AN INCIDENT THAT fire departments sometimes take for granted is the auto extrication. In many larger departments, the auto extrication is an everyday occurrence; in smaller departments, it may only be encountered several times a year. The auto extrication is the beginning of the victim’s “golden hour.” It can be the difference between life and death, and therefore must be a quick, efficient, and safe operation for all departments.

The following is a list of notes which can be applied to even auto accident scene.

  1. Gather as much information about the accident before you respond to the scene. Find out what you must know before you go.
  2. Size-up of the extrication begins with the receipt of the call for help.
  3. Drive defensively and controlled enroute to the scene. You can’t help if you don’t get there.
  4. Establish a command system for your rescue team. The worst type of command is no command at all.
  5. Establish standard operating procedures for your rescue team. SOPs help avoid unnecessary confusion at the scene.
  6. Get the big picture at the rescue scene. Don’t get caught with tunnel vision.
  7. Know the limitation of your rescue personnel and your rescue tools. Don’t overextend either of them.
  8. Don’t get in over your head and play catch-up. Call for assistance early.
  9. Position the rescue vehicle to protect the rescuers. When possible, park between the accident and oncoming traffic.
  10. Provide adequate warning for vehicles approaching the accident scene. Use vehicle emergency lighting and traffic control devices to provide the warning.
  11. Establish a hazard zone around evenaccident scene and allow only authorized and properly protected personnel to enter it.
  12. Don’t let a rescuer become a victim. Stress safety and supervise actions at the rescue scene.
  13. Protective clothing for all rescuers is a must. Insist that all rescuers wear full turnout gear.
  14. Make even rescue a wet one—always have at least one charged line standing by at even rescue scene.
  15. Always consider the possibility of hazardous cargo. Check the scene carefully before committing your entire unit.
  16. Never assume a car involved in an accident to be stable. Stabilize every vehicle before beginning extrication procedures.
  17. Treat every downed electrical wire as if it were energized.
  18. Do not forget evidence presenation. If evidence must be moved, make a note of it.
  19. Keep control of the accident scene. Don’t allow bystanders to interfere in the extrication.
  20. To help control the fire problem, remove the negative lead of the battery. Remember, however, that many new cars have electrically operated accessories. It may be helpful to leave the battery connections intact during initial operations.
  21. Always try before you pry. Don’t assume something can’t be opened until you try it.
  22. Gaining access is allowing the entry of emergency medical personnel to the victim. It doesn’t have to be neat and pretty. It just has to be safe and quick.
  23. Protect the victim from any further injury. Provide adequate protection for the victim from the extrication process.
  24. After gaining access, the rescuer must provide emotional first aid as well as physical first aid.
  25. Once a first responder has gained access, he is the eyes and ears of the rescue team. He calls the shots—the “do’s” and the “do nots.”
  26. The telltale signs of a distorted and damaged automobile interior—spidered and broken windows or mushroomed steering wheel, for example—may indicate additional injuries that aren’t obvious from the victim’s position. Look for these signs—they tell a story.
  27. Treat every victim for possible spinal injuries. Use backboards, extrication collars, and sandbags on every victim.
  28. Completely package the victim before moving him. This includes splinting, bandaging, and backboarding.
  29. An exit route from a vehicle must be large enough to remove a packaged patient. The more packaging, the greater the size of the exit route.
  30. Continually size up and survey the scene for developments. Operations can get out of control quickly. Stop the momentum before it gets started.
  31. Explosive forces can be encountered when working on and around damaged vehicles. Be alert and prepared for them.
  32. Don’t make extrication more difficult than it has to be. Take the easy way in and the easy way out, but make sure it is the safe way.
  33. Make sure all victims are accounted for. Don’t leave until you are certain of this.
  34. Make good decisions on extrication procedures; take the sure things first and uselong shots only as last resorts.
  35. A successful extrication is not based on how much damage you do to the car but, rather, how quickly and safely the victim is removed.
  36. Extrication scenes are just like kitchens. Don’t leave until you clean them up.
  37. The extrication incident is not complete until the paperwork is done. Be sure that every incident is well-documented.
  38. Extrication equipment is only as good as the rescuers behind it. Become familiar with your equipment and train with it frequently.
  39. Do not rely solely on powered rescue tools. Train with and be prepared to usehand tools.
  40. Maintain your rescue equipment. Check it regularly and after each rescue.
  41. Never modify rescue equipment. It was built to operate safely.
  42. Cross-training among fire-rescue and EMS personnel is a must, making it much easier to understand each others’ problems and to work together.
  43. Extrication is a team game. If the police, fire rescue, and EMS units all play by the rules, everyone comes out a winner.

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