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Richard Marinucci |
Auto extrication requires teamwork, practice, staffing, and the proper tools. The job is getting more complex as automobiles and other vehicles on the road have more options and variances.
This challenges firefighters and officers who act as incident commanders to continually learn as much as they can while struggling to find the time to prepare for all types of emergencies. Regardless, organizations that want to make a difference must commit to improvement through preparation. This includes staying current on the latest tools and finding opportunities to practice, preferably on newer vehicles.
Extrication Objectives
There are two main objectives for extrication: rapidly removing and properly treating the injured. Both require skills, though not necessarily the same ones. Treatment probably is the more frequent application as medics, emergency medical technicians, and first responders take care of patients regardless of how they suffered the trauma. Extrications are generally not as frequent and therefore require more practice to obtain and maintain competence. To make it even more challenging, many crashes today involve fewer entrapments because of improvements in vehicle construction.
Training
Most, if not all, firefighting operations require teamwork whether for a medical call, fire, or extrication. Creating teamwork can be a challenge regardless of the type of department – all career, combination, or volunteer. In career organizations, between leave time, shift trades, and reassignments, it can be challenging to get the same crews together consistently to improve teamwork. It is not better in other organizations where personnel response is not likely to be the same from day to day. The only way to overcome this is to have very consistent policies and procedures and train to competence on these policies and procedures. Simplified, it means that as personnel are assigned, the expectation of performance is reliable. To put it another way, take a sports team. Members must know their roles. If there is a need for a substitution, the rest of the team can expect little, if any, drop-off in performance.
Practice, practice, practice! This is much easier said than done. Even in organizations with exemplary training programs, there is the ongoing challenge of finding the time to repeat skills enough to become as close to unconsciously competent as possible. Members expected to use particular tools must know their operation, indications of when they are best used, and their limitations. You will need to be good with power tools and hand tools. Proper shoring is essential for both safety and expedience. Departments should inventory all tools that are likely to be used during an extrication and create a spreadsheet to track training on all tools. There are some who will require more frequent training to maintain competence than others. But, all need occasional review.
Staffing on apparatus in many departments may not be adequate for the complex nature of some extrications. This can slow an operation or even create some situations where certain techniques cannot be performed because there are not enough hands. Some initial dispatches are made with a very basic response. Those who arrive first should receive training so they recognize sooner that a particular event will require additional resources. This is not any different than a structure fire that calls for multiple alarms. Many times, senior officers are not dispatched to crashes if there is not specific dispatch information. As such, junior officers or firefighters will need to make that call. These are not high-frequency events, and the culture of some departments does not encourage asking for additional resources, especially if it might require mutual aid. I realize this area has improved greatly in many parts of the country, but it is a good idea to revisit these issues from time to time.
Proper Tools
Having the proper tools can make all the difference. There are a few factors to consider. First and foremost is the budget. As these types of incidents are not very frequent in a lot of places, there could be a tendency to delay purchases or neglect learning about improvements. Awareness of “new and improved” is important so firefighters have the right equipment for the job. As mentioned above, newer vehicles present different challenges. Some of these challenges can be better addressed with the proper tools. There is an old saying that if all you have is a hammer, everything looks like a nail. If you have one major tool, the tendency would be to use it for everything, even if it is not the best option.
Putting the right tools in the toolbox is the first step. Training to competence on them is next. The training should be based on existing standards, best practices, and the manufacturer’s suggested use. The best tools used incorrectly won’t help as much as they could. Instructions for new tools shouldn’t be treated like the owner’s manual for your car! Someone (maybe everyone) should read the literature. Also consult with the sales representatives. Learn as much as you can before the tools are needed.
Maintenance is another big component of functional tools. This can be related to some of the other challenges facing organizations. Infrequency can lead to complacency. Busy companies or departments may not have the time and not prioritize. The reasons don’t matter. When someone calls 911, there is an expectation that the crews will be ready and their equipment will work. It is a bad time to find out the hydraulics are leaking, the blades aren’t sharp, or other equipment is not ready to be used. The equipment needs to be exercised to be in optimal condition – just like firefighters.
Scene Safety
Safety on the scene must be the priority. Those working in a hazardous environment will perform better if they are not looking over their shoulder to make sure there is no danger approaching. Creating safe work zones is possible but not always perfect. There has been much work done on creating standards and training for highway operations, much of it by the Emergency Responder Safety Institute. This organization has the most up-to-date information on its Web site respondersafety.com. Members of your organization should visit this site frequently so they are on top of things.
Extrications can be some of the most challenging events for fire departments. This is because they are usually not frequent calls, and other job responsibilities make it challenging to maintain skills, competence, and equipment. Effort is needed to overcome these issues and make sure that firefighters are prepared to do what is necessary for successful outcomes. Extrications with good outcomes are very rewarding. This is an area where a big difference can be made that really emphasizes the value of a well-trained and well-equipped fire department. Accept the challenge to stay prepared and ensure the readiness of everyone in your organization.
RICHARD MARINUCCI is the executive director of the Fire Department Safety Officers Association (FDSOA). He retired as chief of the Farmington Hills (MI) Fire Department in 2008, a position he had held since 1984. He is a Fire Apparatus & Emergency Equipment and Fire Engineering editorial advisory board member, 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 has a master’s degree and three bachelor’s degrees in fire science and administration and has taught extensively.
