In spite of all of the lockdowns and craziness surrounding the world in which we live today, I consider myself blessed to have been able to get out and offer some (very delayed) training programs over the past number of weeks. My travels have kept me stateside, however some of the things that have resulted from these fantastic “sharing of knowledge” opportunities have strengthened my resolve about a number of issues surrounding extrication size-up.
During an evening of training here at home in central Eastern Idaho, I had a number of students from a department that had responded to a vehicle rescue call that obviously caused them some serious angst. It seems that an “impaired driver” traveled through a “T” intersection, through a railroad chain link fence, and became firmly wedged (in parallel) between two loaded boxcars. The driver patient’s legs were pinned by the dash which had collapsed on impact, and there appeared to be no viable way to effect a dash displacement to free the patient’s legs because there was a loaded boxcar on either side of the car.
While working with a group of fire departments doing heavy rescue programs in rural Minnesota (Dodge Center) a week or so later, a very similar story was shared, with the same patient access challenges as the rail yard call in Idaho.
My last stop on this tour was in (not really rural) New Jersey, where I had firefighters sharing with me about challenges they have had with vehicle rescue calls with motorists becoming wedged in “turnpike overpass abutments” (we don’t have turnpikes or overpass abutments here). For those not familiar with this situation, imagine a sloped concrete ramp that ascends from ground level to intersect with the bottom of an overpass. This situation creates an environment where in the vehicle becomes hopelessly wedged between the bottom of the overpass and the concrete “side hill” that intersects it.
What each of these scenarios has in common comes down to what the person in charge found because of their individual size ups.
So, my question to you all is: what formed or shaped the parameters of our extrication size-ups? The answer is relatively easy. It came from what we were taught back when, or perhaps what our individual states or departments mandate regarding this issue. You see, most, if not all, of us were taught how “thou shalt work on it” wherever or in whatever shape you encounter a vehicle that has been involved in a wreck. Apparently, nothing could be farther from the truth.
New vehicle technology has forever changed the way we once thought about extrication. Tougher metals and new construction methods and techniques have forced us into a new way of thinking about extrication. A big part of that new thinking involves our initial as well as our ever evolving size-up.
Since the stone age when I took my first extrication program, we were taught (and have continued to teach) that we work on the vehicle or vehicles “where we find that they came to rest.” I was also originally taught that it was against EMS protocol to “move” a wrecked vehicle with a viable patient in it. Even today, this seems to be a misnomer, with the exception perhaps of pulling an under-ride (where a car slams into the back of a big rig trailer and becomes wedged underneath it) out from the truck after lifting the trailer.
In each of the scenarios that I listed above, the proper course of action because of a good size-up is to move the trapped vehicle so that you can extricate the entrapped occupants. Extrication is the art of making space. Sometimes we need to make space by extricating the vehicle, so that we can extricate the patients from the vehicle! Don’t wait to make this decision. If deemed necessary, the decision to move a trapped vehicle should be made during the initial size up.
Is your department equipped and prepared to safely move an entrapped vehicle? Are you up to date on your winching operations? In addition to lots of training, winching operations require a few special, but not necessarily expensive tools and adjuncts. Although NOT done with ropes to move vehicles, many departments will add winching training as a module of high- and low-angle rope rescue training. That said, there is no one who can offer a fire department better training on the topic of vehicle recovery like a good towing service. Remember that they winch, roll, lift, and haul wrecked vehicles for a living. These guys can be a vital resource for your rural department. Even if you have everything you need to effect moving a vehicle, a good wrecker service can usually do it in about half the time, allowing your crew to concentrate on removing the patients from the vehicle once you can gain access to them. Many rural departments now put their local wrecker service on auto dispatch for vehicle rescue calls. I personally think this is a fantastic idea, as these vehicles are going to need to be cleared from the scene anyway.
Not to belabor this subject, but think about something for a minute; If a vehicle is upside down with victims trapped in the back seat, there is FAR LESS risk involved in working professionally (not just dumping it over with manpower) to roll that car back onto its wheels with a good wrecker service and/or a well trained and equipped fire department than trying one of the moronic “extreme advanced tactical extrication” maneuvers like “crack the egg.” Trust me when I tell you that today’s tough new vehicles are made very much like high speed race cars wherein they consist of a roll cage as the superstructure for the vehicle. Once you compromise, or break the integrity of that superstructure, there is literally nothing left to support or hold that car together. No matter how cool they sound, or how fun they are to try in junkyards with old cars, “whiz bang tactical” moves don’t and shouldn’t apply to new vehicles. Invest your time in learning about how and what these cars are made of and how they’re constructed.
If what I’ve to shared with you about moving wrecked vehicles to allow access to work on them violates any state, local, jurisdictional law, or EMS/fire department protocol, please don’t implement without prior approval. I offer that disclaimer because I understand that there still may be places in the country that insist on “doing it the way we’ve always done it.” Stay sharp, stay safe, and size it all up!
CARL J. HADDON is a member of the Fire Apparatus & Emergency Equipment Editorial Advisory Board and the director of Five Star Fire Training LLC, which is sponsored, in part, by Volvo North America. He served as assistant chief and fire commissioner for the North Fork (ID) Fire Department and is a career veteran of more than 25 years in the fire and EMS services in southern California. He is a certified Level 2 fire instructor and an ISFSI member and teaches Five Star Auto Extrication and NFPA 610 classes across the country.