View Poll Results: Do you find these type of "What and How To Do" forums beneficial to your training?

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  1. #1
    FIGJAM
    lutan1's Avatar
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    Question How Would You Extricate?

    The picture below is of an MVA we attended some time ago. There was one person deceased in the rear seat. This is a view of the drivers side of the car.

    Assuming the person was alive, how would you extricate them from the vehicle?
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    Luke

  2. #2
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    Without seeing anything else I would stabilize, control hazards and start with the roof. Once the roof was clear I would have to see what we had. I'm guessing the front seats might need to come out for access. I see a lot of cutting in our future.
    For the record I like these senerios because they keep you thinking. A similar call years ago had one DOA in a full sized ford with the roof wrapped around a tree. After pulling the car off of the tree it came down to a lot of cutting.

  3. #3
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    To answer the first question first, YOU BET I DO. I get one hell of a lot of info from reading these sorts of posts.

    For the second question, I will hold off a little bit while I think on it. That's the joys of a classroom environment!
    If you don't do it RIGHT today, when will you have time to do it over? (Hall of Fame basketball player/coach John Wooden)

    "I may be slow, but my work is poor." Chief Dave Balding, MVFD

    "Its not Rocket Science. Just use a LITTLE imagination." (Me)

    Get it up. Get it on. Get it done!

    impossible solved cotidie. miracles postulo viginti - quattuor hora animadverto

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    First of all, stabilize.

    As ADSN/WFLD said, taking the roof off first is the way to go and removing the front seats for patient access is probably a good idea..

    Looks like this car was hit above the frame, maybe by a large truck? Anyway, the frame looks intact, but it looks to me like the body is all that’s crunched up, and that is probably what’s pinning the rear passenger. If that assumption is correct, I’m thinking we might cut the trunk lid, fender and rear window frame out pretty quick with a reciprocating saw. That stuff is going to have to go if that is the reason for entrapment.

    I wouldn’t mess with trying to remove the rear doors unless removing all that sheet metal isn’t a possibility.

    And yes lutan, I find these situations you give us very informative. It's been an eye-opener just seeing how different people approach the same problem.
    Bryan Beall
    Silver City, Oklahoma USA

  5. #5
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    Stabilize...

    Is that a round hay bale I see above the car? Just thinking we may need a tractor/front end loader special called to secure & remove it for safety's sake.

    I agree with the ADSN & Company that let's get the roof off and look some more.

    I'd give the rest of the crew a heads up we're probably gonna be taking off the front doors and moving the seats forward. We're usually fortunate to have enough experienced members a couple can be assigned to simply size-up "the next move" so while the roof is coming off, they're already deciding where the tool teams' next moves are.

    In the back of my mind is the opinion of our former Deputy Chief that it's easier to move the part of the car that's not crushed than trying to uncrumple it.

  6. #6
    FIGJAM
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    The vehicle was struck up the rear end by a 4x4 vehicle at approx 100kp/h- no skid marks, so the assumption is no braking either.

    That's not a hay bale, its low hanging branches from a Ti tree.

    Out of interest, how are you guys that have suggested it, going to get the seats out?

    Food for thought- an impact of this magnitude is going to severely crumple the floor pan. How do you access the mounts?

    We can assume that the rear passenger is probably going to be pinned by the front seat/s- once again how do you remove it without aggravating the injuries? (If you opt to use spreaders or similar, your going to move the seat alot....)

    Keep thinking!

    Luke

  7. #7
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    Assuming a roof cut, The remains of the boot would need to be chocked and rammed to prevent springing.

    easing back on the rams could give further room to see where next.

    rear far side passengers door looks to be a reasonable access to the vic, that side appears relatively ok from the pici.

    At least we got a medic in to say hallo to the vic doing that.

    Which ever way you go, that is going to hurt like hell for vic.
    Psychiatrists state 1 in 4 people has a mental illness.
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    Stabilize as best you can. Remove roof for better view and access. Without being able to see inside, possible to remove front seats by blocking below and spreading up and/or cutting. When front seats are removed, there may be access to patient from the front.

    Yes, floor plan will be crumpled, but with enough blocking below where you are spreading, it will hold up to pop the seat bolts free. We found this out after an elderly couple parked on railroad tracks and met a train. Their car was lifted and sent wrapping around the train gate post. Both died on impact, and the car was a mess. Floor boards were wrapped around legs and feet bad enough that Coroner gave us permission to cut the legs off to remove the driver...sorry, not gonna do that. They got in the car in one piece, they commin outta the car in one piece. Agreed, this will take a lot of time and careful spreading little by little, but I think would work.

  9. #9
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    Cool

    I would probably start by seeing if the seats functioned enough to slide them forward.

    For removing the seats as suggested, I would say unbolt them or use the cutters if you could gain the access. Another point would be are the victim's feet pinned by the base of the seat. If they are not at least use the cutters to remove the seat backs.
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    A different approach would be to remove both the rear doors. Drivers side for the medic. On the passenger side use a ram horizontally between the “B” post and nater bolt. This will open the space between the seats and also straighten the floor. The roof and the closed front door will help support the “B” post. This is basically reversing the collision. Once the space is open remove the roof to gain better access. Depending on the position of the patient, this procedure could move the patient and may not be possible.

  11. #11
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    Lutan, I love these things. You can't replace experience, but hopefully we can all learn from someone else's.

    How much fuel is leaking? The ground looks pretty flammable there. I would be concerned with possibility of sparks lighting the leaked fuel on the ground.

    What about using bolt cutters on the seat hinges once you had access to them? The patient might still be pinned at the feet, but you would have better access to assess and treat with the top portion of the seat removed.

  12. #12
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    Once all the preliminaries are addressed, cribbing, charged hoseline etc, then the real work commences.

    Time would be of utmost concern here, if the occupant is still alive.

    I am wondering about access through what remains of the rear of the car. If possible, I am thinking that a two sided attack on this one might be warranted. Using the recip, try to cut through the back end, and remove as much of the "trunk" and remove the roof. When that is done, I agree with removal of the front doors and attempting to take out at least the seat backs, to allow maximum access to the rear. If it will come off, at least one of the rear doors should come out as well (flapping the remains of the chosen side).

    Well Done Lutan, this is a great exercise of the mind. I came back to this one three times before making this answer, and will be back again many times to reassess. I feel that I am missing something important here.
    If you don't do it RIGHT today, when will you have time to do it over? (Hall of Fame basketball player/coach John Wooden)

    "I may be slow, but my work is poor." Chief Dave Balding, MVFD

    "Its not Rocket Science. Just use a LITTLE imagination." (Me)

    Get it up. Get it on. Get it done!

    impossible solved cotidie. miracles postulo viginti - quattuor hora animadverto

    IACOJ member: Cheers, Play safe y'all.

  13. #13
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    Lots of cribbing is a must because there is going to be a fair bit of cutting.

    Hose line out and charged.

    First, I would probably do most of my work on the far side because I believe it would be damaged less. I believe this because as you look at the rear of the vehicle you can see that the side facing us is really damaged, but looking closer you should be able to see that the rear fender/wall of the truck appears to still be in good shape, this makes me believe that the far side will be in better shape and easier to attack.

    However, for this scenario we can play on this side of the vehicle.

    I am going to cut the posts all the way around and take the roof right off. Easy enough.

    While that is happening, spreaders on the rear door pin, displace that, and the front door hinges (not shown) and fold the sidewall down. This is going to give me lots of room above and to the side of the PT. If the PT is pinned some how in the rear, the ram, or spreaders, can be used to displace what is pinning him.

    Now, moving seats, if they are not in contact with the PT, the spreaders or combie tool can get in there (through the open sidewall) and displace them with relative ease. If not, folding the seat forward, quick spread with the tool will take the back of the seat right out, leaving just the base still attached to the frame (nice and soft to sit on while working ).

    Lots of cribbing. With the roof and sidewall down I would expect the vehicle to start to sag. It looks like a newer model so the structural integrity is going to be compromised be removing things such as the sidewall and roof. No need to let the vehicle sag and have unnecessary PT movement.

    I think that is all I have got right now? Anyone else?
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    "No one ever called the Fire Department for doing something smart..."

  14. #14
    FIGJAM
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    You're spot on Firefighter26! The passenger side was fully workable, in that both doors could be opened and closed.

    Would you fold the side down or remove it totally?

    Also wouldn't it better to leave the roof on until the doors are popped to give us a bit more strength and integrity whilst we're popping latches,etc?

    In the real world scenario, the fatal casualty was pinned between the front and rear seat- badly!


    Mmmmmm. had a "No" vote on the poll. Does that person want to elaborate as to why, either via my email or on the forums? I'm intrigued...
    Luke

  15. #15
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    It looked as though the truck that rear ended this car hit it at an angle, leaving the far side relatively intact. If given the choice, I would attack that side first.

    My personal preference is to remove the sidewall totally. I don't like having it in the way. Displace the rear door at the pin, front door at the hinges and cut up high, then down low, and walk it away. I like cutting up high first, that way if the PT crashes you can fold it out of the way and grab and go. But, if the PT is stable, I like having it right out of way.

    I agree Lutan, I would displace the pin and hinges, then start to work on the roof. Sawsall or recipsaw on the far side to cut the posts while the cutters on the side shown. Having a nice strong frame to displace against is worth waiting. If things are too weak, when you go to displace those doors you'll spend spend most of your time spreading sheet metal and not moving the door.

    The PT being pinned between the front and rear seat, I would think using the ram, or spreaders, to move the front seat away would be the way to go. Of course, "try before you pry," I would see if the seat could slide forward before setting tools up. Using the ram and just like a dash push on the base of the front seat to the C post.

    Hey lutan, don't worry about the NO vote... probably a Mutt or someone still wanting to stir up trouble.
    "No one ever called the Fire Department for doing something smart..."

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