What's wrong with these pictures?

[jonnycutter]

nmfire

I agree and i retract any comment made as to the skill of the crew, and my post has been changed accordingly.

I like you am only looking at the pictures from my pc so perhaps we both are not in the best place to comment?

We all have different ideas about what we would do.

I have been a bit hasty with my original wording and not given some of the comments as much thought as they deserved. And i have given myself a slap

But if i was OIC for the incident i would not be happy,

We go on about PPE and other procedures, and the phases of an extrication, i see none of them here.

i respect your experience with this type of incident, however with this type of incident i would put money on some type of spinal injury, so space creation would be needed, so that leads me to stability to enable this to happen.

Are you saying you would be happy to man handle the casualty out of this situation with a possible spinal injury without space creation?

Personnel in the hot zone / inner cordon with no Gloves Helmets etc, do you see what i mean, don't shoot me but we will naturally have different protocols for our own fire dept, we should learn from each other and not let these debates get into a slagging match.

Yes i hope we can put my original post down to a badly thought out post. Apart from my bad comments (now erased) i know the subject and will stand by the points i have raised.

I never meant to pxss any one off, or give myself a bad reputation, for that i apologies.

John

[nmfire]

I don't understand where you keep coming up with this set in stone need for "space creation". If the patient isn't pinned and is not in an awkward position, no you don't need "space creation" and no you don't need to "man handle" the patient out either.

Once again, if the crew needs to make room or cut holes, I'm sure they will do that. This 1/400th of a second look at a small part of the scene with no information about what happened, who has responded, who is responding, and what their plan is does not give you any ability to judge them. You don't know enough to say they aren't doing the right thing or should be doing it differently. Hell for all you know, the patient got ejected and they're just getting the registration for the police. Or maybe the rescue isn't on scene with equipment yet. Or or or or or I can go on with or's forever because the details aren't there.

[Rescue101]

Jonny,Why do YOU think there is spinal injury?

As I mentioned,I've done quite a few of these and with the exception of unbelted occupants,EVERY one I have attended has been a signoff and they WALKED away.

At least here in the States the modern construction combined with the restraint systems lets one survive SERIOUS events with little or NO injury.

Space usually consists of the back window or whichever door opens easier. If there is spinal compromise,treat accordingly. If not,why overcomplicate things? T.C.

[Rescue101]

And the ONLY people I see WITHOUT PPE is the USUAL. Cops and Bus attendants. AND their Protocol varies considerably from ours. T.C.

[jonnycutter]

Ok i see where you are both coming from.

No i am not at the incident, i am just commenting on the pictures, and yes there may be no one in the vehicle, and yes the picture gives very little information.

I thought the pictures and the post where there because there was someone in the vehicle.

The vehicle has been in a roll over, which in most cases would lead you to assume a c-spine injury.

If there is so little information why are you assuming the vehicle is 100% stable and that their are no injuries.

I thought the idea was to debate the information and look at learning points to better our skills. If i am so wrong then why even bother to post these pictures. No of us know exactly what has happened

If the patient has no complaints and is able to get out then fine by me. I agree keep it simple and safe.

There doesn't have to be actual entrapment to warrant space creation, what about entrapment by virtue of their injuries?

If all you want to do is vent anger at me then fine but if we can not have a constructive open minded discussion, then i suggest we end it and move on to happier posts.

As i said i am only replying to the original post, with a lot of assuming, why doesn't whoever posted the pictures get the facts and let us know, u guys are guessing the same as me.

With regard to vehicle restraints, if you do the research you will see that they are actually responsible for a lot of post accident injuries and fatalities, that go un-reported. Airbags do not prevent whiplash and other spinal injuries. Come on lets keep this operational and not personnel

We are all assuming, what ifs by the pictures, so lets not get at each other

John

[jonnycutter]

OK this is how it is for us, there is one guy with a fire tunic on, not done up and what looks like a baseball cap. Ok it could be a passer buy etc who is wearing it for warmth, but if that was a FF in the service i work for they would be disciplined for that lvl of dress at an incident.

All the others would be in the outer cordon unless in correct PPE and part of the rescue.

Are we not responsible for everyones safety?

[nmfire]

We are not making an uneducated and uninformed assumption about the stability of the vehicle. That assumption is educated and informed based on experience and knowlege of vehicles design. This educated and informed assumption is reinforced by the apparent actions of the crews on scene. Done, end of discussion on vehicle stability.

As far as the patient condition, neither you nor I have any knowlege of this. There is nothing in the picture or description. R101 and I are making an educated and informed suggestion that the crew is acting properly based on whatever the situation in there happens to be and the resources on scene during the 1/400th of a second captured in the photograph.

For all you know the guys on scene got there in their POV because they live on the way to the station and there isn't even an apparatus or incident command on scene yet. Based on the small number of people on scene, this is actually pretty likely.

[scootr2200]

Ok, I didn't put it as best as I could when I talked about the ground giving way. To me, it looks like the vehicle is on a slope. I meant if the ground could not support the load on that slope.

Well, I made my post out on the information given to me by all of my training and experience that says, stabilization should be done before entering the vehicle.

You are all right by saying we do not know what the conditions are. I do not see the need to skip this step, even if you BELIEVE you are certain that the vehilce cannot move. Some sort of cribbing should be done in the even something does happen and the vehicle shifts.

Mickey

[Rescue101]

I can SUGGEST to LE they vacate the area unless they suit up. They, in turn ,CAN ARREST me for "interfereing" with an investigation. Like I alluded to you earlier,differing ways of doing things.

Going to the STABILITY issue. I'm 100% comfortable with my assessment of this vehicle being basically stable.Get one and try it yourself if you don't believe me.As far as the patients,for ME it's no problem. OUR only mission is provide whatever access is needed for the Medics and assist under THEIR direction.And I'd say we're having a meaningful discussion here once everybody rubs their feathers down.

What we do in Maine will be different than NY, Maryland, Texas and almost anywhere else. We ALL have different Laws,procedures,and "Dress" codes. In the end,if you have a Viable patient,no one got hurt, then it was a GOOD operation. THEN I get to work MY magic,put it back on it's wheels. T.C.

[jonnycutter]

nmfire

You are obviously greatly misunderstanding my points, i have had enough of your insults on my intelligence and knowledge, you do not know me as much as we do not know the topic pictures, so stop judging me. If you are not up for the exchange of information without turning to insults, then perhaps you should think twice before posting.

I never questioned anyones experience, or actually called anyone an idiot, if this is the response one gets from taking part in this forum, then i will think twice before re-visit this forum.

rescue101 i know what you are saying and yes i have been in similar situations, our protocol will still be to add some type of stability, thanks for keeping it relative without the insults

There have been some great posts in the past, this one seems very short sited.

Sorry to the other posters that it has turned this way.

[nmfire]

Again, I'm not judging anyone. Just pointing out simple facts.

[Rescue101]

Mickey,I'm OK with your assessment if indeed you feel that way.HOW are you going to remedy it? Using WHAT equipment? I've stated my views and reasoning,so now it's YOUR turn. Give up YOUR solution,and what equipment you will utilize to make it happen.Keep in mind this MAY be 100's of feet from the highway. T.C.

[Rescue101]

OK Jonny,I'm pinning you to the spinwheel. HOW are YOU( your agency)going to "secure" this wreck?

As I advised Mickey you MAY be 100's of feet from the road.

And HOW will this affect your procedure?

How common is this type of vehicle in your area(Xtra cab pickup)? You're up,buddy. T.C.

[jonnycutter]

nmfire

we have obviously got off on the wrong foot, sorry. I hope we can make amends? i am sorry if have made you feel you don't want to see me here again.

Yes i am assuming a lot from the pictures.

As this is an extrication forum i would expect this pic to be of an extrication.

rescue101

Yes i am sure we have all been to bad accidents where the driver / passenger has got up and walked away before we arrive, but that would not leave us much to talk about if that was always the case.

Ok fair one putting me on the case: remember this is our protocols. Its not how would i, its how would we the rescue team.

Initial scene assessment and safety with Firefighting media set up

Casualty access and assessment

NO matter how far from the road initial stability would be set up using StaBfast, with either blocks and wedges or possibly the use of air matts. We put in control measures to remove the risk, and there is always a measured level of risk. You could say overkill, or you could say its a good idea to implement some type of simple risk control.

Only rescue personnel with a task in the immediate area.(we would possibly have a crew of 9 FF's within the space of 5-10 mins) unlike yourselves. So again that makes a difference.

I agree if the medics decide that the casualty is ok we would then assist with their removal and no space creation may be needed.

If extrication is needed the fire service is responsible for the rescue, working inline with medical intervention, the police would leave us to it and investigate after the casualty has been removed, the only time this changes is for a fatality.

once the lvl of entrapment is determined we would determine the extrication plan, the stability would have been set up to leave these options open

casualty package and removal

This vehicle is not that common, but our stability sops are the same if not slight adapted for each scenario.

This i thought would be what posts we would be writing to exchange these ideas.

I look forward to the next beating with a stick JUst Kidding

[Rescue101]

Jonny,Constructive observations: You better have some TALL bags or a Schitload of cribbing. Rear area of body will be in EXCESS of 4' off the(probably closer to 5') ground,MINIMUM. Without trucking a truckload of stuff down there,the ONLY practical way is a telescoping strut. So that you and I are on common terms,the Width of this cab is about 6' and the length of the roof approaches 5'. As I mentioned earlier these fold a little in the middle when they roll and form a pocket near the axis with the A posts.Get your calculator out but anywhere I went to school thats a pretty good Footprint. Making a Extrication plan shouldn't take long. Takes 1000- 1800# of force to start this vehicle back upright. Will take probably about 1000# to get it to move ANYWHERE unless the grass is WET. T.C.

[jonnycutter]

Thanks rescue101

Thanks for the additional info on the cab dimensions, yes i agree a good surface area intact with the ground, should be pretty stable.

We use 2 sizes of StaBfast one for large vehicles / trucks etc these would be set up either side at around the rear third area, this would support the vehicle should there be a problem or if any supports need to be removed. you might say with your experience that this is going over the top, but that is our policy that we have to work too. Cribbing and wedges would be used against the bulk head gaps and additional packing under any posts as deemed necessary the StaBfast will be supporting the main load by displacing the weight down through the struts onto a solid platform to avoid sinking into the ground.

John

[Rescue101]

Trust me,I've NEVER had an "arguement" here that didn't benefit our operations somewhere along the line. Any chance you could provide a link to the Stabfast units? I suspect they are like our Rut struts. Nevermind,Found them. Yup,that's the way to go on this job.Thanks,T.C.

[HuntPA]

As to the picture itself, I see what appears to me, that there is a backboard on the ground. This signifies to me that there is a patient inside and that this is an active rescue, there is some form of apparatus on scene to provide at the least, medical equipment. I also see two people in what appears to be matching uniforms with no gun belt and medical gloves and a third under the vehicle similarly dressed. I am assuming that these are medical personnel.

I am in PA. We are not an OSHA state. We have found out that even though that is true, any accident will be investigated by OSHA. With that being said, everyone in the hot zone MUST have at a minimum of flame retardent clothing, gloves, hard hat, and eye protection.

In my department:
We are full volunteer and provide EMS (non-transport) as well as fire and rescue. We respond to MVA with light rescue, engine, and utility for additional manpower. We would respond with full PPE. As we do not have extrication suits, this is turnout gear. We do have hard hats for vehicle rescues in lieu of fire helmet. Those with patient contact would have medical gloves. No one would be under the rear of the vehicle until stabilized (verbal assessment could be done without entering the "collapse zone"). The vehicle would be stabilized with a simple picket system from the front of the vehicle from both front corners. If this is not done within 2-3 minutes, we are not doing it properly.

In PA, we are legally responsible for the safety of the patient, people responding, and the public on the scene of an emergency response unless it is an assist to PD. If the police officer does not listen to us and by doing so endangers any one of the aforementioned groups, he is the one that will face disciplinary hearings. Once the patient has been extricated and is enroute to medical care, the scene is then reverted to the jurisdiction of the police.

I do not criticize what other people have posted as their SOP's, governing laws, and experience my be different than mine. Our department has been through the legal system with people injured (not from our department, but on a mutual aid call) and can attest that the lawyers will immediately go after lack of PPE and adherance to SOP's especially on scene safety.

[ADSNWFLD]

The standard of care is to stabilize the vehicle, period end of story.
Yes, odds are nothing will happen to the responders or patient, but that is not what a professional rescuer does. I would go with a buttress system (because we have one) but cribbing is possible and cheap.
Proper PPE is required yet that may not be turnouts. Our USAR teams enter collapsed buildings in BDU's so why does a crash require structural firefighting gear?
Extinguisher as a minimum for protection.
No auto maker makes vehicles that sit on their roof, something could happen so as a professional we need to do what is right, not convenient, not fastest but the correct thing.

[Rescue101]

ACTUALLY,your statement is a bit misleading.Auto mfgs DO make the roof columns and the roof the way they do for JUST this eventuality. They ARE an Engineered structure.If this were NOT so,why bother putting Boron and other enhancements in the posts? I guess we could argue the Right/not fastest thing all day.Still comes back to: EXPERIENCE,Patient condition,safety, available manpower/tools and protocol/Sop's or Sog's. Could this be CRIBBED? Maybe but unless you crib ONLY under the roof area(on the corners)it's gonna take more cribbing than MOST of us carry on our rig. This picture offers LITTLE background so it's wide open to interpretation. We can't see if maybe just off camera is a Fire extingusher and we REALLY can't get a good feel for Slope/Ground conditions. T.C.