Chapter 38 Vehicle Extrication and Special Rescue

Chapter 38 Vehicle Extrication and Special Rescue A) Vehicle Safety Systems a) Shock-absorbing bumpers provide protection from low-speed impact i) After a crash, they may be compressed or “loaded” ii) Avoid standing in front of them and approach from the side b) Air bags are in the steering wheel and dashboard i) Normally deploy when involved in a crash, but not always ii) Maintain 5 inches between side airbags, 10 inches from driver side airbags, and 20 inches around passenger side airbags B) Fundamentals of Extrication a) Extrication is the removal from entrapment or from a dangerous situation/position b) Entrapment – a condition in which a person is caught within an enclosed area with no way out of has a limb or other body part trapped c) The rescue team secures and stabilizes the vehicle, provides safe entrance and access to patients, safely extricates patients, and provides adequate room to be removed properly d) Law enforcement controls traffic, maintain order, establish a perimeter, and investigate e) 10 Phases of Extrication Process i) Preparation ii) En Route to the Scene iii) Arrival and Scene Size Up • Park uphill and upwind from the hazard • Size-up is the ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics to manage an emergency iv) Hazard Control • Most often will cut off the battery to the car v) Support Operations • Include lighting the scene, staging areas, landing zones etc. vi) Gaining Access • Need to consider how safe/stable the situation is and severity of injuries • First step is simple access, trying to get to the patient as quickly and simply as possible without using any tools or force • Complex access requires use of special tools, such as pneumatic and/or hydraulic devices, & special training including breaking windshield or removing the roof vii) Emergency Care • If scene is safe, do primary assessment and provide care before further extrication viii) Removal of the Patient ix) Transfer of the Patient x) Termination • Involves returning the emergency units to service C) Specialized Rescue Situations a) Technical Rescue Situations i) Requires specialized skills and equipment to safely enter and move around b) Search and Rescue i) If someone is missing outdoors and a search effort it initiated, an ambulance usually comes to the incident command post or staging area ii) Ask family if any for patient medical history and be prepared to treat when found c) Trench Rescue i) Cave-ins and trench collapses have poor outcomes due to lots of weight from dirt ii) Secondary collapse during rescue is a concern for personnel iii) All vehicles should be turned off and 500 feet away to prevent vibrations iv) Do not enter a trench deeper than 4 feet without proper shoring in place d) Tactical Emergency Medical Support i) When violence is involved, wait for PD to secure the scene ii) Special weapons and tactics team (SWAT) – used for hostage incidents, barricaded subjects, and snipers require this specialized law enforcement iii) Lights and sirens should be off when approaching a tactical situation and outside radio speakers should not be used e) Structure Fires i) Defined as a fire in a house, apartment building, office, school, plant, warehouse, etc. ii) Park far enough away from the fire and do not block other units from arriving iii) Incident commander will determine your location