I am not going to pretend to write an article on vehicle extrication based on my vast knowledge: it would be a very short article. I am not going to "reinvent wheel;" Ron Moore has this subject covered about as thoroughly as possible. He breaks down every imaginable aspect of vehicle extrication into very detailed articles. I am going to take a step back and write a basic article on extrication as a reminder to most and a good starting point for some. For most firefighters outside of rescue companies, this information is more than enough to make you competent and professional on the scene of an extrication. This information is all that you will use on 95 percent of your extrication calls.
Extrication has been taught to me over the past five years by one of our rescue captains, Mike Noyes. By pure coincidence, he subscribes to Ron Moore's theories on extrication. Therefore, I subscribe to those same theories simply because that is what I have been taught and in practice they work very well.
Extrication has four steps according to Ron. The first step is actually three parts.
The first is scene size-up. This starts from the initial dispatch. Is the crash on the freeway or on a residential road? Is this a reported rollover? Are there any reports of people trapped? Is the reported location known to be the scene of previous accidents of consequence? Any piece of information that you can obtain enroute to the scene will assist you in formulating your game plan. Once on scene most other questions will be answered simply by observation.
The next part of step one is scene safety. This is where you start looking for hazards that can adversely affect your crew, your patient and any bystanders and property. The first hazard to be aware of is downed power lines. Make sure that you do not inadvertently drive over or park on top of a downed line. The officer and driver should both be aware not only of traffic and apparatus positioning for the safety of the scene from oncoming vehicles, you also need to be aware of broken or damaged power poles. Both may cause lines to drop onto the ground, a damaged vehicle or on top of a fence that may be involved in the accident. Always clear the scene of power lines. The second hazard is fuel products, whether it is gasoline or diesel. Make sure to place absorbent on any fuel product that has been spilled. Hybrid cars also present special hazards. Click here for an in-depth article on hybrid vehicle safety.
At this point you want to make sure that a protective line is also in place in case of fire. Not a lot of thought is put into the placement of this protective line. The line should be placed on the side of the vehicle where personnel are currently working and it should be placed mid-vehicle. The two sources of fire from fuel are going to be the engine compartment, which is most likely at the front of the vehicle and the gas tank, which is most likely at the rear of the vehicle. It is impossible to tell which source will ignite. By placing the protective hose inline with the midsection of the vehicle you can effectively suppress a fire from either direction while blowing the flames away from both the patient and rescuers.
At this point you want to identify any possible airbag locations. Make sure when any part of your body is entering a vehicle that you stay out of the range of any airbags. Also, keep away from the front of vehicles due to bumpers and struts. Both have been known to project away from the vehicle at an explosive rate.
The third part of the first step is vehicle stabilization. Most stabilization can be achieved with cribbing. Click here for a more in-depth article on vehicle stabilization. The one no-no when stabilizing a vehicle is to make sure that you always stay either on your feet or one knee. Never get down on two knees when working around an unstable vehicle. Your reaction time is greatly reduced by positioning yourself on two knees.