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  1. #1
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    Default Head-on & Broadside & Rollover in One...

    Here's another scenario for those so inclined to contribute their 2 cents. Your dispatch is to a rollover with entrapment on a high speed state highway. Enroute you're told the vehicle has hit a large tree head- on before rotating sidewise into another tree and landing on its roof up against a fence. Driver is trapped by the dash/steering column and hanging by her seatbelt. Everyone got the picture, if not here are a few:
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  2. #2
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    Another angle, notice the chain link fence is supporting some of the front end of the car.
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    Last photo. Driver is pinned at mid-thigh by the dash, stable vitals for now. Obvious head laceration and arm fracture.
    How would you stabilize this vehicle, access, treat, and disentangle this patient??
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    1. Apply wedges and blocks in front of the 'A' post. Crib between ground and fence and then above that between fence and vehicle.

    2. Apply Res-Q-Jack jack stands with the universal chain wrap at the rear.

    3. Stake the hood to the ground or apply some forward and/or rearward ties to some stationary point to restrain forward/rearward movement. Expanding to a 3-point strut setup for #2 in rear may handle it.

    4. cut as much of the fence away as possible to get it out of the way. Remove the section of fence between the two immediate fence posts. Leave piece under the vehicle where it is sandwiched into the cribbing.

    5. If necessary, add some additional front end cribbing from ground to vehicle in area where fence has been removed.

    6. Relieve pressure on the roof by cranking the jacks a few turns.

    7. Remove the driver door.

    8. Make appropriate relief cuts and perform an inverted modified dash displacement.

    9. May remove roof

    10. Package/remove patient

    That's my ten cents, RES-Q-JACK
    Following are some pics of the guys at the Houston Station 11 performing this maneuver.

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  7. #7
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    Default Pt. not trapped on that side of car...

    Ok, but the side of the vehicle visible in the third picture is the passenger's side, not the driver's. Driver side door is blocked by the big tree and in contact with the ground. What's your plan B?

  8. #8
    Forum Member kghemtp's Avatar
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    Thumbs up

    His plan would work just fine with access by the passenger door. In fact, we have more room to get a patient out from the passenger side anyway. My plan wasn't as elaborate as his, as I was simply thinking jack & crib the body, removing that visible door. I would consider making the appropriate relief cuts and doing a dash roll upside down if that would relieve any of the points of entrapment. Such a crash would be automatic trauma team activation at the receiving hospital, based only on mechanism. How did the patient do?


    ~Kevin
    FF/Paramedic

  9. #9
    Forum Member Rescue101's Avatar
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    Exclamation Questions

    Resqjack,Why would you worry about the A pillar?It's HARD down against a fence mat ON THE GROUND!In my mind a non issue.I'm taking a different tack on this one.See the tree directly behind the car?It's quite substantial.Two comealongs one to front and rear of car.Roof line is already resting on tree base.Tension lines and "rock" passenger door up more toward vertical and remove roof like a landing door on a aircraft.Remove patient in usual fashion.Understand I don't currently own a strut system so that factors into the thought process.The only real opposing question I have regards the blocking of the A post.If I had it available I'd also use a tow truck for additional stability.T.C.

  10. #10
    Forum Member nmfire's Avatar
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    Thats great and all. But what happens when you don't have all the fancy jacks and stabalizers? Time to get creative....

    First of all, this is going to take some time. Here, this would have a Helicopter on route and probably on the ground waiting for us when we are done.

    DeWalt the fence out of the way.

    We carry piles of cribbing. Pile it under the trunk to keep it from tilting back. 4x4's or 6x6's can fill up the space pretty quick.

    Front & rear doors & the B-Post on the passenger side- GONE! You might be able to fold the whole door & post assembly down from what it now the top. Now you have a nice wide opening for a board and people.

    If you need more vertical room inside, you can get really creative. Get winch cable off the truck, loop it over from the other side or use a snatch block and loop it from the same side. Hook it to something strong on the chassis farthest from the tree. Pull it up and crib under it as you go. DO NOT RELY ON THE WINCH TO HOLD IT!! In the absense of a winch, a come-along or several people pulling will do.

    Roll the dash as needed, being careful not to drop the rams on the patient concidering you are upsidedown.

    And with any luck, the patient will be out and on a board by the time the bird lands.

    Obviously, getting to the battery may be a little difficult so watch the usual electrical hazzards.
    Even the burger-flippers at McDonald's probably have some McWackers.

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    KGH - I agree that access through the passenger side or rear would work better than the driver's side, my thoughts are that jacking the dash on the passengers side is not going to make enough space between the driver and the dash and steering column. Gonna need to door some inside spreading/ramming to free entrapments, ie. spread from center console area.
    Actual patient had decreased loc and head laceration with large blood loss, prone on the roof,pinned between roof and headrest of driver's seat. First in engine cut headrest and reclined seat out of the way. No stabilization done by them due to critical patient. We responded mutual aid and helped them with sliding backboard in through rear window opening, and patient back out same way. Some broken ribs and lung contusions, pt. should make full recovery.

    Nmfire - hard to see from first photo, but the battery was laying on the ground at the rear of the vehicle from the impacts.

    Nm, 101 - hadn't considered pulling the car to a side resting position. I'm still trying to get track this vehcile down for some cut time on it.

  12. #12
    Forum Member nmfire's Avatar
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    Oh, well then I guess the battery isn't an electrical hazzard. We had that happen last week. The guys opened the hood to cut the battery cables during the extrication and it wasn't there. It was located about 10 feet away in the woods.
    Even the burger-flippers at McDonald's probably have some McWackers.

  13. #13
    Forum Member Rescue101's Avatar
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    Default So many ways

    Kevin,A lot of ways you can work this job.As I mentioned earlier with the equipment I have at hand I would use "existing tools"(Ie Maine deadmen:trees) to stabilize with.My only question on the whole scene was why Resqjack wanted to stabilize the A post when it looks like the whole hood/A post area is firmly enough planted to the ground to be relatively stable.Again that's looking at a picture which are often decieving.Time being our enemy in all operations,I want to make things happen as quickly as SAFE operations allow.That being said,why block a spot that is supported by a 1.5 inch pipe and a 4x4 metal pad?On to the disentanglement,once the problem is identified, with the "landing door"option it becomes easier to operate on the obstruction.However on a time critical patient such as this one,other options may need to be considered.In either case the securement method I mentioned allows total freedom to change angle,pull the vehicle to a more vertical position,make "doors"anywhere in the roof area,total trunk/rear deck acess,and so on.And there may be many good reasons to do it in another manner.But as we discuss these scenes,one thing is certain;we learn and have a action plan figured PRIOR to the event.Gotta be a good thing.T.C.
    Last edited by Rescue101; 06-19-2003 at 09:06 AM.

  14. #14
    MembersZone Subscriber NB87JW's Avatar
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    Kevin,
    Great photos. Looks like the gal hit the tree pretty high (airborne) and slid down the other tree and landed of those branches and fence. It also appears the car is at least partially buried in the dirt and jammed against the tree on her front side. One of the photos shows what appears to be the fence possible supporting the passengers front side. (Would cutting the fence have lowered the car prior to stabilization? Just curious)I may have cribbed under the fence at that area too.
    Couple of struts tensioned at the rear end (out of the way) , wedge up in a few places to tighten it up.

    In and out the back window. You can always make more space by cutting (one (or both) of those Rear Pillars (appears to be "B" in this case). In case of pedal entanglement this may be one of those we have to use manual movement of the pedals her feet/legs or a combination of them. Slow release of the belt and lower to the board (prone if ya have to, then roll her supine asap, whilst(<----lutan word)maintaining her spinal immoblilization and airway. Looks like everyone covered this case pretty well from all aspect. Thanks for this Post Kevin.
    fraternally, Jordan
    "Making Sense with Common Sense"
    Motor Vehicle Rescue Consultants
    ( MVRC@comcast.net) Jordan Sr.

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