A “STRAPPING” PROBLEM
TRAINING NOTEBOOK
Seat belt use is on the rise, mainly because of increased driver awareness and laws requiring seatbelts. For rescue teams at the scene of a motor vehicle accident, the seat belt, while no doubt saving lives and often preventing serious injury, can pose problems during extrication and disentanglement procedures. Following are situations in which seat belts can interfere with rescue operations.
Roof removal. Construction features of many new cars, along with the improved cutting ability of hydraulic tools, allow the rescuer options never considered before. The ability to remove a vehicle’s roof completely gives the rescue team total access to the passenger compartment. In the case of multiple casualties, this operation is usually necessary to allow medical personnel sufficient room to operate.
The rescue team officer or leader must check for the shoulder harness attachment points, often located on the B-post or the roof itself. Even if the passengers are not wearing them, you must cut through the belts in order to remove the roof. In some cases the belt is strong enough that it remains attached when rescuers lift off the roof, resulting in a loss of control and possible injuries to themselves or further injuries to victims.
Door displacement. Some newer vehicles have an automatic belt system linked to the vehicle’s front doors. When the door is closed, the occupant of the front seat is strapped in. Some of these belts are connected directly to the door itself; others are in a track-type configuration. As a result, when you attempt to displace the door, the belt may hamper operations and place even more stress on the victim. Again, ensuring that the belt is removed prior to displacing the door will make operations smoother.
Patient packaging and removal. One of the most important aspects of rescue operations is patient stabilization and removal. With the development of KEDs and other equipment we have come a long way in this area. Unfortunately, many times rescuers package patients only to discover that the belt is entangled in the packaging system. In some cases rescuers have cut or disconnected the shoulder strap but have neglected the seat belt. As a result, they lose valuable time trying to free the victim.
Seat belts have caused problems during the operations described above for a variety of reasons. The most common excuses are “I never thought of it” and “I thought you had it.” Often personnel assume that if the shoulder harness has been cut, so has the lap belt, or they assume that the victim was not wearing a belt.
To ensure a successful operationr assign someone the task of checking for and disconnecting or cutting the seat belts. Even if victims are not wearing them, many operations require that they be cut and pulled clear. All members of the rescue team should be conscious of seat belts and how they may affect their particular assignment, such as disentanglement or patient packaging.
Remember, too, that there are different types of belts. Many cars still on the road today have separate lap and shoulder belts; others have two separate belts joined at one connector. In both cases, cutting the lap or shoulder harness doesn’t clear the other belt. In loop-type belt systems, where the shoulder and lap belts are formed by one continuous belt with a sliding connector, you may need to make multiple cuts because the belt is entangled.
Belts are made out of a synthetic material webbing. They can be easily cut with medical scissors, sharp knives, and any of the seat belt cutters on the market. When cutting, hold tension on the belt to speed the cut and reduce the chances of any whipping when the belt is retracted. If possible, cut out and remove the entire belt to avoid having to deal with it later on in the operation.
Granted, this is a small and, to many, a basic operating procedure, but it is an important one. Don’t let vehicle restraint devices restrain you during rescue operations.