Thread: patient removal

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    Default patient removal

    What in the best way to remove a patient from a roll over, truck on its roof when they are still in their seat belts ?

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    Just a suggestion that has worked for me...Place a low pressure air bag onto a lsb, inflate the low pressure air bag until it supports the patient, then release the seat belt. Deflate the bag with patient lowered to lsb, remove from vehicle and log roll patient onto another lsb.
    Developer and Sr. Presenter, Team Xtreme
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    We just had a training planned for this which turned into a tabletop discussion. We had our highway department flip a donated car for us with a mannikin suspended from the seatbelt, but on our training night the wind was blowing 25-30, the temp was 39 and the rain was heavy so we decided to save the hands on for another training.
    Anyway, I went looking for suggestions on the web and found an Australian site with detailed SOG's for all kinds of extrication and a section dealing specifically with suspended patients. They use a KED and a long board and show access and patient removal through the back window. After passing around the photos, our EMS chief said she would not waste the time or add the extra physical manipulation necessary to get a KED on a suspended patient, but that the long board could be useful. Their favored piece of equipment is their vaccuum mattress, which can easily be maneuvered under and fitted around a patient to provide maximum support in the pelvic/thigh area. When it is deflated the mattress ends will extend to either side so that two rescue personnel can hold it to support the patient's descent while two other rescuers support the patient's shoulders and head. Remember, the patient is going to come down face first. A backboard will help stabilize and remove the patient if it can be inserted in the vehicle; the patient can be shifted onto their side or back once out of the vehicle. The back of the seat should be laid back as far as it will go.
    I also found a Firehouse thread which mentioned the low pressure air bag technique as well as using a rachet strap trough the windows and over the bottom(now the top) of the car and used to control lowering the patient. Our rescue chief was concerned with mechanical support in the thigh area as it might leave all the upper body weight suspended from the spinal column, though this could be controlled by having adequate personnel suporting the pelvic and shoulder areas as the seatbelt is cut.
    Questions we had: what do you do when there are people in the back seat, when you can't get in windows, when there are kids in car seats, when the vehicle is in a ditch with water...

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    Waterman27 asks: what do you do when there are people in the back seat, when you can't get in windows, when there are kids in car seats, when the vehicle is in a ditch with water...

    One thing to consider is tunnelling your way in through the trunk. We learned to do this in a Commercial Vehicle Extrication class where we were presented with an underride positioned so none of the car doors were accessible.

    With kids in car seats, ideally they stay in the car seat and the whole thing is removed from the car.
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    "our EMS chief said she would not waste the time or add the extra physical manipulation necessary to get a KED on a suspended patient"

    Waterman, have another look at the site, the KED is not actually applied. Rather it is opened out and placed against the front/face of the patient in the open position, this would then allow a rescuer on either side of the patient to take the patients weight and hold them to the back of the seat while it is rotated back and up towards the floor which is now the top of the vehicle. This is in a sedan not in a pick up or (ute/utility).
    This results in the patient being held in the face down position but straightened out in the vehicle. Now with the rear window removed the spineboard is slid in below the patient and hooked over the steering wheel. The seatbelt is cut.At this point the patient is lowered face down onto the spineboard and extricated towards the rear. Very quick method.

    Great for sedans, not real practical for trucks or pick ups though.
    Also consider the use of straps to pass through the vehicle and take some of the weight of the patient from outside the vehicle. Straps can also be used to take some of the weight of the spineboard, leaving the inside rescuer to manouvre the patient , rather than having to lift all the weight.

    If you read this can you post the site for others to read, I want to see which one you are referring to.

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    I'm assuming the manual referred toearlier is this one by Emergency Technologies, Vehicle Extraction techniques
    Luke

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    If they are in a ditch full of water,upside down,the fastest SAFEST method is to winch the vehicle onto dry land first then extricate.Now I know that concept goes against anything you've ever been taught medically,but think it thru.On the roof you have a king sized sked that will move with very little energy applied.If you don't act swiftly your patients will drown.Supposedly they are belted,even if they aren't they will sustain less injury thru the winching process than they will if you apply almost any alternative method.Then your rescuers are working on "dry"land in controlled conditions rather than in the unpredictable water hazard.Such inverted operations make for a reaL INTERESTING TRAINING,which I reccomend to anyone involved in vehicle rescue.More and more incidents today involve rollovers,be ready. T.C.

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    Originally posted by Rescue101
    If they are in a ditch full of water,upside down,the fastest SAFEST method is to winch the vehicle onto dry land first then extricate.Now I know that concept goes against anything you've ever been taught medically,but think it thru.On the roof you have a king sized sked that will move with very little energy applied.If you don't act swiftly your patients will drown.Supposedly they are belted,even if they aren't they will sustain less injury thru the winching process than they will if you apply almost any alternative method.Then your rescuers are working on "dry"land in controlled conditions rather than in the unpredictable water hazard.Such inverted operations make for a reaL INTERESTING TRAINING,which I reccomend to anyone involved in vehicle rescue.More and more incidents today involve rollovers,be ready. T.C.
    I feel a "tow-truck" coming along here somewhere.
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    I feel a "tow-truck" coming along here somewhere.
    101 doesn't know how to extricate unless it involves a tow truck Don't crash in his response area....
    Luke

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    Hehe,The two of ya can "bite"me.Nowhere did I mention tow truck.I said winch.Be it Trifor for those from away,or Ramsey,Milemarker,Warn or American powerpull if that's all you got.Do it with a chain or strap on your Engine as long as you have a operator with some intelligence.But since you stirred the pot,I suppose you COULD use a tow truck.Point being that this is one of those real stickey gray areas as far as Medics are concerned.Think outside the box,or when necessary,move the box.How that kangaroo stack coming anyway? T.C.

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    Originally posted by Rescue101
    Hehe,The two of ya can "bite"me.Nowhere did I mention tow truck.I said winch.
    We both know you were thinking it though!

    Quote Originally Posted by ThNozzleMan
    Why? Because we are firemen. We are decent human beings. We would be compelled by the overwhelming impulse to save an innocent child from a tragic, painful death because in the end, we are MEN.

    I A C O J
    FTM-PTB


    Honorary Disclaimer: While I am a manufacturer representative, I am not here to sell my product. Any advice or knowledge shared is for informational purposes only. I do not use Firehouse.Com for promotional purposes.

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