This is a unique situation that is not the purpose of this forum post.

Instead, noting that box cribbing was not used, but instead, stair step cribbing. Having only experience using 2x4 and 4x4 cribbing in conjunction with deploying rescue airbags. There is a chance I may have missed something in the video, and can clearly see the firefighter above carrying cribbing, but was a box style of using cribbing in conjunction with the rescue airbag used?

 

Both the IAFC and NFPA advocate the following:

One thing that bothers me about this above photo graph is the pancake stacking of airbags... This has caused both injury and fatalities to firefighters according to NIOSH report below. Things change and I ask the membership for clarification on this point. Shouldn't we, the fire service all be on the same page?

This photograph on the left illustrates airbags being inflated to raise an object without the benefit of cribbing that lead to the death of a products salesman in South Dakota. Read more below:

Volunteer Fire Fighter/Fire Service Products Salesman Dies After Being Struck by Dislodged Rescue Airbag - South Dakota

SUMMARY

On July 10, 2003, a 50-year-old male volunteer fire fighter/fire service products salesman (the victim) died after being struck by a rescue airbag (high pressure lifting device). The victim was demonstrating the use of rescue airbags when the incident occurred. A set of three airbags had been placed under the rear bumper of a front end loader, coupled together and inflated. The airbags were being deflated when they separated and burst out from under the loader. The middle airbag struck the victim on the head and chest. The victim was immediately treated at the scene by volunteer emergency medical technicians and transported by helicopter to a local hospital where he was pronounced dead later that day.

NIOSH investigators concluded that, to minimize the risk of similar incidents, fire departments and fire service products distributors should:

  • provide training to all fire fighters and employees expected to use or demonstrate rescue airbags
  • follow safety rules for airbag lifting operations (e.g., use cribbing)
  • provide and enforce the use of personal protective equipment during airbag demonstrations and use

Additionally, fire service product manufacturers should:

  • ensure that information and photographs contained in catalogs, operator’s manuals and internet web sites correspond with one another and provide consistent safety information

CRIBBING 

“Cribbing” is essential during rescue operations.  In fact, cribbing is one of the most frequently used tools during vehicle rescue operations.  Gravity is inescapable; thus cribbing is used to redistribute the weight of objects into a ‘footprint’. Cribbing provides a temporary support during rescue operations.

 

more flat surface area contact = more strength = more stability

4x4 Box Crib = 48,000 lbs. Strength

6x6 Box Crib = 120,000 lbs. Strength

 

RESCUE AIR BAGS

 

The only airbags I personally have experience are the Vetter Rescue Airbags that come in a variety of sizes and shapes. Having precise control using regulators verses a airline from your engine gives you much more precise control for both lifting and raising an object like a vehicle.

 

 

 

 

 

 

If you have the budget, you can purchase snazzy models like this that have gauges and cool toggle levers. 


 

 

 

 

 

 

 

 

 

 

 

My personal preference is to go simple, save the bucks and use the simplistic valving assembly with the small yellow compressed air tank. It does not take much air to fill up a rescue air bag. My departments policy was to always use one of our SCBA bottles which always worked just fine.

 

USING RESCUE AIRBAGS AND CRIBBING TOGETHER

I am positive that there will be succinct comments shared here explaining the appropriate use of rescue airbags and wood cribbing. To keep the point simple, you use wood cribbing to first build a box to remove any void space between the ground and the bottom of the vehicle. This is done to minimize the distance the rescue airbag has to travel, which enables the bag to work to it's maximum efficiency. 

 

TRAINING WITH RESCUE AIRBAGS AND CRIBBING

This evolution is something we should all be familiar with and the best way to prepare for a vehicle trapped under a vehicle is to simulate it and use your tools, over and over again until you can do it in your sleep... you just might have too.

 

In some situations, maybe it's ok not to use wood cribbing when there are minimal lift distances involved. Again, this is not always clear and as can be seen above, is common practice among fire departments to employ when using airbags.

There are lots of lists of cribbing and rescue airbags can do if the vehicle is upside down, and absolute justification for providing both victim and firefighter safety on scene.

 

Is bigger necessarily better?

USING RESCUE AIRBAGS AND CRIBBING EXAMPLE

Speaking from experience and being old enough to have worked with neighboring volunteer fire departments when they existed in my community, I had the opportunity to respond to a vehicle, driven by an elderly gentleman who ran over an elderly woman. Raising the vehicle using Jaws in conjunction with wood cribbing was not working for fears of failure and collapse back onto the victim. My engine was called in to assist and the guys on the call were my friends. The last thing I wanted to do was have my county engine show up the volunteers, creating hostility and animosity. 

As we responded to the incident, I instructed my crew that our goal was to get on scene, use air bags in conjunction with our wood cribbing, using a coordinated set of commands and one person, my engineer, operating the air control for the filling and deflating or our Vetter Rescue airbags.

What I was not prepared for was the ladies right leg wrapped four times around the drive shaft, with multiple compound fractures, a damn good set of lungs and vocal chords and about 300 tourists watching and video taping what we were doing. Lifting the vehicle high enough for me to get underneath the vehicle safely (and with confidence) required systematic raising of the vehicle using a combination of air bags and wood cribbing. Once the vehicle was raised, a clear work area was made to enable gentle removal of the leg around the driveshaft and transfer of the patient to the spine board, and subsequent transportation to the local hospital where she was treated for both internal injuries and multiple fractures. 

The key point of our response was too quickly assemble our equipment and leave the scene sans any emotions, grandstanding or complements. Get in, get out... Everyone was happy that day and my crew worked together as a team because we had a plan and used our equipment the way it was designed.

 

CRIBBING ENGINE COMPANY STORAGE AND QUANTITIES

 

 

There are lots of lists of cribbing and rescue airbags for you to choose from.

  • How much is enough?
  • What would you share with others to be the minimum inventory for do-it-yourself wood cribbing?
  • What would you consider a minimum engine company inventory keeping in mind that we are not talking about providing a lumber yard for USAR related emergency responses, just plain old simple cribbing?

 

How many of the following would you recommend for an engine company to carry?

  1. 2 x 4
  2. 2 x 4 shims
  3. 4 x 4
  4. 4 x 4 wedges
  5. 4 x 6
  6. step chocks

Rescue Evolution Review and Refresher Training

Fire Chief Ben Waller's Rule of Opposites

"If what you're doing isn't working, do the opposite."

The Rule of Opposites has some corollaries;

1) If you can't pull, push. We used to pull a lot of steering columns with chains and either spreaders and come-alongs. Then crumple zones came along, and we figured out that was often a better technique to push the dashboard with rams.

2) If you can't lift, dig. Heavy lifting is not always possible, especially when the object is very unstable. You may be able to dig the victim out without risking the unstable object toppling, especially if heavy lift capability is not quickly available.

3) If you can't lower, raise. If you are working a vertical rescue on a 500-foot elevation and you only have 300 feet of rope, you won't be able to lower the patient to the ground. It takes more work, but you can simply complete the pickoff and raise the patient to the top, then use the trail, road, elevator, or helicopter to complete the patient evacution.

4) If you can't cut, dissasemble. I realize that this is not, strictly speaking, an opposite, but it's the rule of thumb for heavy machinery extrication. Industrial and farm machinery is made to last, and it is often tougher than our hydraulic cutters, saws, and even cutting torches. A simple ratchet set and a can of WD-40 can make an otherwise difficult extrication into a literal "nuts and bolts" exercise.

5) If one simple machine won't work, try another simple machine.
If an lever isn't working, try an inclined plane. If you are trying to lift a heavy object and can't get enough leverage, try driving cribbing wedges under the edges of the objects. It's amazing what a few wedges can lift.

6) When terminating, reverse the rescue. Stabilizing rescue and extrication scenes can be very complicated. If you're going to remove shoring from a trench or cribbing from a wrecked vehicle, it's usually a good idea to take the shoring/cribbing down in the reverse order that you built it. If you shore trench panels in the "middle-top-bottom" sequence, then the shores should be removed in the reverse order; "bottom, top, middle". We need to be just as careful about using the Rule of Opposites for rescue termination as we do when extricating the patient. Corollary #6 is also used when bedding aerial ladders. We unbed the ladder after stabilizing the truck in order to rescue or flow the ladder pipe, so we should bed the ladder prior to retracting the stabilizers. Ditto for lateral stabilization. The IFSTA aerial operations manual calls for stabilizing the uphill side first, then jacking the downhill side so that the truck is within 5 degrees or so of level. This keeps the uphill side from forcing the low side down and risking tipping the truck or overextending a stabilizer. When retracting the stabilizers, we should store the downhill side first in order to follow the Rule of Opposites.

The most important corollary is 7) If something isn't safe, make it safe. We deal with inherently dangerous situations every day. We can't control how unsafe the original incident is, but we can make it as safe as possible by wearing appropriate PPE, completing good size-up, developing and following a sensible Incident Action Plan, using Safety Officers, establishing collapse zones, demanding 100% personnel accountability, stamping out freelancing, wearing our seat belts, and staying out of Born Losers.

I'm sure that there are more of these out there. I'd be interested in hearing your ideas. Oh, and now I'll follow Corollary 8) When you want to learn, don't talk.

I updated this to include one point that I forgot in the initial post:

Corollary 9) Reverse the entrapment mechanism.
An example is the dash roll technique in frontal vehicle collisions. In most cases, the entrapment mechanism for the driver and front-seat passengers is that the dashboard and steering wheel/column get forced down and in on the patients. In this case, the Rule of Opposites calls for using our tools to move the dashboard up and out - the opposite of the entrapment mechanism. The same goes for structural components collapsed onto a patient - we use air bags, cribbing and pry bars, or bolting and a crane to reverse the mechanism.

Thanks to Fire Chief Ben Waller, Hilton Head Fire Department for this information originally posted here on the FFN that can be seen by clicking this link.

 

 

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Mike,

 

  If i remember right the initial lift NYPD ESU did on the vehicle was with " the jaws" not airbags. The vehicle slid off the jaws recontacting the patient. While video did show FDNY with cribbing I don't know if it was used or allowed since ESU was already prepping for the lift.

 

  Any rescue class I have taken that used air bags always stated that pancaking was fine to a maximum of 2 airbags. Larger goes on the bottom, smaller on top and if you lift an inch crib an inch. Don't think I would try the set of three airbags you had listed in your example.

 

For cribbing I think:  24- 4x4's (box crib 3 levels high x 4 corners), 12- 2x4's(2 per corner for box crib with a few extra's), 2 step chocks, and as many 2x4 shims and 4x4 wedges as remaining space allows. All of these would be minimums and if you have more space would add 2 step chocks and as many 4x4's as possible.

 

Best thing to have for rescue's is a 1) well stocked tool box with both metric and SAE wrenches and sockets. I've gone on a few calls where we had to disassemble vehicle from around the patient. 2) multiple power options for tools to include battery, corded and air operated. Battery power is nice but doesn't always last as long as the incident.

 

Final thought for this is that it's amazing that as well as NYC handles situations that would be a once in a career type call for most of us, they still allow the ESU and FDNY to bicker over handling routine type calls. Going to budgets it just doesnt make any sense to fund two seperate agencies to handle the same incident. ESU has its place in support of police operations but should stay in that role and unless requested for assistance. 

Unfortunately in this situation it looks like the initial lift with the jaws was initiated before proper cribbing was in place and was done in hast no planning or communication. We teach our guys for every action or move there is potential for an equal and opposite reaction, and you need to know what these potential reactions might be up down forward sideways. (If you lift there is potential for a drop).  So you must plan your actions and stabilize whatever you are moving so that is doesn’t move in any direction but the direction you want it to move, block inch by inch.

 I am sure it can be done but we wouldn’t recommend or it wouldn’t be my first choice to use jaws to lift a vehicle there is too much potential for the jaws to slip tip or even break through the metal you are pushing against ( I am sure you could overcome these potential issues with blocking proper lift points etc. if that’s all you had to work with but again  in this situation this wouldn’t have been an issue if the lift had been done slowly and had been blocked inch by inch stabilizing the vehicle)

We have the step cribbing on our trucks but mainly use step cribbing in situations where we are trying to prevent minor rock or movement of the vehicle during extraction evolutions. Its fast and easy to set up but needs to be constantly monitored to make sure nothing has changed .We prefer to use box cribbing for lifts which offers a little more stability but this is just my opinion, what we do and what has worked for us ( which I am sure will be disputed or criticized by someone on this website)

We had to lift an upside-down tractor off a farmer who was in a ditch he was face up and tangled in the tractor. The ditch had about 6-8 inches of water in it. We had called for a heavy tow truck but initiated the lift with air bags and cribbing. This situation was a huge challenge based on the configuration of the tractor and the points we could use to place our cribbing under, plus we were in a ditch and the ground wasn’t very solid. We used (2x4) would blankets to create a base and then built our cribbing from there. Movement was controlled by the IC and we crib in by inch. it was probably the most challenging lift and   crib set up we have done.  

Stacking two high-pressure air bags is fine, as long as you train prior to the real calls and follow some basic principles;

 

1. Lift an inch, crib an inch.

2. Remember that the lift force is limited to what the smaller bag can lift.  If you have a 30-ton load and a 30-ton and 20-ton air bag, you essentially have a one-bag lift, even if you stack them.

3) Lift only against solid purchase points.  This means frame rails, under rocker panels, or other solid pieces of the car.  Do not lift against anything that can shift, shatter, or break like tires, glass, or plastic bumpers.

4) Don't lift against sharp, ragged, or hot purchase points unless you like air bags that won't hold air.  Squares of tractor-trailer mud flaps work great to pad the upper surface of the top air bag. 

5) If you use plywood panels to help spread out lifting forces, use them only under the air bag/air bag stack.

6) If you need to get a wheel out of the way, use the air bags to life the rocker panel or frame rail until the tire clears the ground, then use an impact wrench to remove the wheel and tire to create more space.

7) Color code your air hoses and use "Up on red", "Hold yellow", and "Down on blue" to reduce confusion and make the operation safer and easier to command.

8) A good air bag operation takes at least 3 to 4 people.  One to place and observe the air bags, one or more to maintain the cribbing stack, and one to operate the air bag system.  That does not count the Rescue group supervisor or rescue company officer.

9) ALWAYS observe the lift to ensure that the air bags are not shifting sideways, even a little. If there is a shift - STOP, crib in place, deflate, and re-stack the air bags.

10) You don't need to do a sky-high lift - just lift enough to free the trapped person and to have enough room to move them onto a spineboard without creating further injury.

 

This was a little random and I'm sure that I missed something that the rest of you will point out.  :-)

 

 

Stacking air bags is like stacking basketballs.

 

Try this: you can palm two basketballs, pin them together, and have a fairly stable, opposite-resistance situation.

 

Now try to palm three basketballs.  The middle basketball will squirt out to the side every time.

 

That's the difference between stacking two HP air bags and stacking three.

 

The round bags shown above have steel plates in the centers.  They have hollow threaded cores that essentially convert two or three of these bags into a single air bag with multiple, connected cells.  There have been at least two fatal training accidents with these air bags.  I believe that in both cases, the threded cores were not used for very heavy lifts and the middle bag failed laterally, striking the operators and causing the fatal injuries.

 

I've also seen this particular bag stack tip a load over due to trying to lift a heavy load an unnecessary high distance, even when the threaded cores were in use.  Remember, a few inches is all most victims need to be freed from entrapment.

 

 

We have always worked in the same manner as Allen. The stepping being inserted under the frame then removed air from the tires to allow the load to settle on the stepped cribbing  for initial stabilization, then as the lift proceeds cribbing is built up to guard against a fall . We also carried several pieces of three quarter inch ply wood (4 toot square )for use as a base in soggy conditions. Communication is paramount during a lift to cover all the angles.

Years ago, I attended an Ag Rescue course and one of the key things I learned and used during my career was the need to have both SAE and metric sockets with an air wrench to not use Jaws to spread things apart, but instead methodically take whatever it is apart. This is critical for limb entrapments. It's cool to hear that you apply this tactic for MVA's.
Exceptional analogy with the basketballs Ben. When I was researching this post, I came across the airbag related fatalities and wanted to draw attention to the dangers. Your comments clarified this point.
I figured out that the key to a successful post is not the number of comments necessarily, but the number of views now provided for each forum post. There are very few comments compared to the vast majority of FFN members that just quietly read the content and learn from what we share.
Interesting way to teach, sans any two-way communication but the support and comments from our senior members sure helps validate and expand on the various forum posts making the FFN site relevant and an actual learning tool for firefighters all over the world that don't have access to our resources or for others to compare to how they do the same thing.
When they spec'd the truck rescue was our number 1 call type. With that in mind the truck was set up to carry multiple styles of tools so we could usually attack a complicated rescue from different angles without having to share tools. Also helped that 2 of tje chiefs are state level rescue instructors including ag rescue. Bu the way both disassemblies involved van chasis commercial vehicles with a bulkhead behind the passenger compartment
great post all the way around captain. come here to learn something everyday and always look for your post or comments to gain that opportunity

That system is fine if your plan is to stabilize the care so that it will not move or collapse during a standard extrication - one that does not involve a lift.

 

Planning a lift with air bags is different.  You have to crib to MOVE the car, not to make it immobile as we do in regular extrications. 

 

Deflating tires for air bag lifts is a waste of time, since the air bags will lift the tires off of the ground.

Ben we  have six stations that share one heavy rescue,and only the heavy rescue has air bags .Since it may be a while before the heavy rescue arrives ,we act as I described . If we have an ETA on the rescue within minutes then our SOGs would change.
Thank you Big O! It's all about trying to come up with ways to both share information but make it fun at the same time for firefighters that may not have the same resources or educational opportunities.

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