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Cutting the steering wheel off ????
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.
Replies to This Discussion
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Permalink Reply by Ben Waller on
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Are you talking about cutting the steering ring or are you talking about cutting the steering column? Sawzall, hydraulic O-cutter, or some other method?
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Permalink Reply by Bull on
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Sorry....cutting the steering column. Why would you ??? Or why wouldnt cut the column ???
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Cutting steering columns - especially with hydraulic cutters - is a bad idea. A basic principle of extrication is that you don't cut unsupported metal except as a last resort, and then you use a technique that will not cause an explosive failure.
Hydraulic cutters cause a lot of explosive failures, and steering columns are supported in only one place, and therefore unsupported when you cut the single means of attachment.
There are numerous other techniques that work just fine to get the steering wheel off of the patient. If you just need a few inches of space, just clip the bottom of the steering wheel off - the Half Moon technique. Or...you can use a spreader with long arms and lift the column. Or...you can use a ram with a floor reinforcement at the bottom and a v-block at the top and lift the column that way. Or...you can roll the dash with rams. Or...you can lift the dash with a spreader. Or...you can lift the dash with a high-lift jack. Non of these methods require you to cut the column, all create more room than cutting the column, none of them require cutting up close and personal with the patient's pinned legs, and all offer better visualilzation of the work area while you're operating the tools. The chances of an explosive failure that can injure the patient is much less with any of these techniques, too. You have to be careful, regardless of which one you use. The most important thing is to remember that extrication isn't just about what we can do FOR the patient, it's also about what we might do TO the patient, in a split second, if something goes wrong. Cutting steering columns is asking for something to go wrong, based on my experience.
Did I mention that you can also relocate the seat backwards?
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Permalink Reply by Joe Stoltz on
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I don't think we've cut a steering wheel (ring, not the shaft) outside of practice. Back in the day we used a chain, a couple of 4x4s and a "handyman jack" to pull the wheel and column up and away from the patient's legs. This technique requires the roof to be still on the car.
Now we generally use the dash roll to lift the dash and wheel up in one piece with either the spreader or a ram, depending on how much room and time we have to play with.
And yes Ben, this is after making sure that the seat is back all the way AND the steering wheel tilt mechanism has been activated.
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Permalink Reply by Trainer on
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Cutting the column is fun...in training, but real world, it takes a ton of power usually makes a projectile, and can damage cutters. For years we would practice spreaders and chains to lift the column, I have done this once in 20+ years, real world, all this was back in the days before airbags. Todays best bet is a modified high dash roll, couple of cuts and a ram aganst the lower b post to the upper a post, clip the brake peddle and open up like a sardine can, spreaders will work if you don't have rams. If you have the little clipers, you can also cut the seat loose. Anybody got a steering wheel cover? we keep ours in a display case.
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Permalink Reply by Spanner 122 on
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I've never seen this done, it sounds dangerous. You can do a dash roll (also not really used a lot in our department any longer) or a limosine cut (quickest in my opinion, less cutting and easier cuts). Whatever it takes to get the pt out, but also keeps them safe.
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Permalink Reply by Butch McCurdy on
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I agree with everyone else on here, cutting the column is dangerous, there are alot of diffrent techniques that can be useed instead. But there is that one in a million call where cutting the column my seem like the only option.
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Limosine cut?
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That might refers to the old-school "laudau" roof flap where the A-posts are severed and the relief cuts are made in front of the B-posts. If you're going to flap a roof, it's better to do a complete flap. Cutting both A and both B-posts, then making the relief cut in front of the C-post takes about 15 seconds longer and makes a much larger opening. When you're planning for the patient plus EMS personnel in that opening,the full roof flap makes a lot more sense than the old partial flap.
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Full roof and removal of B posts to create space if the pt is in critical enough condition, nothing partial, what's the point when it takes maybe a minute more to complete it. We did what we called a "partial limo" when the car was on it's roof and crushed so the vehicle was unrecognizable. Used the rams to keep the car's floor from collapsing and removed the B posts, door was already ripped off on impact. Slid the pt out in limited space on the backboard. It was pretty spectacular.
The limo cut is full B post removal and roof removal for easy access, clearly depends on the condition of the front of the car, 9 times out of 10, removing the door in question has been enough. We've never even trained with the partial roof flap.
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Remember to remove plastic before cutting b post, it's been preached for some time to cut the post high to avoid the belt tenisoner, but with side curtin bags, nothing is safe. Seen something neat on TV, tried it once in training, worked good. Cut c b and a leave windshield and fold foward, it's a little tougher but with a lot less glass flying around. I've never heard the "limo cut" but removal of the top is a no brainer, well except for the bags.
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Permalink Reply by lutan1 on
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Can you cut columns? Yes.
Are there haards associaed with it? Yes, dependig on how they're cut. With hydraulic cutters, I've seen them become projectiles but with a sawzall, ec, no problems.
More importnantly, we need to ask rselves, "Do we need to?". I'd suggest NO. Most extrications require only a few inches of metal movement to free someone- cut the wheel itself (the ring) and yu've often (Not always though) created enough room to remove the entrapment.
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