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Extrication on a priority 3 patient.
Last night we responded to a 2 vehicle t-bone accident with 1 patient trapped. I was first on scene with my pov and decided that we'd have to pop the driver side door off to get this patient out. I had the spreaders in my hand when I noticed the patien was not covered up with a blanket. I asked one of our FF to go and get one. My captain tells me we dont need one (the glass is already broken) I told him that we're not popping this door tell she's covered up. I know sometimes you dont have time to spare and you need to get the person out NOW. She had no life threating injuries and I wanted to make sure that she was covered. I've always been tought to cover the patient up. Was I in the wrong for telling my captain no in this case? He was not bad with me at all, he just thought I was wasting time. What would you have done?
Replies to This Discussion
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Permalink Reply by jason head on
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Safety frist all was in less its life over limbe but remember you are # 1and your crew #2.
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Permalink Reply by Ben Waller on
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Oldman,
What triggered the SRS deployment? The cell phone may have been enough to recharge the capacitor, but simply putting electricity into the system shouldn't deploy an air bag, air curtain, or seat belt pretensioner.
Ben
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Permalink Reply by lutan1 on
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The use of hard protection is really the unusual versus the normal over here.
Most are still using blankets or tarps or clear, thick plastic sheets (flexible).
There has been some interesting debates as to whether it is better for the casualty to be able to see what's happening (behind a clear sheet) versus being hidden away under a blanket only able to hear the noises that go with extrication.
I've spoken with a few paramedics who confirm the use of clear sheets based on their observations on things like heart rates whilst being extricated.
Some interesting food for thought....
I also think things likehard protection may need to be reconsidered given the number of airbags, etc- I beleive it's only a matter of time before one of these pieces of hard protection gets launched through an undeployed bag, regardless of how careful we are being.
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Hard protection won't get launched if you use it properly,
If the vehicle doesn't have side impact protection systems, hard protection should have no chance of being launched, because the board will be between the doors and the patient, while the SRS system are toward the patient's front.
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Permalink Reply by morris washburn on
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Its not wasting time its be safe ,you job is to secure the sence, pt. safety , as well as yours.I would have done the same thing ,cover and protect the pt.
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TO be the devil's advocate here Ben, neither will SRS protection systems such as Holmatro's Secunet- the key is if used properly...
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Permalink Reply by PFC Harmon on
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Yes pt's should always be covered. Better to be safe than in a hurry.
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Permalink Reply by Kimberly A Bownas on
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T.J. I would have done the same thing. We don't do any extrication without the patient covered. It is a matter of safety for the patient more than anything else. You never know if there is going to be pieces of glass or plastic that may pop off and head in the direction of your patient.
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Lutan, we're talking about two different things here. Barrier boards are hand-held, and can be positioned so that they're between tools and the patient and between metal being moved and the patient without being placed in the SRS deployment path. That's a GOOD thing.
SRS restraint systems like the Securenet are designed to be installed between the SRS and the patient, and that's a BAD thing. Even if used properly, SRS restraint systems force a deploying air bag to deploy in a manner different than how the car builder designed it. That means that the agency that installs the SRS restraint has taken any product liability off of the car manufacturer and placed it squarely on themselves.
Here's a hypothetical - a driver is pinned, and the rescue company puts a SRS restraint device over the driver's frontal air bag and secures it according to the device's manufacturer's instructions. Then, said rescue company gets sloppy and triggers the SRS deployment. The bag is restrained, so it can't smack anyone, but the talcum powder or corn starch that the bag is packed in is forced out the air bag vent holes at high velocity...right into the patient's face or a paramedic's face. That can cause blindness, inhalation injury, or other injuries.
Rule #1 is is "Primum Non Nocere" - First, do no harm.
Rule #2 is "Don't make the cure worse than the disease".
Barrier boards - mobile and manually controlled - good thing.
SRS restraint systems - immobible, not manually controlled, and force SRS systems to deploy abnormally - bad thing.
Remember, there are extrications somewhere on a daily basis. Those patients need protection from common hazards, including extrication activities. There have been less than 10 documented accidental SRS deployments since the technology became common in the 1980's. Most of those have been due to fires, not extrications. The extrication deployments were 100% preventable.
One other problem with SRS restraint devices - they are designed ONLY for the driver's frontal air bag, so they give you a false sense of security. They don't protect anyone from passenger-side bags, side impact bags, air curtains, or seatbelt pretensioners. With up to 14 SRS devices on some cars now, taking the time to use a device of questionable utility to protect from 1/14 of the hazard doesn't seem to be a good trade-off to me.
Ben
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I agree with you Ben- the point of my post was the key words you used in your reply- if used properly.
The same applies to hard protection.
I'm being the devil's advocate here to promote debate on key issues- as I said in my original post, the use of hard protection here is rare, if at all. (So is the use of SRS restratint system as just about service Australia wide has banned them)
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lutan,
I don't think there is any "used properly" for a SRS restraint device - it's a flawed concept. Banning them nationwide is an excellent idea, and puts firefighter safety above someone's cool-sounding sales pitch.
Proper use of barrier boards - absolutely a good idea. Even if the national fire service doesn't encourage their use, you can make your own out of plywood, lexan, or any other thin-but-strong sheeting material.
Ben
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Permalink Reply by Christopher on
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Just remeber the captain is the captain for a reason, Comply first, then grieve as my old capt would say. He may not be right but its in his hands now. If he says do it just do it, unless its a life threatening issue. Remember its better to grieve after the fact then to blow off the supervisors order and then look like the bad guy.
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