SUBJECT: Total Sidewall Removal
TOPIC: "Blowing Out the B-Pillar" Evolution
OBJECTIVE: Remove both doors and B-pillar on one side of a four-door vehicle
TASK: Given a simulation of two jammed doors on one side of a four-door vehicle, the entire sidewall shall be removed using the "Blowing Out the B-pillar" technique
Almost any time a patient is trapped, rescue crews have to work with some portion of the side of the vehicle. If a four-door vehicle is involved in a collision, especially a T-bone collision, occupants can be trapped by a jammed front and rear door and by the inward crushing of the B-pillar. What procedures does your department use when confronted with the rescue challenge of total sidewall removal?
There are four different overall strategies that could be used to remove the entire sidewall of this vehicle. One strategy would be to have crews remove each door and the B-pillar individually. Another plan would be to have the front door opened and removed then the rear door opened and removed along with the B-pillar. A third technique would assign rescuers to open the jammed rear door at the latch then attack the jammed front door at its hinges. Then with a cut high on the B-pillar, the entire sidewall would be moved down and out to ground level like a wing. This University of Extrication column will discuss a fourth strategy; what this author refers to as the "Blowing out the B-pillar" evolution.
Total Sidewall Removal Evolutions
- Front door, Rear door, B-pillar
- Front door, Rear door with B-pillar attached
- Rear door at latch, front door at hinges, B-pillar cut at roofline, sidewall lay down
- B-pillar Blow Out
As with all jammed door evolutions, total sidewall removal cannot be effective unless the vehicle is first stabilized, the electrical system shutdown, the patient and inside medic protected, and window glass removed. Once all these preliminary tasks are done, total sidewall removal can begin. There is an unofficial benchmark time that this author has established for completing the "Blowing out the B-pillar" task. Once practiced by the rescue team in a training environment until the crew becomes proficient at it, the entire blow-out task can be accomplished by two rescuers with two tools in two minutes or less. For maximum efficiency, the two tools are a dedicated spreader and a dedicated hydraulic rescue system cutter, although a recip saw or an air chisel can do the cutting tasks as well. Blowing out the B-pillar is not a task for combination-type hydraulic rescue tools.
There is an easy-to-remember, easy-to-train sequence for the blow-out evolution. The words "Spread, Cut, Spread, Cut" describe the four fundamental steps that comprise this total sidewall evolution. Spread, the first step, begins by forcing the jammed rear door open at the latch.
Cut, the next step, begins after the rear door is opened. The B-pillar is cut into horizontally just below the bottom of the bottom door hinge. This is not a cut that goes completely through the pillar. It simply creates a weak point that will essentially tear once force is applied with a power spreader. One good, deep cut into the back of the pillar will weaken it enough that the power spreader can tear it off the vehicle.
Spread, the third step, involves strategically placing one tip of a power spreader on the outer edge of the rocker channel and the other tip against either the corner of the door or the lower hinge plate on the door. The intent is to spread the upper B-pillar away from the base of the pillar where the cut was made. After several small spreads, the spreader will be in a good position to separate and tear the B-pillar apart. The tool operator will see the daylight appear along the lower area of the front door; this is the blow out. You have torn the base of the B-pillar apart, allowing both doors attached to the B-pillar to move away.
Cut is the fourth and final step of the blow out process. While one rescuer was blowing out the pillar with the spreader, the partner cut the seatbelt and stripped away the upper trim on the B-pillar near the roofline. Once the blow out occurs, the cutter person moves into position to cut through the B-pillar at the roofline. This cut disconnects the pillar and allows the entire sidewall, now a double-wide door and pillar unit, to be widened 180 degrees by brute force until it touches the front fender. The entire double-wide can be totally removed, although rescuers must remember that removal is not always an essential step. Don't take time to cut the door off at the hinges if that time could be better used removing a critical trauma patient who is now completely accessible.
The task is completed by covering the sharps high and low where any jagged exposed metal was created during the evolution. Sharps hazard areas include the B-pillar stub at the roofline and the low stub at the rocker channel, the rear door latch if metal has torn, and the front door hinges if the sidewall is completely removed.
With practice, your team will be able to accomplish this within an impressively short period of time. "Above Average" benchmark time is two minutes or less from start to finish. An '"Acceptable" benchmark time is three minutes and 30 seconds or less. If it's taking you longer than that to remove the sidewall, you need better tools or more training.
"Blowing out the B-pillar" evolution tactics include:
- Vehicle stabilization
- Patient "sharps" protection and safety
- Confirmation that both doors and truly jammed
- Removal of side window glass
- Cut/remove seatbelts
- Open rear door at latch
- Cut B-pillar below bottom rear door hinge
- Blow out B-pillar with spreader at rocker channel
- Remove interior trim panel from B-pillar
- Cut top of B-pillar at roofline, widen the "double-wide" door assembly on the front door's hinges
- Apply sharps protection to cover exposed metal
- (Optional) Remove total sidewall at front door hinges
RON MOORE, a Firehouse® contributing editor, is training chief for the McKinney, TX, Fire Department. He also authors a monthly online article in the Firehouse.com "MembersZone" and serves as the Forum Moderator for the extrication section of the Firehouse.com website. Moore can be contacted directly at Rmoore@firehouse.com.