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  1. #1
    andres044
    Firehouse.com Guest

    Question Rollover Extrication

    On Saturday 4:00am we responded to a Rollover trapped victim accident. We found the car resting on the passenger side. The driver's head was trapped between post A, the roof and post B. The patient's weight was hanging from the seat belt. We proceeded and cut the post A, B and C to flip downs the roof. The problem was that the seat belt was locked and it does not allow the roof to come down. When we cut the seat belt the patient fells down inside the car. How can we manage the patients weight when we cut the seatbelt?


  2. #2
    rmoore
    Firehouse.com Guest

    Post

    Andre:

    You described a rollover with the driver on the high side suspended by the seatbelt. I have set up training drills that are similar to your actual crash.

    In training, the one method used to solve your problem involved several rescuers and the use of a longboard.

    In the drills, at least two rescuers at each end of an immobilization longboard place it in a horizontal and flat position under the patient. They then lift the board upward until they are supporting the entire weight of the suspended person.

    Another rescuer then cuts or disconnects the seatbelt which now has slack in it because the weight has been removed by the longboard crew.

    Once free of the belt, the longboard and the patient is lowered and removed from the vehicle.

    You could also do this with a rescue harness, web strapping, even fire hose placed around the patient to lift and support them. A blanket or tarp could also be suspended under the patient to lift their weight and support them but the longboard provides the best spinal support.

    Let us all know what ideas your crew believes would have worked the best for your specific rescue situation.

    Ron Moore
    University of Extrication
    Message Forum Moderator
    <Rmoore@firehouse.com>

  3. #3
    larescue
    Firehouse.com Guest

    Lightbulb

    Andre,

    In the event the roof is crushed to the extent that longboard placement is not possible, another tactic also works in these scenarios.

    We had a similar crash that during size-up we noticed the roof rail was crushed down several inches making it impossible to use the longboard technique. The way we handled it was to cut the B post between the roof rail and shoulder harness turnbuckle on the B post. Before making this cut, special care was taken to ascertain that the cutter blades would fit between the roof rail and shoulder harness turnbuckle without contacting the injured driver.

    Prior to cutting the B post, we cut the A and C posts on the high side of the vehicle. After cutting the B post, we then cut the A and C posts on the lower side of the vehicle. Next we rotated the roof down onto the ground. The shoulder harness was still attached to the B post which was still connected to the vehicle. Consequently, the patient remained in position.

    As soon as the roof was rolled away far enough to allow room for the longboard's placement, the board was positioned along the patient's right (i.e. lower) side to support his weight.

    The entire process was accomplished without losing control of the patient and without causing further injury.

  4. #4
    MetalMedic
    Firehouse.com Guest

    Lightbulb

    If we are brainstorming here, this is not the best solution, but might be an option I would consider.

    First, make darn sure you have the car secured well before you cut ANYTHING. Now, if you have access, cut the A, B and C posts on the PASSENGER side, take the windshield and rear windows out, then use a reciprocating saw or air chisel the cut the roof horizontally to gain access to remove the patient or, put in releif cuts and attempt to flap the roof upward to gain access. If you flap the roof upward, be sure to secure it before you try going under it!

    Either way, you have not given up the integrity of the driver's side where the seat belt assemble is located. No one mentioned how to free the trapped head. I assume a simple spread of the driver's side window opening accomplished this?


    ------------------
    Richard Nester
    Orrville (OH) Fire Dept.

  5. #5
    Eng 48
    Firehouse.com Guest

    Thumbs up

    I agree! everyone always goes for the hydrolics...don't forget we have other tools in the bag. The sawsall or air chisel would be very effective in this situation.

    ------------------
    Be safe everyone!

  6. #6
    Rich Behling
    Firehouse.com Guest

    Post

    just a quick bit here beware of viberation with either the air chisel and or sawzall, with the pt's head traped as such any movement could be dangerous. Just my two cents stay safe

  7. #7
    MetalMedic
    Firehouse.com Guest

    Smile

    Vibration is a consideration for sure. Even your hydraulic tools will cause this, especially when the shear occurs while cutting metal. I would probably address freeing the head first if possible just to better maintain the airway if for no other reason.

    ------------------
    Richard Nester
    Orrville (OH) Fire Dept.

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