Photo By Ron Moore Photo By Ron Moore Photo By Ron Moore

The University of Extrication "Phases of Rescue" drill program is presented to serve as a standardized national model for extrication training and team evaluation. Participation in this national model drill allows departments to measure their extrication efficiency against national benchmark timeframes.

Timing each portion of the drill as explained in this guide and documenting these times allows you to give your rescue crew an “A,” “B” or “Needs Improvement” rating. Continued practice with this Phases of Rescue drill allows you to watch the improvement in your elapsed times over a period of weeks and months.

Using this new national extrication drill within your department will also make your training sessions more interesting and challenging, especially for your experienced personnel. The Phases of Rescue drill allows you to compare your department to what other rescue crews across this country are able to accomplish under the same circumstances. The drill will also improve your extrication work at real-world crashes.

The "rules" of this drill are simple. They are presented to standardize the extrication tasks as much as possible, requiring everyone to work under similar circumstances nationwide. With standardized setups every time the drill is conducted, comparison of the elapsed times for each phase is valid.

Rules of Engagement include:

• Four-door acquired vehicle (all doors closed, windows up, doors locked).
• Vehicle on level surface.
• Vehicle on four wheels.
• Simulation of unconscious, unprotected driver and front-seat passenger patients.
• Simulation that all doors are "jammed."
• All rescue tools are set in a tool staging area.
• Rescue team of four or five personnel, one member as team or crew leader.
• Starting line minimum of six feet from acquired vehicle.
• Tools to be used for each phase can be completely hooked up, power plants running, hydraulic lines charged, plugged in, etc.
• Rescue team members line up at starting line with full personal protective equipment and clothing donned properly.
• Tools may be at starting line and in hands of rescue team members.
• Team crosses starting line upon signal from timekeeper and stopwatch begins.
• Team members hold arms up upon conclusion of final tasks signaling completion of all work for that Phase and stopping of the clock.
• Times are recorded on Phases of Rescue scorecard.
• Team discusses its plan, prepares tools and lines up at starting line when ready to begin next evolution.

Conducting The Drill With the acquired vehicle ready, the crew lined up at the starting line and the tools fired up, the first Phase 1 evolution begins upon signal from the timekeeper. Phase 1 activities begin with initial approach to the acquired vehicle while carefully assessing the scene for patients and safety-related hazards. Airbag scanning must be accomplished by the team in Phase 1, along with accomplishing electrical system shutdown, trunk access and hazard control. Once the scene and the vehicle are stabilized, initial access is provided to the interior of the vehicle by breaking a side or rear window. This lets a team member enter the vehicle and simulate initial contact with patients by covering the front seat with a blanket. In reality, rescue activities at an actual incident are more involved than this. The national drill is designed to emphasize teamwork, time and task management, and efficient tool operations. It does not attempt to simulate all challenges confronting responders to real-world scenes. In the Phase 1 evolution, crews are concentrating on command and control, stabilization of the scene including the vehicles, and initial patient access.

Phase 1

During Phase 1, the activities that the participating crew members must complete include:

• Arrival and safe positioning at crash scene (simulated by crossing the starting line).
• Scene size-up/assessment 360.
• Establishing command.
• Scene and vehicle stabilization.
• Airbag "scanning."
• Battery access and electrical system shutdown.
• Documentation of capacitor drain time.
• Hazard control (fluid leak or spill) assessment.
• Initial patient access opening (removal of window glass).
• Initial interior access.
• Patient protection/safety (cover front seat with blanket).
• Determining contents of trunk.

Upon completion of all required Phase 1 activities, the team members or crew leader raise their arms in the air, the timekeeper stops the clock and records the elapsed time. If there were safety violations or errors in tool operation, a penalty of five seconds is added to the elapsed time for each infraction. The crew returns its tools to the starting line, dresses down, rehabs and critiques its evolution.

When ready for Phase 2, the crew assembles and prepares their equipment. Once ready and at the starting line, the timekeeper signals the start of Phase 2.

The goal of Phase 2 is total sidewall removal on one side of the vehicle. Two doors and the B-pillar are removed making a large opening.

When it comes to jammed doors at real-world incidents, generally if opening one door is good, opening the entire side of the vehicle is even better. This drill will prove how quick and effective total sidewall removal can be. Opening or removing both doors and the center B-pillar allows maximum patient access on that side of the vehicle. With practice, your team will be able to accomplish this within an impressively short period of time.

Phase 2 also requires that interior trim panels be removed on any roof pillar that is to be cut; in this case the B-pillar. Stripping plastic trim with a tool such as a screwdriver or small pry bar exposes the inner structure. Rescuers will then be able to see the pillar’s thin or thick areas, any seatbelt pretensioner devices, thick Nader pins, or seatbelt spools and reinforced metal areas. In addition, when cutting rear roof pillars later during Phase 3 of this drill, stripping the interior trim reveals the location of roof-mounted airbag inflator modules that must be avoided.

Phase 2, a total sidewall removal evolution, must include:

• Re-checking vehicle stabilization.
• Re-checking patient protection/safety.
• Removing side window glass.
• Cutting/removing seatbelts.
• Removing interior trim panel materials (B-pillar).
• Total sidewall removal, including, front door, rear door and B-pillar.
• Covering exposed metal.

Phase 3 removes the roof. Total roof removal is the single most effective vehicle rescue task that provides the greatest degree of patient access for all occupants of a vehicle on its wheels. Total roof removal is effective especially for those vehicles with thin roof pillars or roofs that contain power sunroofs. Total removal is preferred in situations where you encounter roof-mounted heating and cooling units, such as in the newer-model SUVs. Total roof removal is recommended when working on a new vehicle that has an airbag system mounted along its roofline.

Exposing roof pillars and removing the entire roof allows for minimum disturbance of the roof airbag system. The best roof removal evolution in almost every case is total roof removal, making the vehicle into a “convertible.”

For Phase 3, crews must cut or remove the laminated windshield glass as part of their roof removal evolution. In an effort to increase efficiency and decrease the overall time, consider cutting the glass low along the dash from A-pillar to A-pillar. With this technique, the windshield will remain attached to the roof as both are lifted off the vehicle.

If the windshield remains attached to the roof, crews should lift the roof and move forward. This takes the broken windshield glass away from the patient area rather than dragging the glass over the heads of simulated patients.

The design of the vehicle’s rear roof pillars is another important factor to consider in roof removal evolutions. It takes more effort to cut through a large rear C-pillar compared to the front A-pillar. Crews should consider cutting rear roof pillars first and working forward. This sequence allows the front A-pillars to remain intact until all others have been cut. This provides a degree of safety for the patient and medic inside the vehicle. With rescuers holding the roof steady, the A-pillars can be cut last, allowing the roof to then be removed completely.

All tasks related to total roof removal are accomplished during Phase 3 activities and must include the following;

• Re-checking vehicle stabilization.
• Re-checking patient protection/safety.
• Side and rear glass removal.
• Windshield glass cutting or total removal.
• Cutting/removing seatbelts.
• Removing interior trim panel materials at roof pillars.
• Severing roof pillars.
• Roof removal to debris area.
• Covering exposed metal.

Phase 4 requires movement of the dashboard, instrument panel and firewall. In this final rescue phase, strategic cuts are made in the firewall structure and pushing, spreading, pulling or lifting equipment is used to simultaneously move or lift the dash, firewall, steering wheel, column and pedals away from the simulated front seat occupants. This scenario is ideal for a hard-impact frontal collision.

Phase 4 activities are related to dash and firewall movement and must include the following:

• Re-checking vehicle stabilization.
• Re-checking patient protection/safety.
• Cutting/bending of steering wheel ring.
• Cutting A-pillar and/or rocker channel.
• “Rolling” of dash or “jacking” of dash.
• Covering exposed metal.