Roadway Extrication

Introduction • 40 hour course – minimum attendance is 90% – end of course exam 80% or better – practical examination-must pass all evolutions • State Certification – Practical passed at 100% – State written exam at 70% – Firefighter 2 certified Roadway Extrication 2

General Safety Principles • Must protect the patient and rescuers during the extrication process • Three factors that contribute to overall safety of an accident scene – The environment – The incident itself – The vehicle itself Roadway Extrication 3

Personal Safety • Protection of the Rescuers – This is our number one priority – Full protective clothing with eye and ear protection – Proper lifting and working techniques – Proper evaluation of scene hazards Roadway Extrication 4

Patient Safety (victim) • Protect patients physical and mentally – Physical protection • Cover patient with blanket • Protect with backboard or barrier • Utilize eye and ear protection equipment?

– Mental protection • Early communication between rescuer and victim • Protect from unpleasant visual sights • Protection of personal property Roadway Extrication 5

Scene Safety • Eliminate, Control, or Neutralize Hazards – DO NOT TRADE LIVES FOR LIVES • Scene Safety Priorities – 1st Priority -- Rescuers – 2nd Priority -- bystanders, Good Samaritans – 3rd Priority -- victims • Use apparatus as scene barrier-100ft away Roadway Extrication 6

Scene Safety • Hazardous Materials incidents-minimum of 2000’ uphill and upwind of incident • Night operations require special considerations – Do not use headlights – More scene lighting makes operations more effective • Vehicle stabilization is paramount Roadway Extrication 7

Scene Safety • Plastic fuel tanks in use – failure within 30 seconds of fire • Handlines and extinguishers are a must • 2 pole rule for downed power lines • Use action circle and safety zones Roadway Extrication 8

Anatomy of a Vehicle • 1973 was start of vehicle construction changes – Iron and steel to plastic and aluminum frames – Bolted to spot welded and glued • Three types of frames – Full frame – Uni-Body-integrity depends upon roof, posts – Space Frame-cage like construction Roadway Extrication 9

Anatomy of a Vehicle • Posts – A Post; divides engine compartment from passenger compartment, extends to roof – B Post; divides passenger compartment in half or is rear post in 2-door vehicles – C Post; divides passenger compartment from trunk in 4-door vehicles Roadway Extrication 10

Anatomy of a Vehicle • Wheels – Steel, aluminum, plastic, composite, alloy • Catalytic Converters – 1300 to 2000 degrees • airbags damage at 200 and will melt at 330 – Potential ignition source • Drive Shafts – hollow and will explode as projectile Roadway Extrication 11

Hazards of Vehicles • Catalytic Converters • Alternative Fuels – CNG – LPG • Fuel Emission Control system – Vapor holding canister • Fuel Tank – 10-25 gallons, located between frame rails Roadway Extrication 12

Hazards of Vehicles • Bumpers – Spring loaded bumper (5 mph impact in 1970s) – Piston fluid filled (2 1/2 mph impact) most popular in use today – Egg crate • newest concept, 2 1/2 mph impact • Assume all are loaded and ready to rebound – Chain or drill 1/4” hole in narrow piston – Bumper strike zone up to 300’ Roadway Extrication 13

Hazards of Vehicles • Batteries – Most common hazard at scene – Key component in electrical system – Cut NEGATIVE cable in 2 places first • make sure power is not needed first; seats or windows • assure key off or fuel pump in EFI may keep running Roadway Extrication 14

Hazards of Vehicles • Steering Columns – Old ones were solid one piece rods – New ones have hollow joints with up to 4 knuckles for various adjustments • Wrap wheel low if you must pull – Cut spokes of wheel to allow more room Roadway Extrication 15

Supplemental Restraint Systems • Minimum of 3 sensors in place on vehicle – 2 must activate before system can deploy – Needs about 12 mph impact • Identification of unactivated system is key to rescuer safety – Look at steering wheel and dashboard – Assume at least 1 in place after 1990 – Maybe in headliner, seat and doors in new cars Roadway Extrication 16

Supplemental Restraint Systems • Uses 12 volt charge to ignite SODIUM AZIDE canister which burns producing nitrogen gas to inflate bags rapidly – Alkaline substance which may cause minor irritation – Mostly non-toxic – Caution on FORD, Potassium Nitrate used • Key is to disable electrical system immediately – SRS can stay active up to 30 minutes Roadway Extrication 17

Windows • Front windshield is laminated glass – 2 pieces of safety glass bonded to plastic material between – Made to resist shattering on highway • Side and rear are tempered glass – Shatter to pieces the size of fingernail – Reduce the severe lacerations?

• Rescuer should control breakage of glass Roadway Extrication 18

Vehicle Rescue Life Cycle Stage 1 - Readiness • Readiness of Personnel – Training and experience • tools, equipment and SOG’s • Readiness of Equipment and Apparatus – Maintained and functioning – Back-ups of primary systems Roadway Extrication 19

Vehicle Rescue Life Cycle Stage 2 - Accident Stage • No control over this step • Golden Hour begins – 60 minutes to reach appropriate health care facility – Into surgery if indicated Roadway Extrication 20

Vehicle Rescue Life Cycle Stage 3 - Notification Stage • Starts when accident is reported – Response SOG’s – Information recieved about accident – Size-up enroute • conditions • traffic patterns • Dispatch tones and additional information Roadway Extrication 21

Vehicle Rescue Life Cycle Stage 4 - Response Stage • Vehicle responds in safe manner – Obey traffic law – Use of visual and audio devices – Position of apparatus Roadway Extrication 22

Vehicle Rescue Life Cycle Stage 5 - Arrival • Staging should be 100’ from incident – Assessment of immediate threat – Rescuer caution exiting and operating around scene • May be most hazardous time for rescuer safety Roadway Extrication 23

Vehicle Rescue Life Cycle Stage 6 - Size-Up • Begin to gather information – 360 degree view of scene – Assessment of known hazards • Wires • Fuel • HazMat – Prediction of possible hazards – Assessment of capabilities Roadway Extrication 24

Vehicle Rescue Life Cycle Stage 7 - Incident Command • Essential to success of operations – Establish Command – Stay out of work and run the show – Stay in outer action circle Roadway Extrication 25

Vehicle Rescue Life Cycle Stage 8 - Scene Safety, Stabilization and Support • Action circle - 10’ around car – Only those doing ems or rescue • Outer circle - 10’ - 15’ outside – Tool and equipment staging on tarps – ICS • Identify and control the hazards Roadway Extrication 26

Vehicle Rescue Life Cycle Stage 9 - Patient Access • Pathway to get to patient – Door – Window • Qualified EMS provider inside to assess the patient and the effects of the rescue process • Begin care inside, calm, reassure and talk to patient • Communicate needs Roadway Extrication 27

Vehicle Rescue Life Cycle Stage 10 - Treatment • Triage – Colors and priorities • Call for additional help • Begin treatment according to policy Roadway Extrication 28

Vehicle Rescue Life Cycle Stage 11 - Disentanglement • The actual removal of the car from the patient – goal is not to cause additional harm and injury – protect patient throughout – stop actions that are causing harm – evaluate progress often Roadway Extrication 29

Vehicle Rescue Life Cycle Stage 12 - Extrication • Remove the patient from the vehicle – Proper splinting and immobilizations – Exercise rescuer safety • back injury frequency high here Roadway Extrication 30

Vehicle Rescue Life Cycle Stage 13 - Transportation • Appropriate level of care – Trauma center – Regional hospital – Medivac Roadway Extrication 31

Vehicle Rescue Life Cycle Stage 14 - Termination • Wrap-up of equipment – clean and service – secure scene with police • Completion of documentation • Review incident with participants – learn from every experience – learn from doing Roadway Extrication 32