Extricating a victim from a vehicle crash as quickly and safely as possible translates into better outcomes for the patient. This also applies to almost every other rescue scenario. The faster patients get the most appropriate care saves lives. It reduces time spent in hospitals and time spent in rehab and lowers the likelihood of long-term problems.
Every fire department and every member should understand this and work toward continually improving their competence – individually and as a member of a team – in order to give the patient the chance for the best outcome.
It is safe to say that extrication today is vastly improved from what it used to be just a few years ago. This is no small accomplishment, as the vehicles have changed significantly, presenting more challenges than ever before. Today's vehicles have different components with different materials as well as added safety features, such as airbags and improved seatbelts. If you consider the newest developments with hybrid vehicles you can appreciate the need to continually study, train and practice.
Consider the challenges facing firefighters as they try to be the best they can be: newer vehicles; the limited availability of newer models to train on; a greater variety of tools available; and additional job responsibilities limiting the time needed to become competent in a variety of required skills. These issues add to the fact that many fire departments have been forced to cut staffing levels due to economic issues. Regardless, there is an expectation that professional, competent, fast service will be provided every time a fire truck rolls out the door.
Much has been written about the changes in vehicles. Suffice it to say that the vehicles crashing on the interstate today are different with different challenges to responders. Improved safety has helped in many ways. Not too long ago, a rollover accident on a limited access highway meant serious injuries if not fatalities. Today responders often find the "victims" walking around after a rollover – protected by seatbelts, airbags, and better construction.
But these improved features can create problems for firefighters and must be known to the responders so that the appropriate action can be taken. Do all your members know what to do if they are faced with the following:
- Batteries in hybrid vehicles.
- High-strength steel components.
- Un-deployed airbags.
- Quiet vehicles operating on battery power, still turned on.
One opportunity is to work with neighboring departments. Resources may be limited, and sharing provides more prospects for new learning. There are also individuals and companies that provide extrication training. If you are considering this, do your homework. Not all trainers are created equal, nor can they provide the same level of competence. Even if competent, they may not be what you thought you were getting. Do your homework, get references, know all the costs and make sure you communicate your expectations.
Extrication training and practice most often takes place under ideal conditions. While this is good for safety and learning, it may not mimic what firefighters can be faced with on a real emergency. Darkness, weather and an assortment of obstacles such as Jersey barriers, power poles, culverts, trees, and the like create scenarios not often practiced. Understand that these challenges exist.
Competence in the basics will allow energies to be focused on the problem solving needed. Good lighting will also prove to be very beneficial. Look at all your lighting options and get the most appropriate for your situation. Consider your power sources and space. There are advantages to elevated lights that shine down on the operation. If the emergency scene is properly lit early in the operation, firefighters will operate more efficiently, effectively and safely.
Think about the types of weather you may be facing in your community. We all know that extrication can be tough enough without dealing with the elements. Rain, wind, snow, ice and even extreme heat and cold can factor into decisions that are made during extrication.
Working at a wreck can sap the energy of even the most fit firefighter. Slipping and sliding don't help with the outcome. Plan ahead. Carry salt or other material to melt ice or snow around the incident area. Be prepared for rehab and rotation of firefighters in extreme weather conditions. Accidents that leave the roadway can end up in mud creating a less than desirable work area. Anticipate that you will be asked to do your job under bad conditions and prepare accordingly.
There was a time when extrication tools were limited to pry bars and hydraulic tools. Through experimentation and trial and error, many common tools have been found to be helpful for specific tasks during extrication. Anything that can be used to help remove the vehicle from around the victim is a good tool.
You can learn more by reading the literature, attending trainings outside your organization or talking to your neighboring departments. Of course, as with everything we do, we know that something else will challenge us. As you add more tools, you need to find compartment space. If you are like most agencies, your trucks are full. You will need to prioritize and get creative to find the space you need.
In a majority of fire departments, extrication requiring significant effort is not a frequently occurring event. However those incidents often present circumstances where quick, decisive action on the part of the responders will produce a successful outcome. These are very rewarding to the firefighters who work very hard on behalf to the injured. There are no shortcuts to competence.
Every firefighter knows of the golden hour – the time period where proper treatment can mean the difference between life and death (or a return to normal health). Speed definitely counts, and you can't get better without practice and repetition.
Know your tools and techniques inside and out. Study the vehicles and understand the challenges that the work environment places on you and your crew. Keep your firefighters safe and give the victim the best result possible.
Editor's Note: Richard Marinucci is chief of the Northville Township (Mich.) Fire Department. He retired as chief of the Farmington Hills (Mich.) Fire Department in 2008, a position he had held since 1984. He is a past president of the International Association of Fire Chiefs (IAFC) and past chairman of the Commission on Chief Fire Officer Designation. In 1999 he served as acting chief operating officer of the U.S. Fire Administration for seven months. He holds three bachelor's degrees in fire science and administration and has taught extensively.