1. #1
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    Default Suspended upsidedown

    More and more we are finding patients hanging upside down in the seatbelt after roll-over accidents. Our training on how to access these patients has been good. We are using the "clamshell" method to gain entry, the problem is when we cut or release the belt, even with the seat back tilted back or removed, even with as many hands as we can get on the patient, even with a back board directly under the patient, I'm still not happy with the sudden drop that takes place when the belt is released. Any thoughts?

  2. #2
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    MetalMedic's Avatar
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    Could a KED give you a little more control?
    Richard Nester
    Orrville (OH) Fire Dept.

    "People don't care what you know... until they know that you care." - Scott Bolleter

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    Can't remember where I saw it ( maybe JEMS ) . Some crews have used a set of two air lifting bags once the side has been removed to support the patient in position and then slowly deflate one then the other once the belt has been released. Assuming you are going to log roll the pt from face down onto a second board this may work. Have not been able to try it as I work race tracks and we don't have lifting bags. Usually we just open it up as much as possible and get as many crew on the pt as we can but yes there is that initial lurch downwards as the belt is undone.

    We sometimes do a controlled righting of the vehicle using wreckers, personnel and winches as given the confined spaces in some cars even with a clamshell there is not enough space due to engine /transmission layouts. This only works if you have a well coordinated team and the driver is using a 6 point harness in a proper racing seat.

    Let me try this one in training again and I will get back to you if we have any blinding flashes of inspiration.

    Regards


    Colman Gilligan
    Motorsport Rescue Services

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    There is a great little technique you can do with a 4" wide ratchet tie down. Place the ratchet assembly on the top of the car.( Of course the bottom is the top since its upside down.) Now run the strap through the car, across the lap of the patient, and out the other side, returning to the ratchet. Thread the strap through the slot in the ratchet but do not use the ratchet to tighten. You have basically created a friction device to lower the patient. By pulling on the strap by hand you can take up the tension while the seat belt is cut and then ease the patient down by slowly releasing the strap.

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    Lightbulb Try this!

    Without a lot of detail included, try this in training:

    For suspened patients secured with a seatbelt, I've placed a low pressure air cushion (bag) underneath the patient. Slowly inflate the bag until it fills the voids surrounding the paitent. Obviously extreme care must be exercised when the bag is inflated to prevent further injury. Once the bag is inflated, the patient is released onto the soft surface of the bag. The bag is slowly moved to a position where the patient can be removed from the bag itself. Generally this involves sliding the bag on a protected surface with the patient prone. Logrolling is then used to place the patient onto the board. Takes practice and isn't the panecea, however try it and let me know your results.

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    A Posting from Forum Moderator Ron Moore

    The assumption is made that you have a longboard positioned below the suspended patient with personnel on each end.

    When ready to release the patient, have the crew holding the longboard lift UP slightly.

    Then release the belt.

    With this method, there is no sudden lowering or dropping action because the longboard crew already has the weight of the patient supported prior to releasing the seatbelt.
    Ron Moore, Forum Moderator
    www.universityofextrication.com

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