Vehicle Rescue and Extrication

1
Vehicle Rescue and Extrication
2
Objectives (1 of 2)
25

• Describe the vehicle anatomy.
• List the hazards involved in responding to an
  emergency scene.
• List the hazards to look for when arriving on the
  scene of a vehicle extrication situation.
• Describe cribbing.

3
Objectives (2 of 2)
25

• Describe the extrication tools that are used for
  stabilizing, bending, cutting, and disassembling.
• Describe how to gain access to the victim.

4
Introduction
25

• Beginning fire fighters must understand the
  process of extrication.
• Should have some proficiency in extrication
  skills
• Most fire departments are involved in some part
  of the extrication process.
• Members of special rescue teams should complete a
  course in rescue techniques.

5
Conventional Vehicles
25

• Majority of vehicles on the road
• Use internal combustion engines
• Burn gasoline or diesel fuel
• Hazards
• Fuel leaks
• Short circuits
• Battery acid leaks

6
Alternative-Powered Vehicles (1 of 2)
25

• Powered by compressed natural gas (CNG)
• Cylinders usually in truck, but can be in any
  convenient location
• City buses and other fleet vehicles
• Identified by CNG sticker mounted on front and
  back of vehicle

7
Alternative-Powered Vehicles (2 of 2)
25

• After crash, cylinders or fuel lines could be
  damaged.
• CNG could escape.
• Threat of BLEVE

8
Electric-Powered Vehicles
25

• Propelled by electric motor powered by batteries
• Contains a large number of batteries
• Hazards
• Large amount of energy stored in batteries
• Potential electrical shorts
• Leakage from damaged batteries
• Voltage higher then 12-volt car battery

9
Hybrid Vehicles
25

• Use battery-powered electric motors and a
  gasoline-powered engine
• Electric power used at low speed, gas power at
  high speed
• When stopped at a traffic light, both sources of
  power turn off.
• Car said to be hibernating
• Hazards posed are same as gas- and
  electric-powered vehicles.

10
Vehicle Anatomy (1 of 2)
25

• The front of the vehicle is where the hood is and
  travels down the road first.
• The rear of the car is where the trunk sits and
  goes down the road last.

11
Vehicle Anatomy (2 of 2)
25

• The left side of the car
• On your left as you sit in the vehicle
• In the United States and Canada, the drivers
  seat is on the left side of the vehicle.
• The right side of the vehicle is where the
  passengers seat is located.
• Always refer to left and right as they relate to
  the vehicle.

12
Vehicle Posts
25

• Connect the body of the car to the roof of the
  car and are structural supports
• A post is located nearest the front of the
  vehicle.
• B post is located between the front and rear
  doors.
• C post is located behind the rear doors.

13
Bulkhead
25

• Divides the engine compartment from the passenger
  compartment
• The passenger compartment includes the front and
  back seats.
• Sometimes called the occupant cage or occupant
  compartment

14
Platform Frame
25

• Platform frame uses beams to fabricate the
  load-bearing frame.
• The engine, transmission, and body components
  connect to the frame.
• Provides a sound place for stabilizing the
  vehicle and an anchor point for attaching cables
  or extrication tools

15
Unibody Frame
25

• Unibody seen in most modern cars
• Combines the vehicle frame and body into a single
  component
• Allows manufacturers to develop lighter weight
  vehicles
• Remember that unibody vehicles do not have the
  frame rails in platform frame vehicles.

16
Respond to the Scene
25

• Safe response includes
• Picking the best route of travel for the time of
  day
• Driving in a safe manner
• Knowing limits of your vehicle
• Keeping seatbelts fastened
• Evaluating the dispatch information
• Listening carefully for any direction

17
Arrival and Size-Up Traffic Hazards (1 of 3)
25

• Determine where to locate your emergency vehicle.
  
• Take into account the safety of emergency
  workers, the victims, and the motorists.
• Do not hesitate to request the road to be closed.

18
Arrival and Size-Up Traffic Hazards (2 of 3)
25

• Use large emergency vehicles to provide a barrier
  for motorists who fail to heed emergency warning
  lights.
• Place apparatus at an angle to the crash.
• Traffic cones or flares can be placed to direct
  motorists away from the crash.

19
Arrival and Size-Up Traffic Hazards (3 of 3)
25

• Fire fighters need to be visible at a crash
  scene.
• PPE should be bright.
• PPE used at night needs to be equipped with
  reflective material.
• Be alert for any vehicles that might cause you
  injury.
• Do not assume that motorists will always heed
  your warning lights.
• IC should perform a size-up.

20
Arrival and Size-Up Fire Hazards
25

• Look for spilled fuels and other flammable
  hazards.
• Look for the presence of fire.
• Fire may trap the vehicle occupants and require
  suppression.

21
Arrival and Size-Up Electrical and Other Hazards
25

• Electrical hazards
• Look for downed or damaged power lines.
• Other hazards
• Environmental
• Rain, sleet, ice or snow can pose a hazard to
  rescue workers.
• Crashes that occur on hills are harder to
  stabilize.
• Be aware of the possibility of hazardous
  materials.

22
Arrival and Size-Up Other Hazards
25

• Look for the presence of infectious bodily
  fluids.
• Sharp edges and objects should be identified and
  when possible covered or removed.
• Watch out for violent behavior by vehicle
  occupants.
• Family pets may react protectively when rescuers
  attempt to gain access to their owner.

23
Stabilize the Scene
25

• Consists of reducing, removing, or mitigating the
  hazards at the scene.
• The order in which hazards are stabilized depends
  on the specific scene conditions and the amount
  of risk each hazard poses.

24
Traffic Hazards
25

• Traffic must be slowed or stopped as motorists
  approach the scene of an emergency.
• Traffic hazards are best handled by the
  appropriate law enforcement agency.
• Work with law enforcement officials to control
  traffic in a safe manner.
• If law enforcement is not on the scene, verify
  that they have been dispatched.

25
Fire Hazards (1 of 2)
25

• It should be SOP to advance a charged hose line
  close to a damaged vehicle.
• At least a 1.5" hose should be staffed by a fire
  fighter in PPE.
• Hose line can provide protection for rescuers and
  victims of the crash.

26
Fire Hazards (2 of 2)
25

• Crashes that pose large fire hazards or actual
  fires may require additional fire suppression
  resources.
• Small fuel spills can be handled by using an
  absorbent material to remove the fuel from the
  area around the damaged vehicle.

27
Electrical Hazards
25

• Disconnecting the vehicles power source should
  be done following your local SOP.
• Downed power lines should be handled by the power
  company.
• Do not approach a vehicle and do not let a victim
  leave the vehicle until the electricity has been
  controlled.

28
Other Hazards
25

• Heat and cold should be dealt with.
• Ensure adequate lighting at night.
• Prevent slips and falls on wet and icy surfaces.
• Wear proper PPE to reduce the risk of injury from
  sharp objects and infectious bodily fluids.
• Remove animals from the scene.

29
Cribbing
25

• Used to stabilize a vehicle
• Lengths of wood used to prevent a vehicle from
  moving backward and forward
• After cribbing has been placed, a vehicle can
  still move.

30
Step Blocks
25

• Shaped like stair steps and are placed under the
  side of the vehicle
• Place one step block toward the front of the
  vehicle and a second step block toward the rear
  of the vehicle.

31
Box Crib
25

• Standard cribbing can be used to form a box crib.
• Place cribbing at right angles to the preceding
  layer of cribbing.

32
Vehicle Stabilization
25

• A vehicle on its side or roof is very unstable.
• Can be stabilized using box cribs or step blocks
  on each end of the vehicle

33
Wedges
25

• Used to snug up loose cribbing or when using lift
  airbags
• Should be the same size width as the cribbing
  with the taper end no less than 0.25" thick

34
Rescue Lift Airbags (1 of 3)
25

• Pneumatic-filled bladders made of rubber or
  synthetic material
• Used to lift or spread
• NEVER use alone to shore or stabilize
• Always use cribbing when using rescue lift
  airbags.

35
Rescue Lift Airbags (2 of 3)
25

• Often used to lift a vehicle or object off a
  victim
• Use extreme caution when using rescue lift
  airbags.
• Adhere to all the safety precautions in the
  owners manual.
• Cribbing must be used in conjunction with rescue
  lift airbags.
• Top layer of cribbing should be solid underneath
  the rescue lift airbag.

36
Rescue Lift Airbags (3 of 3)
25

• Should not be used without properly blocking the
  wheels
• This is a safety precaution in case of a
  catastrophic failure of a rescue lift airbag.
• Rescue lift airbags can fail as they age.
• They should be tested according to manufacturers
  recommendations.
• After ten years, they have generally reached
  their useful life.

37
Three Types of Rescue Lift Airbags (1 of 3)
25

• Low-pressure airbags
• Often used in recovery operations and sometimes
  used by departments for vehicle rescue operations
• Come in many shapes and sizes but square airbags
  offer greater stability.
• Can be less stable until fully inflated as
  compared to high-pressure airbags

38
Three Types of Rescue Lift Airbags (2 of 3)
25

• Medium-pressure airbags
• Have either two or three cells inside their
  design
• Best when used in aircraft or truck rescue

39
Three Types of Rescue Lift Airbags (3 of 3)
25

• High-pressure airbags
• Most common airbags used by the fire service for
  rescue work
• Heavily constructed
• Generally made of vulcanized rubber mats that are
  reinforced by steel or other material woven into
  a fiber mat and covered with rubber

40
Principles of Gaining Access and Disentangling
the Victim (1 of 2)
25

• Use four techniques
• Stabilize
• Stabilize by using cribbing
• Bend, distort, or displace
• Bending a vehicle door back to get it out of the
  way

41
Principles of Gaining Access and Disentangling
the Victim (2 of 2)
25

• Cut or sever
• Cutting a roof
• Disassemble
• Removing a vehicle door by unbolting the door
  hinges

42
Tools Used in Extrication (1 of 5)
25

• Stabilizing tools
• Cribbing
• Rescue lift airbags
• Step blocks
• Be certain that they are placed firmly under the
  vehicle and that vehicle is stable before
  attempting to enter it.

43
Tools Used in Extrication (2 of 5)
25

• Bending tools
• Hand tools such as pry axe, short pry bars, long
  pry bars, and Halligan tools
• Can be used to bend sheet metal
• Power tools such as hydraulic rams and hydraulic
  spreaders

44
Tools Used in Extrication (3 of 5)
25

• Cutting tools
• Hand tools used for cutting are axes, bolt
  cutters, cable cutters, hacksaws, and manual
  hydraulic cutters.
• Use the power tool to cut the proper material.
• Power tools for cutting can be powered by air,
  electricity, or hydraulics.
• Some examples are air chisels, rotary or
  reciprocating saws, hydraulic cutters.

45
Tools Used in Extrication (4 of 5)
25

• Air chisels can cut metal posts.
• Hydraulic cutter can cut through the roof posts
  of a vehicle.

46
Tools Used in Extrication (5 of 5)
25

• Tools for disassembling
• Mechanics tools such as wrenches and
  screwdrivers
• Specialized equipment includes the come along.

47
Gain Access to the Victim
25

• Open the door.
• Easiest and simplest way to gain access
• Try all doors even if they appear badly damaged.
• Make sure door is unlocked and try the door with
  the least damage first.
• Try the outside and inside handles at the same
  time if possible.

48
Break Tempered Glass (1 of 3)
25

• Consider breaking a window if victims condition
  is serious and doors will not open.
• Do not try to break and enter through the
  windshield.
• Made of laminated windshield glass
• Difficult to break

49
Break Tempered Glass (2 of 3)
25

• Side and rear windows are made of tempered glass.
  
• Will easily break into small pieces
• Can be your primary access route
• If possible break a window away from the victim
  to avoid further injury.
• After breaking glass, use a gloved hand to remove
  as much of the broken glass as possible to avoid
  injuring rescuers.

50
Break Tempered Glass (3 of 3)
25

• Aim for a low corner if using something other
  than a spring-loaded punch.
• When the window is broken and glass removed, try
  to unlock door.
• Breaking the rear window will sometimes provide
  an opening large enough to enable a rescuer to
  gain access to the victim.

51
Force the Door (1 of 4)
25

• Door displacement
• May be difficult and somewhat unpredictable
• Choose door that will not endanger the safety of
  the victim.
• Use hand tools to bend the sheet metal away from
  the edge of the door where the hydraulic tool is
  to be inserted.

52
Force the Door (2 of 4)
25

• Place the spreader in a position so that it is
  not in the pathway of the door.
• Do not stand in a position that might put you in
  danger.
• Activate the hydraulic tool to push apart the
  outer sheet metal skin of the vehicle to expose
  the hinges or door latch.

53
Force the Door (3 of 4)
25

• Once the outer sheet metal has been exposed,
  close the tips of the spreader and remove them.
• Insert the closed tips onto the inner skin of the
  door and the doorjamb just above the latch or
  above the hinges.

54
Force the Door (4 of 4)
25

• Activate the spreader.
• Separating a door at the latch side
• Place a 4" x 4" cribbing under the bottom of the
  door first.
• Some hydraulic tools can cut door hinges.
• Separating a door from hinge side
• Place the spreader on top of the bottom hinge and
  separate door from hinge.
• Place 4" x 4" cribbing underneath the door to
  hold it in place.

55
Provide Initial Medical Care
25

• As soon as you have secured access, begin to
  provide emergency medical care.
• A qualified emergency medical provider should do
  this.
• Provide emotional as well as physical care.
• Care can be provided while extrication is taking
  place.
• Work toward the goal of getting the victim
  stabilized and removed from the vehicle as
  quickly and safely as possible.

56
Disentangle the Victim (1 of 3)
25

• Purpose is to remove the parts of the vehicle
  that are trapping the victim
• Remove the sheet metal and plastic from around
  the victim.
• It is not cutting the victim out of the
  vehicle.

57
Disentangle the Victim (2 of 3)
25

• Before beginning disentanglement, study the
  situation.
• What is trapping the victim in the vehicle?
• Perform only necessary procedures.
• The order in which procedures are performed is
  dictated by scene conditions.

58
Disentangle the Victim (3 of 3)
25

• Protect the victim at all times.
• Use backboards and blankets to shield victim.
• Explain procedures to victims to reassure them.

59
Displace the Seat (1 of 5)
25

• In frontal and rear end crashes, the driver may
  be trapped between the steering wheel and the
  back of the front seat.
• Displacing the seat can
• Relieve pressure on the driver
• Give rescuers more space for removal

60
Displace the Seat (2 of 5)
25

• Attempt simplest steps first.
• Attempt to move seat back on its track either
  manually or engaging power seats.
• Attempt to lower adjustable seat.
• Perform a dash displacement if moving the seat
  back does not work.

61
Displace the Seat (3 of 5)
25

• As a last resort, use a manual hydraulic spreader
  or a powered hydraulic tool to move the seat
  back.
• Place one tip of the tool on the bottom of the
  seat.
• Avoid pushing on the seat channel that is
  attached to the floor of the vehicle.

62
Displace the Seat (4 of 5)
25

• Place the other tip of the spreader at the bottom
  of the A post doorjamb.
• Support the victim.
• Engage the seat adjustment lever on manual seats
  and open the spreader in a careful fashion.
• Seat should move backward in a controlled
  fashion.

63
Displace the Seat (5 of 5)
25

• Remove seatback in some cases.
• Cut the upholstery away from the bottom of the
  seatback.
• A reciprocating saw or a hydraulic cutter can be
  used to cut the supports for the seatback.
• Be certain that the victim is supported and
  protected during this procedure.

64
Remove the Windshield (1 of 5)
25

• Removing windows provides better communication
  between personnel inside and outside the vehicle.
• Try and roll down windows first.
• Side and rear windows are tempered glass that can
  be removed by striking in a lower corner.
• Protect victims from glass by covering them.

65
Remove the Windshield (2 of 5)
25

• Windshield made of laminated glass
• Cannot be broken by spring-loaded center punches
• Consists of plastic laminated glass and designed
  like a sandwich
• When struck by sharp stone or spring-loaded
  center punch, a small mark is formed, but remains
  intact.
• Remove the windshield in one large piece.

66
Remove the Windshield (3 of 5)
25

• Most common technique is removing the windshield
  by using an axe.
• Protect victim.
• Begin cutting at the top of windshield at the
  middle using short strokes of the axe.

67
Remove the Windshield (4 of 5)
25

• Cut down the side next to the A post.
• Finish by cutting the bottom of the windshield.

68
Remove the Windshield (5 of 5)
25

• Second rescuer starts at the top of the
  windshield and cuts second half of the
  windshield.
• When the second rescuer is finished, lift window
  out of the frame.
• Place it in a safe area.
• A saw can be used to accomplish this technique as
  well.

69
Remove the Steering Wheel (1 of 3)
25

• During a crash, the steering wheel may be pushed
  back into the victims abdomen or chest.
• Removing the steering wheel can help in
  disentangling a victim from the vehicle.

70
Remove the Steering Wheel (2 of 3)
25

• Removal of the entire steering wheel is possible
  using hand or power tools.
• Hand tools include hacksaws or bolt cutters.
• Power tools include hydraulic cutters and
  reciprocating saws.

71
Remove the Steering Wheel (3 of 3)
25

• One method of removal is to cut the spokes as
  close to the hub as possible.
• Second method is to cut the hoop or ring.
• Can be removed completely or one section can be
  cut or removed.
• Cutting the hoop or spokes leaves sharp edges.
• Sharp edges need to be covered.

72
Displace the Dash (1 of 5)
25

• During frontal crashes, the dash will get pushed
  down or backward.
• If victim is trapped by dash it must be removed.

73
Displace the Dash (2 of 5)
25

• Technique is called dash displacement or a dash
  roll-up.
• Objective is to lift the dash up and move it
  forward.

74
Displace the Dash (3 of 5)
25

• Requires a cutting tool such as hacksaw,
  reciprocating saw, an air chisel, or hydraulic
  cutter to cut A post.
• A mechanical high lift jack or hydraulic ram is
  needed to push the dash forward.
• Cribbing is needed to protect the opening made
  from displacing dash.

75
Displace the Dash (4 of 5)
25

• Sequence for displacing dash.
• Open or remove both front doors.
• Place backboard between victim and bottom part of
  the A post.
• Cut the bottom of the A post perpendicular to
  where it meets the sill or the floor of vehicle.

76
Displace the Dash (5 of 5)
25

• Place the base of the tool at the base of the B
  post.
• Place the tip of the tool at the bend in the A
  post.
• Extend the tool in a controlled fashion to push
  the dash up and off the victim.
• Build a crib to hold the sill in position.
• Carefully monitor victim during the dash
  displacement.

77
Displace the Roof (1 of 4)
25

• Removing the roof has several advantages.
• Allows equipment to be passed to the emergency
  medical provider
• Increases the amount of space available to
  perform emergency medical care
• Visibility and fresh air supply are improved.
• Helps reduce feeling of panic caused by the
  confined space
• Provides a large exit route for the victim

78
Displace the Roof (2 of 4)
25

• One method is to cut the A posts and fold the
  roof back toward the rear of the vehicle.
• Provides limited space
• Takes same time as removing the entire roof
• Roof displacement can be accomplished with hand
  tools and power tools.
• Hand tools include hacksaws, air chisels, or
  manual hydraulic cutters.
• Power tools include reciprocating saws and
  powered hydraulic cutters.

79
Displace the Roof (3 of 4)
25

• Steps for roof displacement
• Assure safety.
• As roof is cut, rescuers have to support roof.
• Remove all glass.

80
Displace the Roof (4 of 4)
25

• Cut the posts farthest away from the victim.
• Cut the posts to ensure that the least amount of
  post will remain after roof removal.
• When cutting the wider rear posts, cut them at
  the narrowest point in the post.
• As each post is cut, a rescuer needs to support
  that post.
• Cut the post closest to the victim last.

81
Remove and Transport the Victim (1 of 3)
25

• Victim needs to be stabilized and packaged in
  preparation for removal.
• Definitive treatment of trauma victims needs to
  be done at a hospital.
• Amount of stabilization on the victim while in
  the vehicle should be limited to steps needed to
  prevent further injury.

82
Remove and Transport the Victim (2 of 3)
25

• Develop a plan for victim removal.
• Be sure that a clear exit pathway is available.
• Removal needs to be directed by a designated
  person.
• Use clear commands.
• Assure adequate number of rescuers.
• Make sure that everyone involved understands the
  commands that will be given.

83
Remove and Transport the Victim (3 of 3)
25

• Try to make removal process as seamless as
  possible.
• Locate the ambulance cot close by.
• Follow directions of EMS personnel in charge of
  victim care.
• Transport patient to appropriate medical facility
  for care as soon as initial stabilization is
  complete.
• If your department uses a helicopter service,
  become familiar with procedures.

84
Secure the Scene and Prepare for the Next Call (1
of 2)
25

• Final step is to secure the scene and prepare for
  the next call.
• Gather all of the equipment used, inspect it,
  clean it, sharpen it, refuel it, and place it
  back in the proper location.
• Sometimes this can be done at the scene.

85
Secure the Scene and Prepare for the Next Call (2
of 2)
25

• After major incidents, may be necessary to return
  to the station to clean and restock the
  apparatus.
• Personnel need to prepare for the next call.
• Rehabilitation may be necessary.
• Personnel may need to shower, change, and eat
  before another call.
• Maintain safe practices.

86
Summary (1 of 4)
25

• Most fire departments are involved in extricating
  victims from vehicles.
• Extrication should follow logical steps.
• It is important to prepare equipment and
  personnel for extrication emergencies.
• Respond safely and efficiently to an extrication
  incident.

87
Summary (2 of 4)
25

• Size-up needs to evaluate all of the hazards that
  are present.
• Stabilizing the hazards is essential to assuring
  safety for all people at an emergency scene.
• Tools used for gaining access and disentanglement
  work by stabilizing, bending, cutting, or
  disassembling.

88
Summary (3 of 4)
25

• You gain access to victims by opening doors,
  breaking tempered glass, or forcing doors.
• Techniques for disentangling victims include
  displacing a seat, removing the windshield,
  removing the steering wheel, displacing the dash,
  or displacing the roof.

89
Summary (4 of 4)
25

• Victims need to be properly packaged and
  carefully removed to prevent further pain and
  injuries.
• Equipment needs to be cleaned and returned to
  apparatus to be ready for the next call.