Rescue CBT

1st Quarter 2013

Rescue CBT

Car Crash Caught on Tape (click to view video)

Multi Car MVC

Size up should include but are not limited to the:

• Scope/Magnitude of the incident.

• Number and size of vehicles affected.

• Integrity and stability of the affected vehicles.

• Number of known and potential patients.

• Access to the scene.• Hazards.

Multi Car MVC

• Exposures to traffic.

• Environmental factors.

• Available and necessary resources.

• Declaration of an MCI if applicable– 0-10 (Level 1)

– 11-20 Pt’s (Level 2)

– 21-30 Pt’s (level 3)

– 30+ Pt’s (Level 4)

All of these consideration and many others can be accomplished by completing an outer and inner circle survey

Apparatus Placement

Fire Truck verses Semi (click to view)

Apparatus Placement

As an initial priority, first arriving officer to motor vehicle accident scenes shall assess all four sides of the work zone to determine the degree of risk exposure from oncoming traffic. Based on this assessment, the officer shall include in their Incident Action Plan (IAP), the provisions needed to adequately protect the work zone. These provisions shall be implemented from the onset of the incident and maintained for the duration.

Apparatus Placement

• Place the first arriving apparatus on the traffic side of the incident in a blocking position for the purpose of creating a buffer zone

• First arriving units may consider completely stopping all traffic flow until adequate resources arrive and are able to establish adequate provisions for traffic control.

Apparatus Placement

• Place all EMS units so that the patient loading area at the rear of the EMS unit is positioned within a protected work zone.

• Place other agency vehicles (i.e., police, POV responders, utilities, and State DOT) on the traffic side of the work zone

Apparatus Placement

• Place traffic cones or flares at least 200 feet before the work zone.

• If a detour can be established, consider closing the roadway at a nearby intersection and diverting traffic

Freeway Placement

On highways, increase the distance for cones and flares to 400 feet. For long term traffic control, turn the scene management over to Washington State Patrol or the DOT highway response units.

Safety at an MVC

• Once priorities have been established and protection is in place, additional vehicles should be placed in a safe location, generally at the exit of the work zone.

• Ensure that all members have their traffic vests on any time they are in the work zone on or near the roadway.

• Identify a primary and secondary escape route and communicate these to the members.

• Consider designating one member to serve as a lookout to warn other members of traffic that may not heed warning devices.

Safety at an MVC

• Never trust traffic. Do not turn your back to traffic when walking along the shoulder.

• Place apparatus in a manner that provides an adequately safe work zone.

• Wear visible, reflective clothing.

Patient Care

Basic Principles:

Maintain Spinal alignment

To minimize spinal cord injury and paralysis

Minimize body twisting

To reduce further injuries and reduce fracture movement and pain.

Patient Care

Work with extrication crews to allow for treatment to be started during the extrication process.

A rescuer needs to do a full assessment of the patient before extrication.– Unless rapid

extrication is required

Auto Extrication

Insane Car Accident ( click to view)

Anatomy

Rocker Panel

Upper rail

Anatomy Cont.

A-Post

B-Post

C-Post

Anatomy Cont.

Engine Compartment

Passenger Compartment

Trunk

Anatomy Cont.

The nadar pin (door striker) is part

of the door latch assembly and

are designed to keep doors

closed during an accident.

They also:

• Make prying doors difficult.• Are not always in the same

spot. • Come in two main styles:

– Latch Style– Pin Style

Anatomy Cont.

Door Hinges – can be

cut or spread apart to

detach a door.

Remember that:• The wiring in doors may be

difficult to cut with hydraulic tools.

• Hinges come in many different styles and materials.

Stabilization

Stabilization can be

broken up into two

separate categorizes:

• Basic

And• Advanced

* Remember when you lift an inch crib

or stabilize for that inch *

Basic Stabilization

• Wood Cribbing• Manufactured Step Chalks• Wedges• Apparatus Wheel Chalks• Straps• Chains/Hook clusters

Advanced Stabilization

• Air Bags• Straps• Chains/Hook Clusters• Struts

– Rescue 42’s– Res-Q-Jack’s– Paratech’s

Methods

There are a variety of methods used for

extrication with the two most popular being:

Hand tools

AND

Power tools

Hand Tools

Include but are not limited to:• Come-along's• High-Lift Jacks• Glass Masters• Wedges• Cable cutter• Pry Bars

Power Tools

Include but are not limited to:• Cutters• Spreaders• Rams• Saws• Air Chisels• Torches• Saw Zalls

Techniques

• Rapid door pop• Total roof removal• Roof Flap• B post blow out (maxi door)• Dash roll• Dash jack/lift• 3rd door conversion• Misc.

Rapid Door Pop

Is used to gain rapid access to the passenger compartment and usually involves the door closest to the patient. May be performed from either the hinge side or the nadar pin side. Is also very useful on trucks and 2-door passenger cars.

Roof Removal

Allows for the best access to the passenger compartment and is accomplished by removing all of the glass, cutting the given number of posts and removing the entire roof from the vehicle. This allows the patient to be removed without compromising their spinal alignment.

Roof Flap

Is used when a total roof removal is not feasible or only a little room is need to free the patient. It too involves removing the glass and cutting the appropriate pillars.

Even works with the care on it’s side!

B-Post Blow out

AKA: Maxi-Door, Side

wall removal.

Allows for adequate access to the passenger compartment and is accomplished by removing the glass, and starting from either the hinge side or the door side. Once the 1st door is removed the ‘B’ post is cut top and bottom and then the 2nd door is removed.

Cut

Cut

Hinge SideDoor side

Dash Roll

Is used to create space in the passenger compartment. The roll provides adequate room but requires a tool be left in place, which takes up allot of valuable space. Relief cuts

Capture the progress of the lift.

Dash Jack1st a relief cut in the foot well. 2nd a relief cut in the upper rail and A post.

3rd Start spreading at the lower relief cut. Spread until you free the patient.

The dash jack provides the maximum amount of passenger compartment displacement.

3rd Door Conversion

Is extremely useful when extricating from a 2-door car or an extended cab truck. The 3rd door allows for more room and better overall patient care and packaging.

Finished.

Material to be removed.

Misc.

Think outside the box!• Pull the steering column.• Cut/Displace foot pedals.• Removing Glass.• Tunnel through the trunk.• Perform a rear window

tint.• Involve the local tow

companies.

High Strength Materials

The auto industry has made huge advances in the construction of their vehicles. Although the advances are keeping passengers safer they are posing a problem for first responders. New stronger tools are not always the answer, the auto industry is still years ahead of the cutting and prying capabilities of our tools.

High Strength Materials

Here is a clip of a brand new 2012 tool stalling while working on a 2012 Mercedes.

Tools stalling on a GL320 (click to view)

High Strength Material

Can be located through out the vehicle. The only way to tell is by peaking and pealing before you cut.

High Strength Materials

Come in many different construction types:– Some are re-enforced

with additional metal– Some are re-enforced

with metal rods

High Strength Materials

Below is a comparison between a 2012 b-pillar and a 1992 b-pillar.

Alternative Methods

In-order to remain efficient at our craft we need to be able to overcome the obstacles by using alternative methods.

Alternative Methods

Alternative Methods

Look for clues while peaking and pealing back the trim, manufactures are starting to place stickers to assist us in where to cut and where not to cut.

THE END

FUNNY CAR VIDEO (click to view)