Lowering seatbelted pt.'s involved in rollover

[laddercompany20]

Does anyone have any creative ideas (that have been used and are realistic) for lowering a seatbelted patient involved in a roof-resting roll over onto a backboard? So much effort is given for spinal immobilization, but it seems when its time to lower a patient down onto a board who is suspended, it is ugly at best. Shoot me some ideas, videos, pics, etc. Thanks!

[pasobuff]

I'm interested in hearing input too...it is never a good scenario! Thankfully the last 2 I rolled up on the operators were not injured - but even getting an uninjured person out of their seat belt without falling is not easy!

[billyleach]

There are a couple of methods(likely more) that are being used with success.

1. Using two full spine boards; one placed perpendicular to the patient's lower legs, seatbelt cut, and patient lowered onto the other spine board which was placed prior to lowering the victim. Pictures are available on the internet.

2. Using low pressure air cushions to lower the victim onto a waiting spine board.

[firedog7]

Check out an article I wrote for Fire Engineering October 2008 www.fireengineering-digital.com/fireengineering/sample/?pg=123[/url]
Called upside down with nowhere to go?
Or I have it on my website www.albertavx.com look under "knowledge articles"
Firedog7~

[Rescue101]

Good stuff! T.C.

[Catch22]

I've had success by sliding a KED in behind them and using it. It's not easy, but you've got the spine immobilized and the means to keep it that way as you lower them. The most difficult part is keeping the board where it needs to be, due to the fact that it's designed to work the to other way. You can use some webbing to go over the shoulders and around a chest strap to help, or try to lower using mainly the shoulders until you can get them more horizontal.

It takes some playing with it, but it can be done and you can keep the spine inline. It just takes some knowledge of the KED, which in my opinion is underutilized, anyway.

[MetalMedic]

I agree, this is never pretty. A SPEEDBOARD can give you as little better control of the head and torso during the process if you have enough hands on the patient to keep them in contact with the device and not allow them to slide down the SPEEDBOARD onto the long board or the roof of the car. If you are able to remove the doors and "B" post on the removal side, you can get more access to move the patient down and out of the car as you release them which will reduce the amount of time they are vertical. If the patient is conscious and you are comfortable in having them help, simply having them place their hands on the roof to hold up some of their weight as you release the safety belt will help both of you a lot!

[Holdasquad]

Only 4 people in the country know how to lower a patient out of their seat from a rollover? I was hoping more people would chime in when I read this cause frankly, I am not sure of a good way to do it! Lets see some posts guys!

[emt161]

Check out an article I wrote for Fire Engineering October 2008 www.fireengineering-digital.com/fireengineering/sample/?pg=123[/url]
Called upside down with nowhere to go?
Or I have it on my website www.albertavx.com look under "knowledge articles"
Firedog7~

The knowledge article link is broken.

The link to FE only includes one page of the article.

[MG3610]

We have done this twice...

A FF gets into the car and on his hands and knees holds the pt in position against the seat from underneath. The seatbelt is cut. Seatback is reclined or removed and then the pt is removed (face down onto a board seems to work best followed by a logroll to face up).

[firedog7]

The knowledge article link is broken.

The link to FE only includes one page of the article.

I'll get my webguy to fix this, weird...

[Ambrose33]

We have done this twice...

A FF gets into the car and on his hands and knees holds the pt in position against the seat from underneath. The seatbelt is cut. Seatback is reclined or removed and then the pt is removed (face down onto a board seems to work best followed by a logroll to face up).

Yes this is the way i've done it and I've found it works the best. After the vehicle has been properly stabilized you can place the firefighter or EMT(if properly outfitted) inside the vehicle to assist holding the patient while seatbelt is cut, then slide patient face down on to the board slowy, and once out of the vehicle log roll them onto a second backboard. The KED is a good idea but the issue with the KED is that you can actually entrap the patient again. The top of the KED for neck stabilization can sometime be too high for some of these sports cars and other vehicles and actually cause a major issue of removing the patient.

[wadejwl@telusplanet.net]

We have used this a couple of times. We have a large diameter approx 1" rope approx 10-12 ft long. With vehicle stabilised two firefighters get on the bottom now top of rollover vehicle run the rope over patients legs seated in seat and take up the slack of patient. As the seatbelt is released or cut they gently lower patient onto spine board face down and guided by other firefighter. This works well because they can control legs, and hips as they lower and there is room still to work in vehicle.

[snowy]

If you would like a photgraphic guide to some techniques. Have a look at WWW.neann.com, under other other products click spinal equipment and then look in the extraction techniques manual starting at page 65.
Sorry didnt have a direct link.

The technique of using webbing or hose line to support the weight of the patient from outside the vehicle should be used if possible. It reduces the OH&S risk for those inside and is less risky than trying to take the sudden weight in a cramped or less than ideal position.

The KED/extrication jacket could be used backwards or along the face of the patient. As it is being used as an aid to lower the patient in line rather than as an immobilisation device. Webbing from the KED can be held by operators outside the vehicle who are in a standing position and better able to take the sudden weight when the seat belt is cut. The inside rescuers can then guide/support the patient onto the spineboard.

[Spencer534]

1) Put the lbb under the pt.
2) Cut the seatbelt
3) Hope the pt falls on the lbb