2. If your rescuers cannot access the patient, then they cannot provide patient care. Having discussed this position with a few trauma physicians, most of them echo a common fact about patient care; they can fix a lot of things on a person, but they can’t fix dead. That not only stands to reason for the patient, but for the rescuer as well.
Remember this point: it may not be necessary to move the vehicle the patient is in. For example, it may just be a question of uprighting a commercial vehicle that has come to rest on top of a car. Once that occurs, patient care can happen immediately. Do not operate with “functional fixation;” these incidents will require some detailed analysis and thought to come up with a solution, so be flexible.
Extrication scenes can be stressful, fast-paced, and tedious at the same time. Throw a large commercial vehicle into the fray and the scene now has added potential kinetic energy hazards, hazardous material control, lifting and moving issues, and considerable reactive forces at work during the incident. Make it a point to include a commercial vehicle into your next extrication training session; even if your rescuers do not cut or spread it, just working on moving it will require some considerable effort. Don’t let your next lesson in this field be in the middle of the highway.
Until next time, stay focused and stay safe.
MICHAEL P. DALEY is a lieutenant and training officer with the Monroe Township, NJ, Fire District No. 3, and is an instructor with the Middlesex County Fire Academy, where he is responsible for rescue training curriculum development. Mike has an extensive background in fire service operations and holds degrees in business management and public safety administration. Mike serves as a rescue officer with the New Jersey Urban Search and Rescue Task Force 1 and is a managing member for Fire Service Performance Concepts, a consultant group that provides assistance and support to fire departments with their training programs and course development. Mike has been guest on several Firehouse.com podcasts including: Successful Rescue Operations in Today's Fire Service, Preparing for Tomorrow's RIT Deployment Today and Basement Fire Tactics Roundtable podcasts. View all of Michael's articles and podcasts here. You can reach Michael by e-mail at: FSEducator@aol.com.