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DO you, or dont you.....
During our vehicle extrication classes, we were always told not to move a vehicle. EX: A car runs under a flatbed and is stuck there. 2 patients trapped in front and are alive. 1 is very critical, and 1 serious. Do you lift flatbed off, and pull car out for easier access ??? Or extricate where it sits ??? Now....at my EMR refresher, the teacher says as long as you can justify moving vehicle, it is all right to move to gain access. What is all your thoughts on this ???
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Replies to This Discussion
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Permalink Reply by Ben Waller on
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Moving the vehicle is OK as a last resort to save the patient's life. It should never be a first choice. I've moved cars with the patients three times in my career, and had one more moved over my protests back in the 1970's. The one moved unnecessarily was due to a very poorly trained rescue squad and EMS system that didn't understand how to extricate from a car on its side. They rolled the car back on its wheels with a wrecker - fortunately, the patient wasn't hurt very badly and didn't get hurt more with that shoddy technique.
Two of the three times I've moved the vehicle were in cars wrapped driver's side around a pole, after all other means of disentanglement were exhausted. Both of these times involved a very slow, controlled move with a heavy rescue's winch, with the patient in a c-collar and manual neck support and the area around the patient cushioned with rolled blankets.
The other time was an underride of a car beneath a log truck. We lifted the truck with air bags and winched the car out - and saved one of the two people in the car. The other one was already dead. The next few times I was faced with this situation we either tunneled the trunk/hatchback or simply stabilized the car and bisected it behind the front seat, then cut the seat back away to free the patient. Both of these methods are faster and safer than moving the car, virtually all of the time.
Moving a car with the patient trapped should be done only with the big vehicle or object stabilized, slow, controlled movements, and under the command of a very experienced incident commander or rescue group supervisor.
If you have good tools, good training, and a good extrication team that spends a lot of time in the junkyard, researching, and developing good SOGs, you'll rarely, if ever, have to move a car with someone trapped in it.
The three I've moved averaged once about every 11 years, most of which was spent running with very busy rescue companies and medic units.
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Permalink Reply by Joe Stoltz on
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I would say: YES. Start extricating, tunneling in through the trunk if you have to AND get heavy wreckers moving toward the scene as quickly as possible. Tunneling can establish patient contact and assessment but extrication is gonna be a real bear.
Justifying the movement of a vehicle is easy if the patients are critical; they aren't going to get any better until they are out and checked into the trauma center. Any way to expedite the extrication SAFELY would be indicated.
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Permalink Reply by Spanner 122 on
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Judging by your photo, you would have room to work, limited of course, but still room. If at all possible, no, the car should not move. I've heard of people rolling cars back over with pt's inside and it makes me shudder. Secure the scene and get to work, that's what our training if for, right? Makes us able to adapt.
Now, is the car hanging off a cliff? Yeah, move it!
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Permalink Reply by Butch McCurdy on
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We teach not to move the vehicle also, bit some times you got to do what ya got to do. We had a car run up under a verry large tree that had fell across the road. After much deliberation and tryong every thing possible the car was slowey moved out from under the tree. The pt was not critical and had no back or neck injury.
We had a truk that run off the road and the pt was critical. There was a 12 ft ditch on the drier side of the truck so workig from that side was not an option. Luckley the pt. was not pinned and we were able to pul him out the passenger side of the truck. After the call was over we were talking, if he would have been pinned it woud have been hard to remove the Pt. woth out moveing the truck away from the ditch, but luck was on our side that night and it was an easy removal.
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Permalink Reply by Robert Owens on
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In classes and on actual calls any time we can move the vehicle we do. FOr example in an underide situation ona tractor trailor we will get a wrecker or use our standard lifting equipment and lift the trailor portion then use either another wrecker or the winch on the apparatus to move the vehicle from underneath it.
This gives you all kinds of advantages. The only disadvantage I can see is possible causing more injury to the patients but if we can't get them out any way then whats the difference they either get hurt a little more and we get them out or we can't and they die.
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Permalink Reply by lutan1 on
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Never say never in vehicle extrication.
I've had to move cars, as have others reading below-we just need to be very mindful of the risks associated with doing it....
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Permalink Reply by Ron Maddox on
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Every run is different, If thats the only way to get to your patient of course lift the truck. We did it with a school bus that got rearended by a car.
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Permalink Reply by T.J. on
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I'd say we'd try to lift the trailer to get more head room so we can work, but we would not pull the car out unless it was a last resort.
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Permalink Reply by Paul Burley on
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You do what you need to do....the driver was pinned!!
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Permalink Reply by Michael Bates on
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thats pretty much what i figured when i saw the first picture. I don't know if this would work, but maybe by getting that front right wheel out of the way it would give you some room to work. just an idea, if a heavy wrecker wasn't easily available.
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Permalink Reply by Wes Anders on
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yea I would say you did what ya had to but in my response area a heavy wrecker is at least 45 minutes to an hour away. I'm glad we haven't had this issue yet and hope we can make it through my career without it.
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