Auto extrication & stabilization:
auto extrication & stabilization:A systematic approach to an extrication, is the best way to ensure that tasks are performed as quickly yet effectively as possible. The ideal number of rescuers for a simple single patient entrapment is said to be approximately 5 – 6 persons.possible crew organization:Captain (Extrication or Rescue Group Leader)Vehicle AssessmentScene Safety officerResponsible for the overall coordination of the rescue teamStand back and ensure they have a good overview of the incidentAddressing what steps will come nextCommunication focal point between rescue teams(s) and ICEngineer or FF2(Logistics)Extrication toolsVehicle stabilizationPreparing and staging equipmentAssist with extrication when neededScene lightingFirefighter 3 (Primary Tools)Ground Tarp for toolsPatient Cover/TarpRescue/Extrication ToolsWorks with (FF2 or Engineer) and has bulk of the actual rescue operationFirefighter 4 (back up tools)Rescue / Extrication ToolsHand ToolsVehicle StabilizationWorks with FF 2 or EngineerAmbulance PersonnelPatient Contact/CarePatient logistical needsscene safetyTo promote a safe and organized rescue scene it is important that rescue zones be established:Inner circle (action area) is an imaginary circle around each vehicle involved.Circle with a radius of approximately 10-15 ft.Outer circle approximately 15-30 ft and should be kept clear of all non-rescuers.Tool stagingParts dump is established for all removed materialFire protection A charged hose line shall be in place with a firefighter in full PPE and SCBA manning the line at all times during the extricationPlace a Dry Chemical extinguisher in the inner circlepatient careEstablish patient contact at the earliest opportunityStay in constant contactInform them exactly what is happing during the rescuethe extricationapproachTry and approach from the front of the vehicleMove around the vehicle and asses for hidden hazardsLook above, below and around the vehiclePatient person makes contact and keeps this contact until pt. is removedDisconnect seat belts if applicableStabilize the vehicleAfter assessment, start vehicle stabilizationMove seats back and roll windows downRemove ignition key away from scene (15’ for electric cars)Disconnect batteryIf battery cannot be disconnected, turn hazard lights on as a warning to rescuersSet emergency brakeGlass managementCover the patient and rescuerRemove glassCenter PunchSharp tool striking the lower corner of the glassRemove glass from inside outBreak glass if window is rolled down into doorEnhanced Protection Glass (EPG) must be left in placeIf breaking glass to access patient, break glass furthest from patientDisconnect seat belts or cutAVOId deployment path of airbagspeel & peakPull trim on opposite side of extrication pointWhat is found on one side will be a mirror imagedoor removalProvides quick access to patient1st Step – Unlock and open if possibleVehicle on its wheelsVehicle on its roofVehicle on its sideside removal- B pillar and 2nd door removal)Create a larger opening if needed for patient care or removalIf a dashboard roll is needed, avoid a side removal3rd door Conversion- (improved rear seat access)Creates a larger opening to the rear seat arearoof removal Improved patient access and removalForward roof flap Backward roof flap Partial roof flapSide roof flapInverted roof flapdash rollAid extrication or gain access to feetRamsdash liftDisplaces dashboard directly upward, away from patient extrication techniques & field exercisesstabilization:vehicle on its wheels3-point system4-point systemvehicle on its sideSupport under A and C pillarsCribbing and strutsvehicle on its roofSupport vehicle at space between vehicle and groundCribbing & chocksdoor removal:door removal-vehicle on its wheelsProvides quick access to patient1st Step – Unlock and open if possibleExpose hingesSqueeze fenderRelief cut fender to allow better spreader movementPlace spreader above upper hinge and find a stable spreading pointRemember attack one hinge at a timeAlternative: If the front of the car is inaccessible place spreader in the front corner of windowsill and door and spread against A pillar until hinges are exposedDO NOT TEAR METAL, STOP AND REPOSITION OR CUT HINGESAfter hinges are cut, cut strap and door electrical cableRemove door from lockPlace door in parts dumpdoor removal-vehicle on its roofSqueeze rocker channelSpread door outwardCut or spread hinges to remove doorside removalRemove front doorRemove back door at the hingesCut the top, then the bottom of the B pillar to removealternativeStart at back door and squeeze the door to create a purchase pointSpread back door until it opensCut lowest area of B pillarPlace tip of spreader on rocker channel and into B pillar cut and spread until bottom of pillar is releasedCut top of B pillarRemove front door at the hingesthird door conversionRemove front doorDeep relief cut at base of B pillarCut through B pillar at roofMake a vertical relief cut in front of the C pillarPlace spreader tips into cut and openroof removal:full roof removalRemove safety glassCut both A pillarsCut windshieldProtect patient and rescuersCut both B pillarsCut both C pillarsSupport roof with rescuersforward roof flapCut B and C pillarsMake relief cuts on both side of roof behind windshieldSupport roof with rescuersFold roof forward and secureinverted roof flapStabilize vehicleRemove glassShore rear of vehicle with strutsRemove rear seat to gain access to front seat if neededTension roof with a ram placed on roof and vehicle floorCut B and C pillarsDrive roof down using ramRemove side doors as neededdashboard roll /lift:dashboard rollStabilize vehicleAdd additional stabilization on ground below B pillarPlace Ram Support on front door rocker channelPosition ram and tension onto dashMake a relief cut through the base of the A pillarExtend ramPlace cribbing wedges into relief cut openingdash board liftStabilize vehicleAdd additional stabilization on ground below A pillarMake relief cut into fender to allow spreadingMake 2 relief cuts into the base of the A pillar approx. 4-6 inches apartClamp spreader on to cut sectionFold this section outward with the spreaderPlace spreader tips into gap and lift the dashA ram can be used simultaneously on the other side ................
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