1. #1
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    Question WWYD: Your average rear ender...

    Ok guys, you get dispatched to a rear end accident with 2 persons trapped. On arriving you see this, with 2 adult males in the rear of the middle vehicle. Whatchya gonna do??
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    Rescue struts to area near where rear wheels used to be.
    Chains from front to car in back to help keep from sliding forward.
    Open doors, remove patients.
    "This thread is being closed as it is off-topic and not related to the fire industry." - Isn't that what the Off Duty forum was for?

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    Bones, I'd do pretty much the same as far as stabilization goes, but the patient removal looks to be much more difficult. Assuming we've got possible c-spine injuries, and the need to c-collar and backboard the patients, I think you're probably need an elevated platform to work off of(flat-bed wrecker perhaps). Just opening the doors leaves them in your way, maybe better to remove the rear door totally, KED and bring them out the side. Anyone else got any ideas???

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    Oops! Re-read the post again. "with 2 adult males in the rear of the middle vehicle" (missed this part) Trapped in the rear, looks like it's only a two door car. Creating a third door in this situation would be lots of fun with it being so high off the ground. How about keeping the struts for stabilization, chain car to front vehicle and block. Tow truck pull rear vehicle out. Reposition tow truck to take up lift of back end and lower vehicle back down to ground using tow truck. Then third door and removal. Yes I know, a lot of people don't like moving a vehicle when the people are still inside, but sometimes, you gotta do what you gotta do. Thoughts?
    "This thread is being closed as it is off-topic and not related to the fire industry." - Isn't that what the Off Duty forum was for?

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    I was always taught to NEVER move a vehicle. You stabilize in place. I have never heard of moving to be an acceptable practice. If you do and someone ends up paralized, believe me the lawyers will find all the experts in the world to screw you. The best bet here is to bring in a tower ladder to work from. Other than that this is an easy cut job.
    THE ABOVE REFLECTS MY OPINIONS AND IN NO WAY REFLECTS THOSE OF MY DEPARTMENT.

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    Kev,
    After the stabilizing (all 3 cars) is taken care of. Perhaps, perform a reverse Top removal, fold the front seats down/forward ( so that the backs of the seats are parallel to the road), bring spine boards in and lay them down on the seat backs. Move the patient(s) onto the boards (long-axis pull) and Carefully "pass" them forward on to the roof flap (which you may have to box crib up to in the center of the roof) and the roof of the car in front and then move them to ground level or an awaiting stretcher or apparatus. "Maintaining" stabilization is paramount.
    Res14cue, We have moved vehicle before in order to extricate (this was only when all other means were attempted) I know many other that have too. The tow-operators would have to be veteran drivers we know could do the job.

    "Never say never, and Never say always"

    Good Photo Kbud (looks like Europe).

    JW
    "Making Sense with Common Sense"
    Motor Vehicle Rescue Consultants
    ( MVRC@comcast.net) Jordan Sr.

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    Assuming the patients in the back seat are belted in, they are going to be at a severe angle facing forward. Irrelative to door/roof removal, rotating patients to a backboard, even with KED, would be difficult at best. You could not slide backboard under patient in sitting position and use seat as a rest for backboard. So you are HOLDING backboard while patient is rotated and lowered to horizontal position, then strapped in and lowered to platform or ground. All this from a raised platform that can only get next to the vehicle still requiriong a good reach to patient?

    I like the suggustion about tilting front seat forward until it is horizontal with ground and use as a support, but don't think the seat would go forward that far. Even if it did, it is still an awkward move to get to that point.

    My thinking is that this is more hazardous to patient than lowering vehicle, which with an experienced tow operator can be done in a controlled manner.

    Any thoughts to actual patient extrication once access is achieved?
    Dan LaRue
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    Elkmont Volunteer Fire Dept.

    Your talents are a gift from God
    How you use them are your gift to God.

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    I Like JW's quote "never say never, never say always" it sums things up pretty well. For decades here we also kept to the "Never move a vehicle with people in it" and now we teach the right way to do it in appropriate circumstances. There is risk in each and every action that is taken in an extrication and the proper management of that risk is our job. The risk to the patients and to rescuers working in an elevated and angled worksite must be balanced against the risk involved in lowering the vehicle. Here we have the ability to consider this (almost unimaginable) incident at our leisure. I am reasonably confident I could organise lowering the vehicle safely and slowly along the lines suggested above and after many years riding in charge of an aerialscope I agree wholeheartedly with the idea working out of the bucket with extrication equipment would not be easy.
    This would make a great training scenario, thanks for putting it on here for us to consider.
    Jim Maclean. IACOJ NZ branch

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    From what I can see in the photo ~~ stabilisation is paramount in the enitial stage of this extrication.
    Rescue struts ( we call them “Accro props”) to support the underside of the middle vehicle and I feel you would want to pay a bit of attention to the front car moving forward às there is going to be a fair bit of downward pressure. Middle car may possiblly act as a pry bar and lever the rear of the front car upwards, allowing the midle car to drop downwards.onto the rear vehicle,…..Maybe.

    Removal of the complete roof, KED both patients and extricate both patients via a rescue boom, ladder truck or worst case, a ladder derrick.



    Stability is the key I believe.
    "Never forget that your safety comes before that of the people that you ar attempting to rescue"
    Mr.Rhys Mags - Director
    Victoria State Emergency Service

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