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Live bodies during extrication training

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  • #16
    I think it is a very bad idea. We got away from allowing the use of live bodies during structrual training for a reason. Things go wrong and we just can't afford to take the chance of causing injuries or worse to our personnel.

    While it is critical to train under emergency scene scenarios, I feel that with the chance something going wrong, that we can and do train with dummies to the fullest extent and to simulate on scene scenarios.

    A couple things come to mind, hydraulic failure, tool slipage, exposure to flying debris and even more so is the sudden failure of the system under extreme pressure with a live member in the immediate area.

    Just don't think it's a wise idea.
    These views/ opinions are my own and not those of my employer/ department.


    • #17
      Any extrication training I've taken has used live victims. The victims are always in full turnouts with helmet and sheild down. It's always been your standard car-on-four-wheels type scenerio.

      I did participate in a video for driver's ed where our live victims were unprotected civilian actors.

      I've got to admit, I have never really thought about using a dummy.

      As 27 said, training is for developing technique, so speed isn't the focus. That allows the instructors to keep a watchful eye at all times.
      Bryan Beall
      Silver City, Oklahoma USA


      • #18
        Similar points of others. We use live victims when are training in victim removal. We do use our "Rescue Randy" (180lb dude) for most of our extrication scenarios. We place the dummy in the vehicle before we have it rolled and or smashed around him. This makes the scenarios for extrication more realistic. Obviously we won't do that with live victims. We have used live bait before during our simple evolutions but definately NOT during our training in complex extrication evolutions. I will add that this year we used live bait in in our TERC competition. No injuries or even close call that I am aware of. I have always been a proponent of training like it's an emergency thus the emergency evolves like you train. But common sense prevails in our discussion here. Treat the dummies like live victims when the complex evolutions are being practiced. Let them be our "stand-in" stuntmen. Handle them like it's the real deal.
        "Making Sense with Common Sense"
        Motor Vehicle Rescue Consultants
        ( [email protected]) Jordan Sr.


        • #19
          1999 eh?

          Wow, Lutan, doing some digging I see...
          When I was in EMT school, they used live "mock patients"for our extrication class. But come to think of it, they really should have looked into using dummies...there were a lot of things that day that could have turned into disasters!!
          Interesting thread!
          Jen, EMT-B
          "I got lost in thought...it was unfamiliar territory."
          "I love mankind--it's people I can't stand" --Linus


          • #20
            Your'e right Jiffy! Been looking through the archives and found some interesting forums...

            It's interesting to see how popular it has become now!


            • #21
              As far as using live bodies during extrication training, I think its a bad idea. We all know that sometimes things dont go as planned or something just goes wrong (especially if youre using a car thats been sitting in a junkyard for 5-6 years).
              I dont believe putting a newbie inside a vehicle is necessary for him to learn what our patients have to endure. We certainly wouldnt put a newbie inside a room fire without a hood on just so he knows what its like to have his ears burn or send him into the smokehouse without an airpack.
              With the recent tradgedy of a FF being killed during a live fire training incident we have to step back and realize this could happen anywhere, even when we think we're doing everything right. Would you want to explain to a rookies wife and family he was injured or killed during a training exercise so he could experience what our patients go through?
              We're supposed to look out for each other, especially the rookies.
              "Save a cow......eat a vegetarian"
              "What we do in life, echoes in eternity"


              • #22
                We have always trained with live casualties in the vehicles and have never had a problem. We normally use another fire fighter or an ambulance officer wearing full PPE. This gives them a chance to see what it is like on the inside. We train as we play in real life, so we stabilise, use hard and soft protection on the medic and the patient and we take the car away from the patient. If the vehicle moves at all, the guys inside know and tell us, this helps us to perfect our stabilisation training.
                If you do all these things you cannot take any more precautions and it is exactly the same as on the road.
                Also, we smash the car first and then find a way to get in, if we cannot get someone in or we know the car is to be flattened we will use a dummy put in before we smash the car.
                You can get a lot more feedback from live patients and also it makes the team train more realistically. You can bend a dummy around if you need to, but you cannot do that to a live patient. The people who have said there are problems with tool slippage or hydraulic failure, these things could happen in real life so make sure the people inside are protected. The same goes for debris flying across the area, put a clear plastic sheet over the people in the car for dust protection and we also use pieces of hard protection between the tool and area being worked on and the patient and medic. If we have the cutters the piece of hard protection goes right near the blades and stops anything from hitting anyone.
                I am all for using live people in our training!!

                Hope this helps.
                D. Camp


                • #23
                  live patient training

                  I have used new firefighters as live patients as well, and think its a great idea, for the same reasons that you do, I want the outside rescuer to know what its like to be the patient in a crash and know why you must be careful outside the vehicle when you are performing your extrication manouvers. I think that if the live patient feels the cars reaction as you stabilize and disassemble, he will have a new appreciation for the victim the next time he responds to a call. If you think that you are putting the live patient in danger, then you probably are,change your game plan, what about hard protection, having a medic inside as well. Remember we are there for the patients safety, what a better way to learn about his position, than being there in a controlled situation. just do it safely.
                  Stay Safe


                  • #24
                    I want the outside rescuer to know what its like to be the patient in a crash
                    Yeah! We strap all our new guys in the car and crash them into a tree at 45mph just to get the full effect.

                    You're probably not going to seriously injure a live victim in a basic X class, but is it really worth the risk just so you think they know how the patient feels?


                    • #25
                      live patients

                      Its obvious that you don't understand the practice of live patients or your just being difficult. The vehicles are obviously crashed before we get them from the wrecker, and we slide the live victim inside to what ever position is comfortable to him/her. The whole idea behind this, is to allow the rescuer/patient to hear and feel the reaction of the glass, metal and tools being used around him/her. We have been told by our new recruits that it sheds a new light on what they will do from outside the vehicle, and they truly think of the patients well being first. Not everyone has had the opportunity to slam into a tree at 45 mph. We have also found that when using a paramedic as the live patient, they too have more respect and understanding why we do the things we do.

                      Train Safe

                      Stay Safe



                      • #26
                        The International Association of Fire Chiefs will be using live patients inside crashed vehicles during the 19th Annual extrication competition this month in bloomington Minnesota. These people are being referred to as inside judges who will be evaluating the actions of the teams competing in the event. The Chairperson of the IAFC's Transporation Emergency Rescue Committee(TERC) is Chief Richard Boyes, Sarnia (Canada)Fire Rescue Services.

                        I have excerpted his open letter July 17, 2002. The full letter is posted online at http://www.terc.org/IAFCLivepatient.html

                        "To all committee members and others:
                        Re: Live Patients/Interior judges

                        Much has been said and written in the past few weeks concerning the use of "Live Patients/Interior Judges" in the Limited Pit during the 19th International Competition.

                        Having clarified the insurance issues with both the host and the IAFC insurers, Live Patients/Interior Judges will be used in the Limited Pit only at the 19th Annual Competition and Learning Symposium.

                        After witnessing an actual scenario with a "Live Patient", the change was discussed at the 18th Annual Competition in Burlington at the Saturday meeting of the committee. It was the opinion of the committee members to try the "Live Patient/Interior Judge" in the Limited Pit at the 19th Annual Competition.

                        After the 19th Annual Competition is complete an evaluation will take place and a decision will be made concerning permanent use of the "Live Patient/Interior Judge.

                        As this is major change in direction for this committee I would ask all of our members and teams to embrace this change and give it a chance."

                        In addition, for any department or instructor using live persons inside a vehicle during extrication training, there is a document posted online that will be of interest to you. It was written in 2001 by Mike Akers, a rescue instructor from England. It is titled "CODE OF CONDUCT AND PRACTICE FOR THE MANAGEMENT OF A LIVE CASUALTY TEAM (LCT)FOR REGIONAL, NATIONAL AND INTERNATIONAL CHALLENGES"

                        That document is online at http://www.terc.org/Livepatient.html
                        Ron Moore, Forum Moderator


                        • #27
                          I would never allow anyone to be used in a training exercise while under my command. Some of said that they are teaching, or showing, or learning or "if we can't keep it safe during training..." but what is being forgot is that there are other forces in play (tool reliability, operator inexperience (after all it is a training), let alone far less than perfect conditions. All in all if the training is worth anything more than just ripping and tearing, and the person is alert/involved in the training, they will get any idea about patient potection, safe operation, etc.

                          If you think about doing this I ask you to ask yourself one thing, "Would you put yourself in the victim's seat for a training exercise?".


                          • #28
                            live patients

                            Absolutely, I was used as a live patient in Halifax a few years ago, and would do it again. You must remember that at anytime you don't feel comfortable with what is happening around you, then call a freeze. Ask for an explaination and carry on. If you are afraid to practice with live patients, then how do you make out with live victims, or do you shy away from making certain calls when extricating?

                            Stay Safe


                            • #29
                              Boy Lutan, You really have searched the archives on this one.
                              After 3 years, my opinion has not changed. I still use live
                              patients in training when it can be done safely. I still
                              believe that if you cant make it safe in training, where as
                              stated many times earlier that the pace is slower and many
                              more eyes watching, then how can we keep it safe in the real
                              world. As for Pete, I was judging the comp when Pete was the
                              live patient. It was done very safely and I dont think that
                              Pete was ever in danger, but he will need to atest to that.
                              It really does add another level of realism. I will be at the
                              international that Ron spoke of and will be watching very
                              closely how this untangles. This will be very interesting.

                              Keep practicing and bring everyone home with you.
                              Skip Rupert
                              Skip Rupert
                              Shrewsbury, PA
                              "Keeper of the Rescue Zone"
                              [email protected]


                              • #30
                                Our department has trained using both live patients and dummies. They actually used a live patient and a dummy together in the Western Canadian Extrication Competition (with the patient in the least dangerous situation of course). It can add a lot more realism to the situation (not everybody cares about hurting a dummy). Not only that, but a dummy can't give feedback about how c-spine feels or whats comfortable and whats painful (or if you really want to train realistically the dummy also can't be disoriented, complaining, in shock, combative etc...).

                                As for the person who says that it shouldn't be allowed because of prosecutions and recent liability issues...Isn't firefighting an inherently dangerous profession? (volunteer or career, we are all professionals) maybe we should stop using live fire in training too...I don't think the public would like the idea of the next generation of FF learning their jobs without realistic training scenarios (ie: you can't learn everything about fighting fires unless you actually experience fires). The key is to do it safely. Using proper protective equipment is essential.

                                The person who mentioned the live patient who almost got a recip blade in the head...would this have been that dangerous if the patient were wearing proper head and face protection...actually shouldn't there be additional medium or hard protection between the tool and the patient whenever cutting is being done? Our department always uses hard protection (such as a half spineboard) between hydraulics and the patient. For things such as recip saws we use a minumum of heavy duty (~1/2") rubber mats or tire mud flaps between the patient and the tool. If you train trying to protect the live patient (especially one of your FD members) I think it could significantly improve your patient safety/care techniques.



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