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
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•
•
•
Exposures to traffic.
Environmental factors.
Available and necessary resources.
Declaration of an MCI if applicable
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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
Upper rail
Rocker Panel
Anatomy Cont.
C-Post
A-Post
B-Post
Anatomy Cont.
Engine Compartment
Trunk
Passenger Compartment
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
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•
•
•
•
•
•
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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.
Cut
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.
Door side
Hinge Side
Cut
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 Jack
The dash jack provides the maximum amount of passenger compartment displacement.
1st a relief cut in the foot well.
3rd Start spreading at the lower relief cut.
2nd a relief cut in the upper rail and A post.
Spread until you free the patient.
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.
Material to be removed.
Finished.
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)