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For all you technical 'purists', here's a question from a central NY State fire officer that makes you think.
"Ron,
I just want to pick your brain for a couple minutes. Recently at the station a few of us were discussing what extrication really means. Here are my thoughts. In our County, many departments would refer to using hydraulic tools to remove a door as extrication instead of disentanglement.
The definition of "disentanglement" in Mosby's Paramedic Textbook, Second Edition, defines it as a "systematic removal of a vehicle or structure around a victim". In simple terms, "cutting the car away from the victim, creating a pathway through the wreckage".
We all know what patient packaging is. Collar, board, possibly even a KED.
Now move to extrication. Disentanglement is complete. The patients vitals are stable and injuries non life threatening. The patient meets all of the protocols for having a KED placed on them. With the collar already applied and head stabilization in place, the KED is applied and the board is resting on the seat, you start to EXTRICATE the patient out of the vehicle using the pathway that was created during DISENTANGLEMENT.
See where I am getting at. Why do so many relate to the grabbing the tool as extrication instead of disentanglement? How did that word get lost?
You could have an auto accident with the door to the patient already open and technically, wouldn't we still have a patient to extricate? Disentanglement wouldn't be required, but the extrication of the patient from within the vehicle is still necessary.
What are your thoughts?"
My Reply:
If you want to talk 'technically', then we have to go with the definitions of extrication and disentanglement found in the textbooks. They are there in print but they don't reflect the reality of what we commonly call the things that we do.
An accident with injuries, where the victim is longboarded out an operable door is 'technically' extrication, but if you call that extrication, you'd be laughed at. If you had a serious crash scene and said we needed to "disentangle" somebody, your crew would look at you like you're nuts! "They're trapped...what are you talking about?", they'd say.
The reality of our rescue world is that someone long before us decided to call the ripping and tearing work we do "extrication" and that has stuck ever since. Nobody routinely uses the term disentanglement; we use "people trapped" instead.
I don't make a big deal out of this; working tools to tear a vehicle apart is "extrication" and everybody seems to know what that means, so I just go with it.
This is a case where being technically right, isn't really right.
"Ron,
I just want to pick your brain for a couple minutes. Recently at the station a few of us were discussing what extrication really means. Here are my thoughts. In our County, many departments would refer to using hydraulic tools to remove a door as extrication instead of disentanglement.
The definition of "disentanglement" in Mosby's Paramedic Textbook, Second Edition, defines it as a "systematic removal of a vehicle or structure around a victim". In simple terms, "cutting the car away from the victim, creating a pathway through the wreckage".
We all know what patient packaging is. Collar, board, possibly even a KED.
Now move to extrication. Disentanglement is complete. The patients vitals are stable and injuries non life threatening. The patient meets all of the protocols for having a KED placed on them. With the collar already applied and head stabilization in place, the KED is applied and the board is resting on the seat, you start to EXTRICATE the patient out of the vehicle using the pathway that was created during DISENTANGLEMENT.
See where I am getting at. Why do so many relate to the grabbing the tool as extrication instead of disentanglement? How did that word get lost?
You could have an auto accident with the door to the patient already open and technically, wouldn't we still have a patient to extricate? Disentanglement wouldn't be required, but the extrication of the patient from within the vehicle is still necessary.
What are your thoughts?"
My Reply:
If you want to talk 'technically', then we have to go with the definitions of extrication and disentanglement found in the textbooks. They are there in print but they don't reflect the reality of what we commonly call the things that we do.
An accident with injuries, where the victim is longboarded out an operable door is 'technically' extrication, but if you call that extrication, you'd be laughed at. If you had a serious crash scene and said we needed to "disentangle" somebody, your crew would look at you like you're nuts! "They're trapped...what are you talking about?", they'd say.
The reality of our rescue world is that someone long before us decided to call the ripping and tearing work we do "extrication" and that has stuck ever since. Nobody routinely uses the term disentanglement; we use "people trapped" instead.
I don't make a big deal out of this; working tools to tear a vehicle apart is "extrication" and everybody seems to know what that means, so I just go with it.
This is a case where being technically right, isn't really right.
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