By Brian Zaitz
You are dispatched to a vehicle accident. Upon arrival, you find two vehicles head on with moderate damage. One driver is out and being evaluated; the other driver is still in the vehicle. He states that he cannot exit the vehicle because his leg is pinned under the dashboard. You take a look and see that the due to the impact the dash has come down on his foot, trapping it. How are you going to proceed?
This is a common situation, a minor entrapment that can easily be mitigated with a modified dash roll or, as detailed in this article, a dash lift. Both work to raise the dash off the entrapment and free the patient. The benefit of the dash-lift is that it does not require a hydraulic ram and can be accomplished with a combination tool, routinely found on first-due engines and trucks. The other benefit of the dash lift is that it places the tool out of the way for patient extraction, allowing full patient access.
To start the dash lift (or any extrication procedure, for that matter) first stabilize the vehicle. This critical step ensures the vehicle will not move and places it into a position that is safe for rescuers to operate in and around and safer for the patient. When lifting a dash, it is also necessary to box crib below the lift so as to fill the void from the rocker panel to the ground, thereby producing an area to lift against.
RELATED: Extrication Training Video: Tips and Tricks | IMPROVING PATIENT ACCESS AT EXTRICATION SCENES
Another key aspect to extrication is that of the “pull-n-peek “ technique. This technique pulls away plastic trim and looks for hidden air bag cylinders seat belt tensioners. These areas are “no-cut” zones and should be marked. No two sides are the same, so just because an airbag cylinder exists on the driver’s A post does not necessarily mean it is in the same spot on the passenger side. Take the time to pull-n-peek to see what you have. Never cut blind.
After looking for hazards and recognizing the need for the lift, it is time for relief cuts. These cuts allow for the dash to lift. Cuts are made at the front quarter panel (note that you can also smash this material, which will produce the same effect), the A post, and the hinge side of the door below the dash. Once these cuts are complete, take hydraulic spreaders or the combination tool and begin your lift.
Note that once you begin the lift you cannot reposition the tool or pull out. If this is necessary, you must capture what you have gained to that point in the lift–as you lift, the now-mobile patient may reposition his or her trapped extremity and components of the dash may move. Either of these could lead to further harm if the lift is lost and the dash comes back down on the patient. Only lift what is necessary to extract the patient. During training drills, firefighters have a tendency is to see just how far the dash can go. Although this is not necessarily bad for training, it is not ideal for the real world.
Take the time to get out the extrication tools and review their operation. If you can, go to your local junkyard and practice techniques for your next vehicle extrication.
Download this drill as a PDF HERE (460 KB).
Brian Zaitz is a 14-year student of the fire service, currently assigned as the captain/training officer with the Metro West (MO) Fire Protection District. Brian is an instructor with Engine House Training, LLC as well as instructor at the St. Louis County Fire Academy. Brian holds several degrees, including an associates in paramedic technology, a bachelors in fire science management, and a masters in human resource development. Brian is currently and accredited chief training officer and student of the National Fire Academy’s Executive Fire Officer Program.
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