Challenging Auto Extrication

AT 5:24 A.M. ON SATURDAY, December 23, 2006, the Elmsford (NY) Fire Department was dispatched to a personal injury auto accident requiring extrication on Saw Mill River Road. Responding units included one engine company equipped with rescue tools, one basic life support ambulance, Chief Michael Eannazzo, and me.

On arrival, we found a single-vehicle accident. A lone male driver was entrapped in his four-door sedan, which had collided broadside with a utility pole (photo 1). The pole was broken into two pieces (photo 2); the base was heavily imbedded in the driver’s side of the vehicle while the top portion, suspended by live wires, rested vertically on the car roof (photo 3).


(1) Photos by Tom Bock.

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(2)

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Chief Eannazzo, the incident commander (IC), and I, the operations officer, sized up the situation and verified that the Greenburgh (NY) Police Department, already on the scene, notified Con Edison, the local utility company, to respond.

Based on our size-up, we ordered engine company personnel to do the following, proceeding with a standard extrication operation:

  • Scan the vehicle and immediate area with a high-sensitivity voltage detector to determine if anything was energized as a result of the utility pole involvement. This scan indicated the scene was not energized.
  • Stabilize the vehicle with cribbing under the rocker panel and wheel chocks in front of all four wheels.
  • Stretch and charge a 1 3/4-inch foam line and deploy a dry chemical extinguisher for possible use.
  • Disconnect the vehicle’s battery and gain entry into the engine compartment by cutting the hood with a circular saw and prying it open with a halligan tool.
  • Deploy and stage the cutters, spreaders, and rams.

EMS personnel prepared their ambulance for the victim’s removal.

Because of the position of the vehicle, driver’s side entry, roof removal, and dashboard rolling were not options.

Engine company personnel removed the front passenger side door with the spreaders (photo 4), pushing the lock away from the Nader pin and cutting the hinges. They also forced open the rear passenger door.


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Work began with the victim still conscious and in pain from an apparent fractured leg and internal injuries. He verified that he was alone in the vehicle. Greenburgh Police paramedics continually monitored the victim’s condition throughout the extrication.

Because of previously mentioned limitations, personnel worked on freeing the victim, whose legs and feet were pinned by the dashboard, driver’s side door, accelerator, and brake pedals.

They used a small ram, placing it between the floorboard and underside of the dashboard, raising it slightly. Next, they used a larger ram, placing it between the passenger side A post and the inside of the driver’s door, moving it slightly. These procedures freed the victim’s legs, but the pedals still trapped his feet.

Removing the victim’s shoes allowed personnel to free his feet and secure him to a backboard, completing his removal through the passenger side rear door. This was the quickest means of egress, after lowering the driver and passenger seat backs.

After this painstaking work, which took approximately 45 minutes, our department ambulance (advanced life support, paramedics onboard) transported the victim to the nearby Westchester Medical Center Emergency Department (Level I Trauma Center) within the Golden Hour, where he spent several weeks for treatment of his injuries.

Prior to the victim’s removal, Chief Eannazzo and I conferred with Con Edison on the possibility of changing tactics and treating the extrication as an “under-ride collision,” which occurs when a smaller vehicle becomes lodged under another, larger vehicle. This change in tactics would have necessitated the stabilization of the top of the pole with a Con Edison boom truck, and a tow truck would have pulled the vehicle into an area that would have given us complete access to it.

Through this incident, we learned that the most important elements of extrication are the following:

  • Implementation of the incident command system, which enabled the IC to oversee the entire operation and coordinate the various agencies involved while I supervised the tactical part of the operation.
  • The size-up, which facilitated the victim’s safe extrication and ensured the safety of all operating personnel.
  • A progressive training program that includes various extrication scenarios on a regular basis, which enabled our personnel to operate safely, effectively, and successfully under difficult circumstances.
  • Specialized training, which included a number of the officers who had just completed a heavy-duty extrication class. This class gave the officers the ability to consider a number of approaches concerning the victim’s removal, specifically the possibility of treating the incident as an “under-ride collision” had the standard extrication procedures been unsuccessful.
  • A regularly scheduled maintenance/training program, which ensures personnel are able to use tools and equipment in the most efficient manner.

This was a successful and well-run extrication because of the initial and ongoing size-up of the scene, with well-trained and disciplined personnel using properly maintained tools and equipment.

SYDNEY HENRY JR. is chief of the Elmsford (NY) Fire Department and a 42-year veteran of the volunteer fire service. He previously served with the Tarrytown (NY) Fire Department and was an engine company lieutenant and captain with both departments prior to becoming an assistant chief in May 2004. As an EMT-B, he is in charge of the department’s EMS operations, in addition to EMS and fire training and various other administrative duties.

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