A recent event that occurred between the NYPD and FDNY revealed long standing issues regarding response and performing rescues. This is a unique situation that is not the purpose of this forum post.

Instead, noting that box cribbing was not used, but instead, stair step cribbing. Having only experience using 2x4 and 4x4 cribbing in conjunction with deploying rescue airbags. There is a chance I may have missed something in the video, and can clearly see the firefighter above carrying cribbing, but was a box style of using cribbing in conjunction with the rescue airbag used?

Both the IAFC and NFPA advocate the following:

One thing that bothers me about this above photo graph is the pancake stacking of airbags... This has caused both injury and fatalities to firefighters according to NIOSH report below. Things change and I ask the membership for clarification on this point. Shouldn't we, the fire service all be on the same page?

This photograph on the left illustrates airbags being inflated to raise an object without the benefit of cribbing that lead to the death of a products salesman in South Dakota. Read more below:

Volunteer Fire Fighter/Fire Service Products Salesman Dies After Being Struck by Dislodged Rescue Airbag - South Dakota

SUMMARY

On July 10, 2003, a 50-year-old male volunteer fire fighter/fire service products salesman (the victim) died after being struck by a rescue airbag (high pressure lifting device). The victim was demonstrating the use of rescue airbags when the incident occurred. A set of three airbags had been placed under the rear bumper of a front end loader, coupled together and inflated. The airbags were being deflated when they separated and burst out from under the loader. The middle airbag struck the victim on the head and chest. The victim was immediately treated at the scene by volunteer emergency medical technicians and transported by helicopter to a local hospital where he was pronounced dead later that day.

NIOSH investigators concluded that, to minimize the risk of similar incidents, fire departments and fire service products distributors should:

• provide training to all fire fighters and employees expected to use or demonstrate rescue airbags
• follow safety rules for airbag lifting operations (e.g., use cribbing)
• provide and enforce the use of personal protective equipment during airbag demonstrations and use

Additionally, fire service product manufacturers should:

• ensure that information and photographs contained in catalogs, operator’s manuals and internet web sites correspond with one another and provide consistent safety information

CRIBBING 

“Cribbing” is essential during rescue operations.  In fact, cribbing is one of the most frequently used tools during vehicle rescue operations.  Gravity is inescapable; thus cribbing is used to redistribute the weight of objects into a ‘footprint’. Cribbing provides a temporary support during rescue operations.

more flat surface area contact = more strength = more stability

4x4 Box Crib = 48,000 lbs. Strength

6x6 Box Crib = 120,000 lbs. Strength

RESCUE AIR BAGS

The only airbags I personally have experience are the Vetter Rescue Airbags that come in a variety of sizes and shapes. Having precise control using regulators verses a airline from your engine gives you much more precise control for both lifting and raising an object like a vehicle.

If you have the budget, you can purchase snazzy models like this that have gauges and cool toggle levers. 

My personal preference is to go simple, save the bucks and use the simplistic valving assembly with the small yellow compressed air tank. It does not take much air to fill up a rescue air bag. My departments policy was to always use one of our SCBA bottles which always worked just fine.

USING RESCUE AIRBAGS AND CRIBBING TOGETHER

I am positive that there will be succinct comments shared here explaining the appropriate use of rescue airbags and wood cribbing. To keep the point simple, you use wood cribbing to first build a box to remove any void space between the ground and the bottom of the vehicle. This is done to minimize the distance the rescue airbag has to travel, which enables the bag to work to it's maximum efficiency. 

TRAINING WITH RESCUE AIRBAGS AND CRIBBING

This evolution is something we should all be familiar with and the best way to prepare for a vehicle trapped under a vehicle is to simulate it and use your tools, over and over again until you can do it in your sleep... you just might have too.

In some situations, maybe it's ok not to use wood cribbing when there are minimal lift distances involved. Again, this is not always clear and as can be seen above, is common practice among fire departments to employ when using airbags.

There are lots of lists of cribbing and rescue airbags can do if the vehicle is upside down, and absolute justification for providing both victim and firefighter safety on scene.

Is bigger necessarily better?

USING RESCUE AIRBAGS AND CRIBBING EXAMPLE

Speaking from experience and being old enough to have worked with neighboring volunteer fire departments when they existed in my community, I had the opportunity to respond to a vehicle, driven by an elderly gentleman who ran over an elderly woman. Raising the vehicle using Jaws in conjunction with wood cribbing was not working for fears of failure and collapse back onto the victim. My engine was called in to assist and the guys on the call were my friends. The last thing I wanted to do was have my county engine show up the volunteers, creating hostility and animosity. 

As we responded to the incident, I instructed my crew that our goal was to get on scene, use air bags in conjunction with our wood cribbing, using a coordinated set of commands and one person, my engineer, operating the air control for the filling and deflating or our Vetter Rescue airbags.

What I was not prepared for was the ladies right leg wrapped four times around the drive shaft, with multiple compound fractures, a damn good set of lungs and vocal chords and about 300 tourists watching and video taping what we were doing. Lifting the vehicle high enough for me to get underneath the vehicle safely (and with confidence) required systematic raising of the vehicle using a combination of air bags and wood cribbing. Once the vehicle was raised, a clear work area was made to enable gentle removal of the leg around the driveshaft and transfer of the patient to the spine board, and subsequent transportation to the local hospital where she was treated for both internal injuries and multiple fractures. 

The key point of our response was too quickly assemble our equipment and leave the scene sans any emotions, grandstanding or complements. Get in, get out... Everyone was happy that day and my crew worked together as a team because we had a plan and used our equipment the way it was designed.

CRIBBING ENGINE COMPANY STORAGE AND QUANTITIES

There are lots of lists of cribbing and rescue airbags for you to choose from.

• How much is enough?
• What would you share with others to be the minimum inventory for do-it-yourself wood cribbing?
• What would you consider a minimum engine company inventory keeping in mind that we are not talking about providing a lumber yard for USAR related emergency responses, just plain old simple cribbing?

How many of the following would you recommend for an engine company to carry?

1. 2 x 4
2. 2 x 4 shims
3. 4 x 4
4. 4 x 4 wedges
5. 4 x 6
6. step chocks

Rescue Evolution Review and Refresher Training

Fire Chief Ben Waller's Rule of Opposites

"If what you're doing isn't working, do the opposite."

The Rule of Opposites has some corollaries;

1) If you can't pull, push. We used to pull a lot of steering columns with chains and either spreaders and come-alongs. Then crumple zones came along, and we figured out that was often a better technique to push the dashboard with rams.

2) If you can't lift, dig. Heavy lifting is not always possible, especially when the object is very unstable. You may be able to dig the victim out without risking the unstable object toppling, especially if heavy lift capability is not quickly available.

3) If you can't lower, raise. If you are working a vertical rescue on a 500-foot elevation and you only have 300 feet of rope, you won't be able to lower the patient to the ground. It takes more work, but you can simply complete the pickoff and raise the patient to the top, then use the trail, road, elevator, or helicopter to complete the patient evacution.

4) If you can't cut, dissasemble. I realize that this is not, strictly speaking, an opposite, but it's the rule of thumb for heavy machinery extrication. Industrial and farm machinery is made to last, and it is often tougher than our hydraulic cutters, saws, and even cutting torches. A simple ratchet set and a can of WD-40 can make an otherwise difficult extrication into a literal "nuts and bolts" exercise.

5) If one simple machine won't work, try another simple machine.
If an lever isn't working, try an inclined plane. If you are trying to lift a heavy object and can't get enough leverage, try driving cribbing wedges under the edges of the objects. It's amazing what a few wedges can lift.

6) When terminating, reverse the rescue. Stabilizing rescue and extrication scenes can be very complicated. If you're going to remove shoring from a trench or cribbing from a wrecked vehicle, it's usually a good idea to take the shoring/cribbing down in the reverse order that you built it. If you shore trench panels in the "middle-top-bottom" sequence, then the shores should be removed in the reverse order; "bottom, top, middle". We need to be just as careful about using the Rule of Opposites for rescue termination as we do when extricating the patient. Corollary #6 is also used when bedding aerial ladders. We unbed the ladder after stabilizing the truck in order to rescue or flow the ladder pipe, so we should bed the ladder prior to retracting the stabilizers. Ditto for lateral stabilization. The IFSTA aerial operations manual calls for stabilizing the uphill side first, then jacking the downhill side so that the truck is within 5 degrees or so of level. This keeps the uphill side from forcing the low side down and risking tipping the truck or overextending a stabilizer. When retracting the stabilizers, we should store the downhill side first in order to follow the Rule of Opposites.

The most important corollary is 7) If something isn't safe, make it safe. We deal with inherently dangerous situations every day. We can't control how unsafe the original incident is, but we can make it as safe as possible by wearing appropriate PPE, completing good size-up, developing and following a sensible Incident Action Plan, using Safety Officers, establishing collapse zones, demanding 100% personnel accountability, stamping out freelancing, wearing our seat belts, and staying out of Born Losers.

I'm sure that there are more of these out there. I'd be interested in hearing your ideas. Oh, and now I'll follow Corollary 8) When you want to learn, don't talk.

I updated this to include one point that I forgot in the initial post:

Corollary 9) Reverse the entrapment mechanism.
An example is the dash roll technique in frontal vehicle collisions. In most cases, the entrapment mechanism for the driver and front-seat passengers is that the dashboard and steering wheel/column get forced down and in on the patients. In this case, the Rule of Opposites calls for using our tools to move the dashboard up and out - the opposite of the entrapment mechanism. The same goes for structural components collapsed onto a patient - we use air bags, cribbing and pry bars, or bolting and a crane to reverse the mechanism.

Thanks to Fire Chief Ben Waller, Hilton Head Fire Department for this information originally posted here on the FFN that can be seen by clicking this link.