Vehicle Extrication Overview

April 24, 2008

Click here to see the Handout

Objectives for tonight
• Concentrate on the Basics
– Anatomy of a Vehicle – Safety Considerations – Our Extrication Tools – On Scene Operation

• Review Common Extrication Techniques • Practice Operating Tools

Objectives for the next drill • As much hands on practice as possible • We should have 3-4 vehicles • Extra Tools provided by Gary Conahan • Concentrate on basic extrication techniques • Thursday. May 8 starting early at 6:30 pm .

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A-POST – The front support post of a vehicle where the roof is supported by extension of the body. .

C-POST – The post supporting the rear portion of the vehicle’s roof. .

B-POST – The center post between the front (A-Post) and rear (C-Post) of a vehicle. .

.ROCKER PANEL – Term used to describe the bottom portion of the door frame in a vehicle.

NADER PIN – Part of the door latch assembly in vehicles designed to keep the doors closed during a vehicle crash. Also referred to as the “striker bolt” .

Door Hinges – can be cut or spread apart to detach a door. . Wiring in doors may be difficult to cut with hydraulic tools.

Engine Compartment .

Passenger Compartment .

Trunk) .a.Cargo Compartment (a.k.

old VW Bug).• The engine compartment and the cargo compartment are designed to absorb an impact so that the passenger compartment remains intact. . • Keep in mind that the cargo compartment and engine compartment may be reversed on some vehicles (i.e.

• Where does a vehicle get its strength? – Older Cars? – Modern Cars? – Space Framed Vehicles? .

• Where does a vehicle get its strength? – Older Cars? – Modern Cars? – Space Framed Vehicles? .

• Where does a vehicle get its strength? – Older Cars? • Full Framed – two steel rails that support the floor and are the support for the vehicle’s construction. . • They are heavier and move in more predictable ways during extrication. • Removing one part has little or no effect on another • Dash Lifts work well when pushing down on the frame rail.

• Where does a vehicle get its strength? – Older Cars? – Modern Cars? – Space Framed Vehicles? .

. • Working on one side of the vehicle may affect the other side. • Operations may cause the passenger compartment to bend downward or lift upward. Solution = Relief Cuts & Stabilization. • Bends and creases of the sheet metal provide the strength. • Sheet metal is lighter and easier to cut.• Where does a vehicle get its strength? – Modern Cars? • There is no central foundation of steel.

• Where does a vehicle get its strength? – Older Cars? – Modern Cars? – Space Framed Vehicles? .

• The Body parts can be removed to expose the frame.• Where does a vehicle get its strength? – Space Framed Vehicles? • Common in full size cargo vans. • Built like a bird cage. • The frame is self supporting. Cut / spread the frame to extricate the patient. The body is put together with a series of panels attached to the framework. .

• Windows – Laminated Glass • Windshield – Tempered Glass • Side windows • Back window – Cut with Sawzall or Z Tool – Break with Center Punch .

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Passive Restraint System .

• There are too many options for airbags in
vehicles now. • Airbags not deployed in an accident can be disabled by disconnecting the battery. • The charge in the firing capacitors will dissipate over time – from 30 seconds to 10 minutes depending on the vehicle (Corvettes may take up to 20 minutes).

• If possible, look before you cut or spread.
Airbags are supposed to be marked. • Take care not to put yourself or tools in front of the steering wheel or other airbags. • Other suggestions?

• Personal Safety
– Full protective clothing including eye protection, helmet, gloves. – Be aware of and anticipate the movement of tools and metal. – When sawing glass HOLD YOUR BREATH – laminated glass turns into powder when sawn.

• Hazard Control – Electrical hazards • Wires down on vehicle • Electrical system of vehicle – Fluid spills – Hazardous cargo .

– Don’t hesitate to shut down the entire roadway. – Turn it over to law enforcement as soon as possible but don’t let them restore traffic flow too soon – COMMUNICATE. .• Traffic Control – Beware of oncoming traffic.

• Crowd Control – Keep bystanders back away from the scene. – Keep rescuers back away from the scene unless they have a job to do. .

– Maintain the patient during extrication. • Airway Management • Spinal Immobilization • Bleeding Control . – Protect the patient from metal movement (use a backboard).• Protect the Patient – Cover when breaking glass.

Broken glass can get imbedded in clothing. car seats and other unsuspecting locations.• Protect yourself – Always wear gloves when handling the patient. .

• Other safety considerations? ? ? ? ? .

What extrication tools do we carry on our vehicles and where are they kept? .

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What other extrication tools do we have in our arsenal? .

TNT Hydraulic Tools Power Unit Spreader Cutter Ram Halligan Tool Flat Head and Pick Head Axes Pry Bar Sledge Hammer Bolt Cutter Sawzall .

4x6) Wedges Angle Bracket Special Door Pulling Rope Hand Tools Wire Cutters Bolt Cutters High Lift Jack Various Old Pneumatic Tools Hack Saw .Step Chocks Cribbing (4x4.

. . . . Anyone? . . . Whitney? . . Bergen? . . . . Bueller? .I probably forgot some . . Bobby Brown? . ? . .

On Scene Operations Assess the scene as you approach Establish Incident Command Size Up Is it safe to leave your vehicle? Is it safe for other incoming units? # of vehicles involved? # of Patients? Additional Resources? Etc… .

On Scene Operations Circle Surveys Outer Circle Inner Circle Lower Level Survey Upper Level Survey .

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On Scene Operations Circle Surveys Outer Circle Walk 360° around the vehicle looking away from the scene (be mindful of hazards) Check for patients that have been ejected from the vehicle Check for any hazards or possible threats .

etc.)? What condition is the ground in with regard to cribbing (soft.On Scene Operations Circle Surveys Inner Circle Walk 360° around the vehicle looking towards the scene (be mindful of hazards) Lower Level Survey – look around and under Is the vehicle on anything (power box. dry)? Is the vehicle leaking anything (gas. hard. wet. etc. oil. power lines. coolant.)? .

On Scene Operations Circle Surveys Inner Circle Walk around the vehicle looking towards the scene (be mindful of hazards) Upper Level Survey – look inside # of patients? Is the vehicle auto/manual – in park or neutral? Ignition on/off? Airbag? Have they deployed? Doors Locked? Power Locks? Power Seats? .

On Scene Operations Stabilization Cribbing Step Chocks (AKA Stair Step Cribbing) Box Cribbing Wedges Air Rescue Bags Post Cribbing (Rescue 42 Bar) .

On Scene Operations Stabilization Cribbing 4 Point Cribbing 6 Point Cribbing Place the cribbing then deflate the tires to stabilize the vehicle Pull the valve stem with a pliers or channel lock Pierce the sidewall with a halligan tool or pry bar .

Post Cribbing .

Four Point Cribbing .

Six Point Cribbing .

. Obtain a tool from the tarp. Once the assigned task is complete return the tool to the tarp. The special tarp keeps tools organized.On Scene Operations Tool Staging – We have a designated tarp on Engine 2 marked with silhouettes of commonly used extrication tools that we carry on our apparatus.

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stretchers and backboards should remain out of the action circle until needed .On Scene Operations Action Circle = an area 10 to 15 feet wide around the vehicle Larger if needed Tool staging area is just outside of the action circle First aid equipment.

On Scene Operations Action Circle – Keep it clear of: Non-essential personnel Tools not in use Bystanders Parts of the vehicle after they have been displaced Always have a charged hose line available just outside the action circle .

On Scene Operations Team Approach – Line up style Firefighters line up behind each other just outside the Action Circle. Firefighter(s) report the assignment complete then get back in line behind the other Firefighters. Firefighter(s) complete the assignment. Firefighter(s) receive an assignment. .

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transport. immobilization. stabilization at the ER. “Platinum 10” – The goal is to reduce extrication time to 10 minutes so there is as much time as possible to get everything else done within the Golden Hour. etc. . extrication.On Scene Operations Miscellaneous Stuff Golden Hour – Time to surgery – That includes responding to the scene.

On Scene Operations
Miscellaneous Stuff
An accident severe enough to require extrication is severe enough to cause a spinal injury.
A rescuer climbing into a car can move it enough to move and injure the patient – Stabilize first! Approach from the front. Gain eye contact and advise them not to move. Approaching from the side may prompt the patient to turn their head causing further injury.

On Scene Operations
Miscellaneous Stuff
Seat belt supports are typically located near the B-Post. Avoid them if possible. They are usually located 6” in front of or 6” behind the end of the post. Cut the battery as soon as possible. Take into account electric door locks, windows and seats. Airbags will be disabled after the battery is disengaged.

On Scene Operations
Miscellaneous Stuff
Remove all glass before spreading or cutting. Intact glass can shatter when using tools dispersing pieces all over the place. Often the best way to “take the glass” is to roll the window down leaving about a ½” showing. Use a window punch or halligan to break the glass. The shattered glass will fall inside the door frame.

Never try to cut the Nader Pin.On Scene Operations Miscellaneous Stuff Push on the interior portion of doors. . Avoid potentially loaded bumpers. When swinging a tool look behind you first and announce loudly “swinging tool”. It is more structurally sound than the sheet metal skin.

On Scene Operations Miscellaneous Stuff Terminology: Freeze = Emergency stop of all activities on scene (usually to prevent unsafe operation) Thumbs Up = Turn on the power unit or engage the hydraulic tool Thumbs Down = Turn off the power unit or disengage the hydraulic tool .

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Common Extrication Techniques “Taking the Glass” Simple Door Removal Fifth Door Conversion Third Door Conversion Dash Lift Roof Removal .

Common Extrication Techniques “Taking the Glass” = Break all the tempered glass safely before cutting or spreading. • Roll down windows/break in door frame • Center punch • Tape first (remove window in one piece) • Plastic Collapsible Spanner Wrench • Tip of an antenna • PROTECT THE PATIENT .

Common Extrication Techniques Center Punch .

Common Extrication Techniques Tape window and remove as one piece .

Common Extrication Techniques Tape window and remove as one piece .

Common Extrication Techniques Use a spanner or other object .

Common Extrication Techniques Use a spanner or other object .

Common Extrication Techniques Disconnect the battery / accessing the engine compartment • Cut the negative battery cable • To disable the airbags • To disable the ignition • Stabilize the vehicle first • Try before you pry • If all else fails. bend up the corner of the hood to access the battery .

Common Extrication Techniques Bending up the corner of the hood .

Common Extrication Techniques Don’t stand in front of the bumper .

Common Extrication Techniques You must overcome the factory bends in the hood .

Common Extrication Techniques Scratch out a line on the hood and beat the metal into a crease .

Common Extrication Techniques Pierce the hood with a halligan and bend the corner up .

Common Extrication Techniques .

Common Extrication Techniques .

Common Extrication Techniques .

Common Extrication Techniques .

Common Extrication Techniques .

Common Extrication Techniques .

• Always stabilize the vehicle first. .Common Extrication Techniques Simple Door Removal • Does it need to be removed or just pulled out of the way? • We have a specially designed rope that provides a mechanical advantage to pull back and stabilize a door (click here to see the handout).

bent knees .Common Extrication Techniques Simple Door Removal (i.e. driver’s door) • Create a purchase point • Spread the door latch assembly apart • Open the door to expose the hinges • Spread or cut the hinges • Work from top down • Be careful not to push tools or metal into the patient • Someone should stabilize the door to prevent it “springing” open .

Push down and pull up to create an opening.An opening made that allows room for the insertion of rescue tools for the purpose of moving metal. . plastic and debris.Common Extrication Techniques Purchase Point .

Common Extrication Techniques Creating a purchase – set halligan with a sledge or flat head axe .

Common Extrication Techniques Creating a purchase – pushing down and pulling up .

Common Extrication Techniques Place the tip of the spreader in the purchase point .

Common Extrication Techniques Spreading the door latch assembly .

Common Extrication Techniques Spreading or cutting hinges .

Common Extrication Techniques Spreading or cutting hinges .

Common Extrication Techniques Fifth Door Conversion • Gain access to the front and rear seats of a four door vehicle. • Stabilize the vehicle first. • “Take the glass”. • Eliminates the B-Post which is typically the piece in the way during patient removal from the vehicle. .

• Spread / cut the front door off of the hinges.Common Extrication Techniques Fifth Door Conversion • Create a purchase point near the hinges of the front door. • Spread / pull the front door back exposing the B-Post. .

Common Extrication Techniques Fifth Door Conversion • Cut the B-Post at the top and bottom • Spread / pull the rear door back as far as possible • Spread the door latch assembly of the rear door apart • Remove the doors from the Action Circle .

Common Extrication Techniques The vehicle is stabilized – 4 point cribbing .

Common Extrication Techniques Spreading to front door off the hinges .

Common Extrication Techniques Bending the door back to expose the B-Post .

Common Extrication Techniques Cutting the B-Post high and low .

Common Extrication Techniques Bending the door back to access the passenger compartment .

Common Extrication Techniques Removing the doors completely (out of the Action Circle) .

Common Extrication Techniques Third Door Conversion .

Common Extrication Techniques Stabilize the vehicle .

Common Extrication Techniques “Take the windows” .

Common Extrication Techniques The windows have been taken .

Common Extrication Techniques Remove the door .

Common Extrication Techniques The door and windows have been removed .

Common Extrication Techniques Make a relief cut in the B-Post and near the C-post .

Common Extrication Techniques Spread the sheet metal away to access the back seat .

Common Extrication Techniques Sorry about the bad slides .

Common Extrication Techniques Dash Lift – using the spreader • Stabilize the vehicle • Remove the front door(s) • Make a relief cut above the wheel well • Consider using the spreader to flatten the quarter panel before cutting .

Common Extrication Techniques Dash Lift – using the spreader • Make a relief cut high on the A-Post • Make a cut above the lower hinge on the A-Post (widen this cut if possible) • Place the spreader in the lower A-Post cut to lift the dashboard • Only lift enough to remove the patient • Stabilize the lift with cribbing in the cut .

Common Extrication Techniques Click here to see a free web video of a dash lift using the hydraulic cutter and spreader Courtesy of American Rescue Technology Incorporated .

Common Extrication Techniques Dash Lift – using the ram • Stabilize the vehicle • Remove the front door(s) • Make the same relief cuts Above Wheel well High on A-Post Above hinge on A-Post .

Common Extrication Techniques Dash Lift – using the ram • Position Hydraulic Ram between the bottom of the B-Post and the bend in the A-Post near the windshield • Cribbing support is needed under the BPost (consider using an angle bracket) • Engage the ram to lift the dashboard • Lift only enough to remove the patient • A high lift jack may work in place of the hydraulic ram .

• Start with the windshield. . • Assuming the vehicle is stabilized and the windows have been “taken”.Common Extrication Techniques Removing the roof • Extra personnel are needed to support the roof as the posts are cut.

Keep your mouth closed when cutting glass It helps to have one person on each side of the car cutting the windshield. if possible. Use a sawzall or Z Tool (or ax) to cut across the windshield.Common Extrication Techniques Removing the roof • The windshield continued… Use the cutter to make cuts in both the driver’s side and passenger’s side A-Posts. .

Common Extrication Techniques
Removing the roof
• After the windshield has been cut and is free, cut both of the B-Posts. • Then cut both of the C-Posts. • Supporting the roof throughout. • Remove the roof completely (towards the front, if possible, to avoid lifting the windshield over the patient). • Remove the roof from the Action Circle.

Common Extrication Techniques

Common Extrication Techniques

Windshield Cut

Common Extrication Techniques .

Common Extrication Techniques .

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.This is an overview of vehicle extrication basics only. Thanks to Bill Muehl for some of the photos. Ted Harris (Viroqua FD) and various Internet sources. Material taken from previous extrication drills designed by Dan Williams.