Vehicle Extrication

Section 2 - EMERGENCY OPERATIONS

PURPOSE:

To provide an organized framework on standard vehicle extrications. Although this SOG addresses basic operations, many of these tasks will apply to any vehicle entrapment incident.

PROCEDURE:

The first arriving unit will provide an arrival report for all responding units. This report should include any significant information, such as power lines, broken water mains, large vehicles, and/or large number of people. This report should detail travel direction and roadway if different from dispatch, as is the case sometimes with on or off ramps at interchanges. Additional requests for law enforcement, DOT (Road Ranger, I4 Ultimate, etc.) shall be made, if applicable, to respond to the scene.

UNIT OBJECTIVES:

First Due Fire Apparatus

• Scene size up and assessment of number of people entrapped and total number of patients. If commercial trucks are involved, check placards and take necessary precautions. Considerations for a Class C - Heavy Duty Wrecker shall be made and requested through dispatch.
• Establish Command
  
  • Determine Level of Entrapment
    • Minor – 1 move (consider Squad)
    • Moderate – 2 moves (consider Squad)
    • Heavy – 3 or more moves (request Squad)
    • All personnel shall utilize all protective equipment. Unless otherwise dictated by the OIC, crews shall wear TRT helmets.
    • Coordinate patient care and overall scene safety.
    • Position apparatus using procedures outlined in SOG 130.07.
    • Stabilize vehicles prior to entering for patient care.
    • Establish patient contact and begin triage and treatment. Update dispatch and/or Command with the total number of ALS or BLS patients.
    • One charged hand line shall be placed into service with one crew member in approved protective equipment manning the line. (An extinguisher may be utilized temporarily until additional crews arrive to assist on the scene)
    • Position apparatus for best application of extrication tools and required equipment.
    • Consider scene lighting.
      

Second Due Fire Apparatus

• Scene size-up. All personnel shall utilize all protective equipment. Unless otherwise dictated by the OIC, crews shall wear TRT helmets.
• Position apparatus for best application of extrication tools and required equipment.
• Meet face to face with command and coordinate with first due officer and/or incident command.

Extrication Group

Command should assign a company Extrication Group. Extrication Group Officer is responsible for coordinating the extrication operation.

• Scene size-up. All personnel shall utilize full protective equipment. Unless otherwise dictated by the OIC, crews shall wear TRT helmets.
• Position apparatus for best advantage of tools and required equipment.
• Meet face-to-face with the officers and or command to determine the best method of patient removal. This should be coordinated between the treating Paramedic and the Extrication Officer.
• Stabilize vehicles prior to entering for patient care.
• One charged hand line is to be placed into service with one crew member in approved protective equipment manning the line.
• Disable the vehicle battery if it is accessible. Starting with negative first, a method known as chunking (cutting a chunk out instead of just one cut) should be used to keep the cut ends from touching once they are cut.
• Make sure the ignition is rendered safe, as some of today’s cars do not have keys.
  

Never cut any cables that are orange or red in color! These can carry high voltage in hybrid vehicles.

• Survey the interior of the vehicle to determine the presence of any supplemental restraint systems. This can be accomplished by stripping the interior molding, and looking for markings indicating these systems. The Extrication Group Officer should account for the presence and locations of these systems prior to the start of the extrication operation. This will avoid accident deployment or damage to system components, which may injure operating personnel.
  

When operating near air bags that have not deployed, personnel should follow the 5-10- 20 rule maintaining a clearance of the following distances from these airbags. 5” for side impact bags, 10” for steering wheel, and 20” for passenger side bag.

• If glass needs to be broken or removed, all occupants shall be covered with a blanket or tarp for protection.
• Based on coordinated plan between extrication groups and command, perform vehicle extrication by utilizing various tactics and tools based on vehicle/patient presentation. During the use of extrication tools crews shall make every attempt to stabilize and protect the occupants from any further harm.
  

First Due Rescue

• Scene size-up. All personnel shall utilize full protective equipment. Unless otherwise dictated by the OIC, crews shall wear TRT helmets.
• Assist crews with patient stabilization and treatment.
• Assess patient for potential medical implications of entrapment (i.e., crush syndrome, compartment syndrome, large volume fluid loss, etc.).

Command Considerations

• Command shall provide additional resources based on input from officers and the number of patients involved.
• Based on the complexity of the incident, Command should consider establishing Divisions and Groups.
• Command shall provide early notification to all specialty resources (Ex. Public works, Utilities and wrecker services).

Safety Considerations

With the increase of safety devices, size of the vehicles, and alternative fuels, extrication has become more complex operation, therefore the combining of two extrication crews will increase the safety of patients and crew members involved. When positioning apparatus, be careful not to have apparatus exhaust directed toward crews.

All personnel should be aware of alternative fueled vehicles and the hazards associated with them. Gas/electric combinations have high voltage systems. Others use CNG (compressed natural gas), LP (liquefied petroleum) and hydrogen.

The Technical Rescue Program shall be formally evaluated by Fire Administration on a yearly basis.