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Hydraulic Ram: The Forgotten Tool
THE CUTTING EDGE
Hydraulic Ram: The Forgotten Tool
Use the hydraulic ram to create more space in the passenger compartment
By Brad Havrilla
During extrications, the hydraulic ram seems to be the third tool of choice, following cutters and spreaders. This is only natural, I suppose, as we’re taught to spread the doors and cut the roof pillars and the hinges. The only use for rams has been to push the dash.
I’ve watched European rescuers use rams extensively to make space in the passenger compartment following a crash. This technique works very well. Note: The vehicle must be stabilized first, especially when moving metal instead of cutting metal, as the vehicle will shift. You must anticipate and manage this shifting; it’s gradual and not dramatic, but you’ll see the car change position ever so slightly. This only makes sense since the car is changing shape.
You can use the ram to put the car back into its engineered position. Following is how you can accomplish this task on various types of vehicle crashes.
The Side-Impact Crash: Imagine that the driver-side door has intruded into the passenger compartment 12–18 inches and is compressing the patient between the door and the center console. Most rescuers think that spreading the door is the proper technique here; however, I’ve found that doing so just increases the pressure on the patient. Instead, try the cross ram technique, which involves finding a hard anchor to push off of—this could be the opposite door, seat back, rocker panel, floor panel or the transmission hump in the backseat area. Carefully place the ram behind the patient if possible and relocate the door off the patient. The door can then be removed using the spreaders or cutters.
The Dash Roll: In training we’ve all made relief cuts and pushed a dash up and practically across the parking lot, exposing the entire passenger compartment. And when doing so, we probably used a perfectly good car with no front end damage. This doesn’t help create muscle memory. Instead, practice this technique with a mannequin in the car, and have the forklift operator or tow truck operator push the dash down on the patient to simulate a head-on or frontal offset crash. Using a short ram, try to relocate the dash from inside the car. The breaking of plastic in the dash is to be expected until you encounter the Boron steel bar that runs through most dashboards. The center console will be attached to the transmission hump and may need to be cut.
A second technique: Simply slide the ram between the seat and the door, and push off the floor and raise the A-post. Only try this in the passenger compartment side without a patient. Keep changing the angle of the push to raise the dash. This can be done while other operations are underway.
The concept is pretty simple: Push the metal back out from the inside. In many cases, the ram can be operated from the outside the car. If it’s necessary, a rescuer can get into the backseat or lean in with their upper body to operate the ram to make the space necessary to relieve the entrapment. The accompanying technique to moving the metal that’s entrapping the patient is the roof removal.
The Rollover: If the roof has been pushed into the passenger compartment, it can be easily manipulated off the patient by using some cribbing to distribute the pressure of the ram, and find a hard spot on the center console or some of the other areas to push off of. By pushing the roof back off the patient even 6–8 inches, this gives the paramedics room to establish an airway and manage the patient’s C-spine while space is being made to place the patient on a backboard and remove them from the car.
Remember: Always train on vehicles that have crush damage to them and incorporate a mannequin or comparable patient. This allows us to establish proper muscle memory when we practice these rescue techniques. And don’t forget to always work safe!
Brad Havrilla is a 21-year veteran with Palm Beach County (Fla.) Fire Rescue, where he is currently assigned to the training division. Havrilla is an international extrication judge and the past vice-chairman of the IAFC Transportation Emergency Rescue Committee. He was the recipient of the Harvey Grant Excellence in Rescue Award in 2004.
Copyright © Elsevier Inc., a division of Reed Elsevier Inc. All rights reserved.
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Hydraulic Ram: The Forgotten Tool
Use the hydraulic ram to create more space in the passenger compartment
By Brad Havrilla
During extrications, the hydraulic ram seems to be the third tool of choice, following cutters and spreaders. This is only natural, I suppose, as we’re taught to spread the doors and cut the roof pillars and the hinges. The only use for rams has been to push the dash.
I’ve watched European rescuers use rams extensively to make space in the passenger compartment following a crash. This technique works very well. Note: The vehicle must be stabilized first, especially when moving metal instead of cutting metal, as the vehicle will shift. You must anticipate and manage this shifting; it’s gradual and not dramatic, but you’ll see the car change position ever so slightly. This only makes sense since the car is changing shape.
You can use the ram to put the car back into its engineered position. Following is how you can accomplish this task on various types of vehicle crashes.
The Side-Impact Crash: Imagine that the driver-side door has intruded into the passenger compartment 12–18 inches and is compressing the patient between the door and the center console. Most rescuers think that spreading the door is the proper technique here; however, I’ve found that doing so just increases the pressure on the patient. Instead, try the cross ram technique, which involves finding a hard anchor to push off of—this could be the opposite door, seat back, rocker panel, floor panel or the transmission hump in the backseat area. Carefully place the ram behind the patient if possible and relocate the door off the patient. The door can then be removed using the spreaders or cutters.
The Dash Roll: In training we’ve all made relief cuts and pushed a dash up and practically across the parking lot, exposing the entire passenger compartment. And when doing so, we probably used a perfectly good car with no front end damage. This doesn’t help create muscle memory. Instead, practice this technique with a mannequin in the car, and have the forklift operator or tow truck operator push the dash down on the patient to simulate a head-on or frontal offset crash. Using a short ram, try to relocate the dash from inside the car. The breaking of plastic in the dash is to be expected until you encounter the Boron steel bar that runs through most dashboards. The center console will be attached to the transmission hump and may need to be cut.
A second technique: Simply slide the ram between the seat and the door, and push off the floor and raise the A-post. Only try this in the passenger compartment side without a patient. Keep changing the angle of the push to raise the dash. This can be done while other operations are underway.
The concept is pretty simple: Push the metal back out from the inside. In many cases, the ram can be operated from the outside the car. If it’s necessary, a rescuer can get into the backseat or lean in with their upper body to operate the ram to make the space necessary to relieve the entrapment. The accompanying technique to moving the metal that’s entrapping the patient is the roof removal.
The Rollover: If the roof has been pushed into the passenger compartment, it can be easily manipulated off the patient by using some cribbing to distribute the pressure of the ram, and find a hard spot on the center console or some of the other areas to push off of. By pushing the roof back off the patient even 6–8 inches, this gives the paramedics room to establish an airway and manage the patient’s C-spine while space is being made to place the patient on a backboard and remove them from the car.
Remember: Always train on vehicles that have crush damage to them and incorporate a mannequin or comparable patient. This allows us to establish proper muscle memory when we practice these rescue techniques. And don’t forget to always work safe!
Brad Havrilla is a 21-year veteran with Palm Beach County (Fla.) Fire Rescue, where he is currently assigned to the training division. Havrilla is an international extrication judge and the past vice-chairman of the IAFC Transportation Emergency Rescue Committee. He was the recipient of the Harvey Grant Excellence in Rescue Award in 2004.
Copyright © Elsevier Inc., a division of Reed Elsevier Inc. All rights reserved.
SUBSCRIBE to FIRERESCUE
Add a Comment
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Comment by lutan1 on November 24, 2009 at 5:56pm
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Comment by Harold Richard Hair on November 21, 2009 at 4:44pm
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i do agree that rams are a great tool that does get over looked alot. i do have a comment on the dash lift though. I am in PA and i have been instructed by instructers here that rams are not always a good idea for the dash lift because, then you have a ram in your patients exit. What they are telling us to do and does work very well and takes about the same time is this, 1st crimp the fender with the spreaders 2nd make two cuts under the top hinge and one above the bottom hinge than take that little peice of metal out put your jaws in the hole and spread. Now i am not saying they way you say is wrongbecasue it works and i have done it that way before. I am only giving another idea to a situaion with many possible rights ways of doing the same job.
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