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  • What would you do?

    You are responding to an accident with entrapment. You are the Captain of a small rural departement, with limited extrication training. The local PD arrive and report that a small compact car has been sideswiped by a truck, and is pushed up against barrier along the road. You arrive on an Engine with a crew of 4, including yourself. Your Squad is behind you, about 2 minutes, with a crew of 3. The nearest BLS is 5-10, and ALS is 10-15. Aeromedical has a 20-25 minute ETA if needed. You exit the Engine, and find that the driver of the truck is uninjured. His truck is jammed up against the car, and the car is against the wall. You can see that there is an elderly woman driving, and she appears to be unconscious but breathing. Your Squad doesn't have Jaws, you have the normal Engine tools, plus a sawzall, an air chisel and a k-bar tool. The Rescue truck is on it's way, but they hada mechanical problem, next due is 10 out.....what do you do.
    Buster

  • #2
    Put the helicopter in the air. If you have water or foam, pull and charge a line. (Or place a CO2 or two nearby.) Stabilize and enter the vehicle (C-spine, O2, IV, etc.)& sawzall the roof. (For starters)

    Comment


    • #3
      Sounds like lots of fun. I bet your one of those guys that likes to throw in those little twists . It is people like you that make practices interesting

      Anyway, I am not an officer, and I am going to assume a K-bar is a halligan tool and that your engine is carring cribbing, ok. So here I go.

      My size up is going to find no hazards and I am going to send one firefighter to check the far side of the accident. When he gives me the thumbs up, the other two are going to start cribbing the car and chocking the truck to keep it from moving, with my firefighter with the highest level of medical training will asess the patient. Of course the driver of the truck is already out and sitting on the tailboard of my engine where I can keep an eye on him. With cribbing done, I am going to assign one firefighter to get the sawzall out and tested(he could pull a preconnect if he was getting board waiting...), while the third is standing by to break glass. My "medic" will cover the PT with a tarp while the side windows are being taken out, (of course doing the medic thing, airway, O2, RBS, vitals, spinal, etc). Using a fire axe to get a purchase on the windshield for the sawzall. Naturally, it will make quick work of the laminated windshield glass. Once out, the sawzall will move around to cut posts on both sides of the vehicle, (making sure the seatbelts are cut as well) with myself and the two other firefighters supporting the roof. Once cut, it can be moved off and away from the action circle. Slipping a spind board between the PT and the seat, the back can be laid down. She can then be eased back slowly and moved up the board until she can be lifted out of the now roofless vehicle.

      By now the rescue should be getting on scene about this time if you factor the limited extrication training and their ETA. One guy is going to look after the driver of the truck, still sitting on the tailboard being a good little boy while we work. If we are still working, their Jaws can be used in addition to the sawzall to get the roof off. If he legs are pinned, a stearing wheel pull can be done, provided the car does not have tilt steering and isn't front wheel drive. If it is, a ram will need to be moved into position to push the dash.

      When ever BLS gets on scene they can take over from my firefighter, freeing him to help out.

      If the truck isn't actually touching the car, it could be rolled back to provide access to the side it is blocking. The cops might not be to happy about moving a vehicle, but it is only a few feet. If it gets the PT out faster, it is on my list of things to do.

      Next
      "No one ever called the Fire Department for doing something smart..."

      Comment


      • #4
        If you think she may have to be flown and have the authority to do it get them in the air. Otherwise at least get word to them that they may be needed.

        If the truck is against the car get 2 tow trucks enroute ASAP. At least one of them has to be capable of moving whatever size truck is involved. Good wrecker operators are a huge help, bad ones are scary.

        All the rest is a given. Provide all the medical care you are able, stabilize the vehicle, pull a hoseline, etc. Can't go further without knowing if and how the victim is pinned.
        _________DILLIGAF

        Comment


        • #5
          Okay, I'm seeing a car and truck, parallel with one side of the car up against the barrier and the other side against the truck.

          First, I'll establish command.

          I'm going to have one of my firefighters check out the truck driver and move him out of the way while I do a size-up, one firefighter is going to the pump panel, and the last firefighter is pulling a line.

          Keeping the hoseline manned, myself and one firefighter will begin pulling the appropriate equipment off of the engine, included cribbing, airchisel and sawzall.

          By now, the squad has arrived, and we're going to stabilize and gain entry. One man is going inside to hold C-spine. Two men assigned to glass removal. Last guy (I'm IC remember) is going to get the sawall ready and start a roof removal, as soon as the glass is gone. Soon as the glass is gone, those two assist with the roof removal.

          My BLS unit is here now, and as soon as the roof is gone, an EMT is going in the car, and the rest of the crew will assist the EMS crew in whatever capacity they need.

          I don't see why we can't have the roof off just after (or just before) the Rescue arrives, and I don't think I'd go for the Jaws unless we REALLY needed them (I'm thinking there isn't much space to work in).

          Helicopter placed on standby if intial assessment deems it prudent.

          [ 08-23-2001: Message edited by: Silver City 4 ]
          Bryan Beall
          Silver City, Oklahoma USA

          Comment


          • #6
            26 you covered it all from my view, sounds like she might make it I think you and Buster collaberated on this one

            Comment


            • #7
              haha, nope, but these are some of the best answers I've heard lately for that scenerio. 26, even though I left out the fact that there was cribbing, you used your head, and decided that the only thing I said you didn't have was the Jaws. Smokeater, he had the chopper in the air right away. Good idea for the MOI. I never thought of using the tow trucks...so that got you thinking. and then silver city re hit everything, with some more detail.....good job to everyone!
              Buster

              Comment


              • #8
                Buster, good scenario. Many times our officers will throw in "little problems" like the jaws or a generator going down. I don't really like it at the time, but it makes us think a little more.

                I figured if the Engine crew had some basic extrication knowledge they must have been carrying some type of extrication equipment, including cribbing. I know our engine doesn't carry cribbing, but I since I am not a captain either, I figured I would "improvise"

                Lt13, thanks, but I had no prior knowledge of the scenario. That's my story and I am sticking to it .

                Anymore Buster?
                "No one ever called the Fire Department for doing something smart..."

                Comment


                • #9
                  26- SOUNDS TO ME LIKE YOU SHOULD WRITE BOOKS GOOD PLAN THOUGH.

                  Comment


                  • #10
                    Check back saturday or sunday, I'll come up with another one.
                    Buster

                    Comment


                    • #11
                      Thanks all, talk about pressure to come up with a good answer on the next one
                      "No one ever called the Fire Department for doing something smart..."

                      Comment


                      • #12
                        Here we go....#2

                        You are Assistant Chief riding OIC on your Engine. You have been transferred to a neighboring department, due to them being on a multiple alarm structure fire. You are dispatched to a motor vehicle accident, vehicle reported under trailer, with entrapment, involving fire on the interstate. Your Engine goes enroute, and a Rescue is dispatched, however, due to this being on an interstate, the resuce is coming from another county, and you are not familiar with them. Enroute, dispatch informs you that the State Police are on location, and believe they have the bulk of the fire knocked down with an extingusher. Your Engine arrives on location, and the State Trooper says, your in charge. Your Engine is a 1985 model, none rescue, you have nothing but basic EMS supplies, and a axe and halligan. You do a size up and see a late model compact car, wrapped under the rear tires of a semi. You can hear the ppl inside screaming, but can't see them. BLS is right behind the Rescue, but ALS is 10 minutes out, pending the back log already starting. Aeromedical calls and has two choppers available, both with a 15 minute ETA. Rescue is arriving, and the "Officer" appears to be a Lt. who comes over and states it just him and the driver, and neither of them have encounterd this before. The truck driver thinks that he did in fact see two male occupants in the car, and they had been trying to pass him, and slowed, and just "drove" under him. You have basic vehicle rescue, plus a chauffer, and two crew members, one of which has done extensive rescue work before, and the other is an EMT.......now, what do you do?

                        [ 08-26-2001: Message edited by: Busterbar ]
                        Buster

                        Comment


                        • #13
                          First, establish command. Before anybody gets off the truck, I'm checking for placards. I'm assuming the trailer doesn't have anything too bad in it, or it would be included in the post, so that's out of the way.

                          Just by the MOI, I'm placing on helicopter on standby, and telling ALS to step it up.

                          My driver is going to the pump panel again, and one guy is going to pull a charged line to the car. The firefighter with extensive rescue work is going to accompany me on my size-up. Rescue company will begin pulling equipment off the truck.

                          The trailer is going to have to be stabilized, and in my neck of the woods nobody carries enough cribbing to do that, so I'm probably going to call for two more rescue trucks for cribbing and manpower, as well as another engine due to fire potential. We're also going to call for a recovery company to remove whatever is in the truck, because even if the goods are okay, the trailer has been on fire. And, I want a big wrecker in case we have to get crazy with the truck (I don't advocate using a wrecker for extrication, but sometimes you need big tools).

                          One EMT from the BLS unit is going to get in as close as possible to evaluate the pts as much as possible.

                          If the car is on all four wheels under the trailer, I'm assuming that it's suspension in being pushed down by the weight of the trailer. We're going to crib under the car, deflate the car's tires, and remove any glass.. Hopefully, this will separate the top of the car and the bottom of the trailer.

                          I'm going to have the truck and trailer's wheeled blocked so it won't move back and forth.

                          What I'd hope to do is remove a door from the car, and pull both occupants out the same side. I'm going with whatever is fastest, because a significant MOI with a fire in a confined space is bad news. If either victim shows burns around the face or shows signs of respiratory involvement, they're flying out.

                          If the door pop isn't an option, I'd try to either crib enough to lift the trailer off of the car enough to cut the top, or attempt to cut through the trailer floor from the inside. Either option is going to cost a lot of time, and I'm betting it's going to be awhile before any more rescue companies arrive.
                          Bryan Beall
                          Silver City, Oklahoma USA

                          Comment


                          • #14
                            Got to make it interesting, eh Buster? Silver, you beat me to it, what's up with that??

                            First thing first, get what is left of the fire out. If the cops have knocked it down with their extinguishers, a 20lb dry chem should finish it off. If not a line will be pulled. Then, lets get at least one of those choppers on standby as well as sending one of the state troopers to make sure a lane for the ALS is open. While this is happening, I am going to find out what the trailer is carrying and have dispatch get at least 4 heavy rig tow trucks heading towards me. Lets say some of what the trailer is moving can removed by hand. The truck driver and any state troopers can start on this (along with any bystanders should they be needed).

                            I am going to place the LT in charge of the extrication and tell him to be creative. His driver is going to get tools ready while the LT uses my guys for cribbing. The trailer will be cribbed and blocked and the vehicle being cribbed as best as possible.

                            I am going to assume the worst, and the car is heavily crushed under the rear axle assembly, with the passanger side un-accessable and heavy damage to the roof, which is crushed down. The driver's side, away from the trailer's axle, is relativly intact.

                            Once things are stabilized, my highest trained medic (my EMT) and BLS are going in to assess the PTs. Since the vehicle is crushed, they will have to work from the outside. For the best performence, we will take the windshield, what ever is left of it, so they can work from the front. Lets assume that the Driver is in stable condition while the passanger is the priority. Since BLS and my emt are working on the PTs from the front, through the windshield, the LT and his guy can take out the drivers door. For fun, lets make this a two door compact. With the door out, they can use their sawzalls and air chizels and do a third third door conversion. (I can explain this later for anyone).

                            With the driver's side opened as wide as I can get it, the driver should be easy to pull out, assuming his legs are free. In not, ramming the dash will take car of that. My EMT in the back seat for spinal, the BLS crew can slip the bottom of a spin board under the driver, take over spinal in with a spinal/sternum grib. The other BLS can grab the hips and pull him along the board while the other keeps the neck and back straight. The medic in the back seat can start working in the passanger. Once clear of the vehicle, they can lay him down and pack him away. ALS should be on scene by now. If BLS can't handle the driver, they can take over, if not, ALS will help my medic look after the passanger.

                            This is the tricky part, since the roof is crushed down, the passanger side crushed and not accessable, and the dash IS going to be on his legs.

                            Here is where my taining gets shakey.

                            If the rescue carries lifting bags, I am going to want them out and checked for ready. Do a basic Lift and Crib. If not, the heavy rig tow trucks that I have had dispatch get for me will work (I was thinking ahead).

                            Ok, so the rescue DOESN'T carry lifting bags. A tow truck on each side of the trailer can hook up and lift. A firefighter, with radio, at each unit to co-ordinate the lifting. The actual lifing will be slow so the LT and his crew can have time to cribb behind it. Basic lift and crib, tow truck style. Any other tow trucks will hook up and act as a safety should the worse happen. I am a little concerned about lifting with the PT under the trailer. A single person will person will remain with the PT. If we can get a foot or two out of the lift and crib, that is all I need.

                            Once lifted and cribbed, we can get back to work. Both A posts will be cut, if they have not been already, while the air chizle can rip though the sheet metal above the back seat. The roof can then be walked away. The dash is going to need ramming, but the passanger side is still not free. Since this is a compact car, it should be front wheel drive. Place some cribbing under the vehicle between the two seats, where the trans would have been. Use the ram between the seats to the centre of the dash. The base of the ram will push down onto the cribbing, and thus move the dash forward. Once done, the tool can stay while the drivers seat is moved forward, or taken right out if needed. A half board can be slipped down behind the PT and the seat can be laid back. With the driver's seat forward (or out) and the hole from the third door conversion, should be enough room to pull him out through the drivers side horizontally.

                            Once clear, ALS can have him, or if needed, that copper would be on its way.

                            From there, the troopers and tow trucks and do their thing and we can basically stand a around or head home.

                            That one really made me thing. My first thought was, since I am a Assistant Chief, wait for someone with more bars to show up, but that might not happen I guess that is why I like being a yellow hat.
                            "No one ever called the Fire Department for doing something smart..."

                            Comment


                            • #15
                              Silver, you can be the Assistant Chief, I'll be the LT.

                              We can work together
                              "No one ever called the Fire Department for doing something smart..."

                              Comment

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