1. #1
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    Dalmatian90's Avatar
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    Default Not another heavy truck scenario...

    Someone requested a non-truck scenario a few days ago, ol' brain cells been chugging, and came up with a good one.

    Simple, straight forward average old accident. Let's say a typical Taurus sedan that traveled off the road, hitting a stone wall hard. Heavy front end damage, driver (only victim) is Alert & Oriented, complaining of a "painful, swollen, deformed" (you know us EMTs, can't diagnose it as broken...) ankle, which he can't seem to get free. Was wearing seat belts, air bag deployed, no starring.

    Oh, he went off the road at a culvert, hitting the stone wall on the other side of a small brook after a good rain storm. So the Taurus is now sitting in 3' of flowing water.

    Ya didn't think I was gonna make it that straight forward, did ya?

    Watcha gonna do now?

  2. #2
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    Watcha gonna do
    Bad boys, bad boys, Watcha gonna do,Watcha gonna do when they come for you?!

    Sorry about that, I got a bit carried away!

    I'm going to assume by this, we can open the drivers door. If not, pop it open. Whilst that is happening, we're going to remove the rear window.

    complaining of a "painful, swollen, deformed" (you know us EMTs, can't diagnose it as broken...) ankle, which he can't seem to get free.
    Not really enough info, so I'm gonna assume (Make an *** out of u and me!) that the casualty is pinned by the pedals. We're going to go back to basics and get a length of 12mm rope and wrap it around each pedal (One at a time) and using a bit of brute strength, we're going to bend them out of the way to free the ankles.

    If we can't bend them out of the way, we're going to use our Holmatro pedal cutter, because we know for a fact our tools will work under water (Do yours? Have you tried it?) and we're going to cut the pedals.

    We're then going to bring the spine board in over the rear parcel shelf. Lower the back of the seat down and place the board in behind the casualty and then vertical lift/slide him up and out the rear window. (If he's a bigger than average person, we'll put the spreaders in between the roof and the parcel shelf and we'll do a vertical spread to create more room.)

    If getting out of the culvert is an issue, we're going to set a ladder up on the enbankment from top to bottom and we're going to place the board on the ladder, put a rope through the top of it and we're going to do a ladder slide up it. (Alternatively, we can place the board inside the stokes basket- once again, ours fits inside it, does yours? We'll then slide the stokes up the ladder in the same fashion.)
    Luke

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    3' Of moving water is a pretty serious hazard. Secure the car. Depending how fast the water was moving or rising I would consider winching the car onto dry land. My arms aren't 3' long so I 'd probably call the dive team in, if the car is in 3' of water we are probably looking at 2.5' of water in the car.
    A set of mini cutters, wizzer saw or hand tools will probably be needed to free his foot. Their isn't much room for a full sized cutter on the floorboard of Taurus.

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    Default My first concern is hypothermia

    Three feet of moving water, I would want to get the car drug out if possible. If not, then stabilize it in place, break some windows, and do an emergency extrication of the Pt with c-collar and manual stabilization only. Flowing water can be fairly cool, especially after a rainstorm. If the car is that deep into water, the Pt in a Taurus is going to be in water to his mid abdomen at least. Bend the pedals if he is entrapped in them, and drag him out a window hole covered in a salvage tarp or out the driver's door onto a backboard. I don't like this option, but the threat of hypothermia is too great. Even if he is AOx3 now, that can change fast in flowing water. You also risk rescuers working in that environment. Best option, drag the car out with c-collar and manual stabilization to Pt. Then you can cover the Pt, KED, and backboard as Lutan described. Am I thinking along the right lines, Dal?
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    he went off the road at a culvert, hitting the stone wall on the other side of a small brook after a good rain storm. So the Taurus is now sitting in 3' of flowing water.
    I have some questions.

    Which direction is the car facing towards the wall with the water (more or less) running directly into the drivers door or passanger door? Or did it bounce and slide so the water is directed more towards the front or rear of the vehicle?

    What are you going to secure this car too? It's in a brookbed, with a stone wall to one side of it. The weight of the car might cause it to sink down into the mud I don't know that I would want to consider that secure. What are the surroundings like, can you get a tow truck in there to winch it out, are there trees or anything else you can chain it too? Chocks would sink into the mud and pose a hazard for both responders and victim because they'd be under water and you wouldn't know if one came lose.

    Also since it was a brook bed (in my neck of the woods a brook is 2" - 8" deep) and is now filled with three feet of water, the current is going to be pretty good. Depending on the positioning of the vehicle you might have to secure the responders to ensure that in the event anyone slipped they didn't get swept away.

    Where are you going to put your gear?

    I would think a secure line to the vehicle would be required, much like in a high angle rescue. Don't want the basket to get away from you either.
    Last edited by Temptaker; 09-16-2002 at 03:29 AM.

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    Well,

    Brooks in our area too are usually 2-8" deep, a couple may get up to 1' or so deep and 12' wide, but after a few heavy rains especially if we had snow on the ground, watch out. They can get to be 3' deep in a hurry.

    Hadn't thought of the bed issue. I'm used to them being firm enough to more or less walk on -- tend to be gravel since water washes the silt away. But in swift water, they could undermine easily I'd assume.

    As for trees, tie off points, orientation of the car, I'll let you guys decide

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    Some thoughts:
    • Tie off car any way possible. One possibility would be to improvise some sort of rope "harness" around/under car & connect to winch on truck & tighten until car secure.
    • Break all glass, then take sawzall & cut A, B, & C posts on both sides, then remove entire roof.
    • At this point you have good access. You can cut steering wheel away from column for more room if needed.
    • Use ropes or prying tools: halligan, etc. to move pedals if needed.
    • Patient receives C-collar, XP/1 or KED if C-spine can't be cleared, lifted vertically onto backboard.
    • Backboard pulled up/along ladder from car to bank.
    If hypothermia a big issue, I'd go with just a c-collar, enough personnel to lift pt. onto b-board or stokes basket, & then pull them along the ladder.
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    Well not haveing much expierience,just watching some videos ill give my un-expert opinion.

    I Would tie the carand firefighters off either to a tree or too the appartus to make sure it does not go walk about. Well you said it went "down" into 3 feet of water so im assumeing that hood and would be under water because the car would be at a angle so the passenger would be somewhat out of the water. Id make sure the person was stabilized. then have a Firefighter cut the roof off and doors and then have a team try move his leg out,before they start cutting crap out of it or pushing the dash back. Once his leg is free,move him to a stokes basket and transport him.

    Just my opinion
    dfd

  9. #9
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    put all rescuers in lifevests, put two people down stream for just in case. if his foot is trapped and the water is 3 feet deep, the water will be covering his feet and it will be muddy. I'd find someway to secure the vehicle since it doesn't take much flowing water to sweep a car downstream. since patient is con & breathing i'd put him in a KED and C-Collar and then try to put a floation device on the patient. depending on which side of the car the water is flowing against, i'd open one of the doors, tie a rope to the patient and feel the pedals for his foot. if it can be freed that way then fine otherwide use a chain and pull the pedals to free the foot. then pull the victim out onto a floatable strokes basket and pull to shore. then package as usual. Just my ideas.
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