Vehicle Extrication communication
Vehicle Extrication is the systematic removal of the parts of a vehicle that has been involved in a crash from around the driver and occupants. It has been developed into a process or system over they years to ensure the safety of the rescuers and victims, and to improve the chances of victim survival. The basic steps to vehicle extrication are scene size up, vehicle stabilization, glass removal, gain access, disentanglement, victim removal, and breakdown/cleanup.
The first step is scene size up. Rescuers start to assess the scene as they arrive at the accident. They are looking at how many vehicles are involved, how many victims are in those vehicles, the extent of damage to the vehicles, and how badly are the victims trapped in the cars. At this point the person that is in charge will form an action plan, laying out the steps that will be taken to free the victims from the vehicle. The rescuers will then start stabilizing the vehicle. This job can be done very quickly if the vehicle is on all four wheels. It can be much harder if it’s on its side, roof, in a very unusual position (hanging off the edge of a parking garage) or if the vehicle is extremely heavy, such as a dump truck. After the vehicle is stabilized the rescuers can start removing parts of the vehicle to gain access and remove the victim from the vehicle.
Most of the time glass will be the first component of the vehicle to be removed. The accident will most likely have broken some windows already. This is good to allow medical personal to access the patient and asses their condition. They will explain to the patient the process and why it’s necessary to destroy their vehicle. The rest of the glass will be removed for the safety of the rescuers. The battery will also be disconnected to disable the electrical system and hopefully prevent airbag deployment while the rescuers are working. A firefighter will be standing by with a charged hose line in case of any flash fires. The vehicle will then start to be taken apart. Most commonly, the doors and roof will be removed. This is done using hydraulic tools, otherwise known as the “jaws of life” If the patient is just trapped, then he will be removed at this point.
Patients can also be “pinned”, where part of the vehicle is physically pinning their body in the car. These are more complicated extrications, where advanced techniques will be needed to free the victim. After being freed, the victim will be removed by rescuers and medical personal and taken by ambulance or helicopter to the closest appropriate medical facility. The crews will then break down the stabilization they did on the vehicle, collect their tools from the scene, and get all the debris back in the area of the vehicle that it came from. This will assist the wrecker crew in removing the vehicle from the roadway. Surprisingly, this is the time where most injuries happen. This is due to the rescuers “guard” being down. They feel the danger is gone after the patient is out of the vehicle and on their way to the hospital.
Most car accidents that involve a need for extrication involve serious injuries and possibly fatalities. EMS and Fire Departments must be aware of what each others roles are at the scene of an accident. The first step in accomplishing this is to communicate with one another of exactly what you need. At most scenes the EMS team will take charge since the priority is to help the injured or trapped patients. This may involve delegating which patient to extricate first, second, third...etc. The Fire Department is responsible for freeing the trapped patient in the safest and fastest method that they can without jeopardizing their own safety or safety of other crew members, It may be necessary for the Fire Department to assist with getting supplies from the ambulance, and possibly lifting or carrying the patient on to stretcher and into ambulance.
Now that the patient or patients in on their way to the hospital EMS is finished at the scene and The fire department will assist any investigation that may need to be performed. These investigations can take 20 minutes or they can take days depending on the seriousness of the accident. In most case the Fire Department will remain at the scene until the vehicle can be moved off of the road by a wrecker and them hauled to it destination. The Fire Department plays a huge role in protection for everyone at the scene by blocking and directing traffic with their firetrucks. They will also usually assist in cleanup of debris from the wreck and any fluids that may have leaked form the vehicle.
Vehicle extrication was developed into a system to make it much safer for rescuers and the victims. By memorizing these simple steps, rescuers ensure that all critical tasks get accomplished and minimize the chance of missing important information. These steps when done in the right order also drastically increase the victim’s chance of survival. This is one area of emergency services where speed is truly of the essence. The more quickly you remove the victim and get them into the care of the EMS staff and on the way to the hospital, the greater their chances of surviving.