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Train vs. Car- What Would You Do?
You're dispatched to a Train Vs Car, with unknown injuries and no further details.
What is your normal response to this type of incident?
See the attached picture, to get an idea what you're going to up against.
What would you do?
As the discussion progresses, I'll add more photos to keep the ideas flowing...
Replies to This Discussion
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Permalink Reply by lutan1 on
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In terms of this incident as depicted in the pictures, I'd still stabilise the car from movement.
Battery would be next- remove the cables, not cu them....
Initial access would more than likely be through the side first, or the rear window, to allow medics in to treat.
Next would be a total roof removal given the damage and positioning of the car. -
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Permalink Reply by ILDisasterEMT on
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See William, I think there is a lot you missed, but as I started to write my answer, I realized I was writing from a medical-rescue point of view and not extrication. However, if there is gas leaking, whether or not it is exothermic when mixed with other chemicals, it isnt the liquid gas thats flammable. its the vapors and when you put metal on metal and start cutting, you can generate a spark and one is all it takes. If there is a gas leak here, let's hose that puppy down. I don't really want to be standing in a pool of gas rolling tin when that puddle goes up because somebody didnt think of it or want to be bothered. Maybe I shouldnt have joined this group. My brain always works med-rescue whether I want it to or not. LOL!
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I also consider the fact as a LZ officer that any extrication in excess of 20-25 minutes gets a helo in the air. Of course we take into consideration the nature of injuries during our triage, but I still think I want a pilot drinking his morning coffee on the pad than in the hangar, because come 25 minutes, I am going to spin him up.
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As far as EMS, you have better eyes than I do if you can see what PPE they are wearing. I also agree with massive amounts of cribbing. That car as one wheel at least 18 inches off the ground. By extrication definition, that is NOT stable. If I am rescue on this run, I am not going to be a happy camper if that car decides it wants to drop. You can always take cribbing out, but once you need more, its usually too late. I also agree that it appears we have a couple of "lookie-loos" who dont need to be that close given that they appear to be standing around with their hands in their pockets: Move 'em back or send 'em home
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Permalink Reply by Stacy Banderinko on
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hey...there IS cribbing there. well what do ya know...so, i totally agree with the access into the patient. and i'm glad somebody agreed with me as far as cribbing goes. also, ALS doesn't mean c-spine goes to the wind. i saw that somewhere on here. it just means you have to move a little faster to get the patient out. the only times i would move a patient without c-spine would be: cardiac/traumatic arrest, unconcious/non-alert but breathing, and shock (mainly hypovolemic). anything else is not important enough to compromise c-spine (i think), and my department would say the same. we have good medics that can work inside a car while the rescue crew works on getting the patient out.
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Permalink Reply by Ric Smith on
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You're right...c-spine ALL THE TIME!!! What I was saying is, if the pt is BLS we can take the time needed (but not take all day) to better access, stablize, & secure the pt. then peel the vehicle away from them.
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ok...now i see what you mean. and i agreed with you on cribbing. it was william i was disagreeing with. i think we both said we should crib the shit out of the car, along with rescue-medic guy.
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Permalink Reply by william on
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and i dont hold it against you neither...but i am sick of seeing my name in your post every time i look....i understand that everyone does it there own way...wich is fine with me...but all i tried to say was that you really dont need that much cribbing....but enough said with all of this...lets just drop the subject and quit this highschool bullshit drama already and just leave it as cold water and nothing said about it anymore how does that sound ? just forget about everything no more fighting about it !
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truce...i'm getting tired of arguing, and it's stupid. i just want to be able to discuss and learn. i guess i need to not be so close-minded. enough said...moving on...
so...what else can we discuss about this? would anyone venture to guess what types of injuries might be present in this crash? specifically to the passenger. i wouldn't think that the driver had anything too serious based on the position of the car. -
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