“Man Under”: Handling Victims Trapped Under Vehicles

the rescue company By Mark D. Gregory

Responses to victims trapped under vehicles occur frequently across the United States. As first responders, we must be prepared to handle these situations by thinking outside the box for a multitude of ways in which to disentangle victims. This article will help you mentally prepare to handle these responses and will offer methods that have proven effective at previous incidents.

(1) Photos by author.

(1) Photos by author.

Mental Attitude Is Everything

Throughout my years of instructing, I have asked students how they would handle “man under” situations. Their standard response is usually to deploy air bags. Although air bags are a good option, they have drawbacks. It takes time to put the air bag system together and space to set up the system, which can result in unnecessary delays in victim removal.

This is the time to drill as if it is the real thing. How often do you do that? The key to success is a step-by-step approach. Have members perform all required skills before starting an evolution, including scene size-up, lockout/tag-out, and stabilization. For example, when using step chocks to secure a vehicle, many members lift the vehicle to place the step chock into operation (photo 1). Although this may be a common tactic at an auto extrication, it may result in additional injuries to a victim pinned under that vehicle. Placing the step chocks on a ground pad (photo 2) or wedge of equal width will be a safer option to gain the height and stability required.

Photo 2: “Man Under”: Handling Victims 
Trapped Under Vehicles

Using the step chock on its side with a wedge on top is another option. I have found using the step chock inverted is quite successful (photo 3). Although the placement of this chock is quick and doesn’t involve moving the vehicle, some consider it an issue that it does not maximize surface contact. Remember, when performing this type of cribbing, be sure to maintain solid contact points.

Photo 3:  “Man Under”: Handling Victims 
Trapped Under Vehicles

Have you trained on what to do if the controller to the air bags is deemed out of service while being put into operation? Would you start from scratch with a new plan? Can you adapt and overcome using the system you already have set up by employing tricks of the trade? The “what if” approach to drilling will allow rescuers to have a plan and a backup so they can handle any difficulty that may arise.

On-Scene Size-Up

As you arrive on scene, you must advise incoming units of what you are dealing with. These reinforcements will not be under the stress of the first-due companies and may have the response travel time to contemplate additional extrication options in case the victim is not out on their arrival.

Photo 4: “Man Under”: Handling Victims 
Trapped Under Vehicles

Walk around the vehicle and get a full size-up. Have a member ensure that the vehicle is not only off but out of gear, with the emergency brake applied. Locate cribbing points to secure the vehicle. Remember that every action will have a reaction. If you lift one side of the car, consider that you need to capture the suspension on the other side (photo 4) to prevent further victim injury or entrapment.

Photo 5: “Man Under”: Handling Victims 
Trapped Under Vehicles

Extrication Methods

There are various methods you can use to remove a victim from under a vehicle. Air bags are quite popular for this type of operation. When using air bags, put them on a cribbing base that allows them to be as close to the lift as possible. Use two bags for maximum efficiency and safety. Remember, for every inch you lift, crib an inch.

Drill with your team on the basic concepts of air bags. When an air bag is rated at 10 tons and has a maximum lift capacity of six inches, what does that truly mean? An air bag will lift a 10-ton load one inch. At its maximum height of six inches, the bag is only rated at half of its weight capacity (five tons). In other words, the higher you go, the less you can lift and the more unstable the lift will be. Cribbing as close to the load as possible and then lifting will provide a much more solid and effective lifting operation.

Photo 6: “Man Under”: Handling Victims 
Trapped Under Vehicles

Rescue teams are carrying the mechanic’s floor jack more often. The floor jack is used thousands of times a day to lift vehicles. These jacks are easy and quick to deploy (photo 5). They do not require much staffing to set up and are designed to handle the common weight of a vehicle. Specialty jacks designed for rescue use are an excellent complement to our rescue cache (photo 6).

The bottle jack is an often-underused tool. It should be labeled with the overall tonnage of the jack, the closed height, and the fully extended height to inform rescuers of its abilities. You can use a paint marker to make your bottle jack “firefighter friendly” (photo 7).

The hydraulic spreader is a quick and an effective means of lifting a vehicle. Use a base pad anytime you use the spreader to lift (photo 8). The wooden base plate will provide a solid foundation for the spreader operation on any type of surface. As the spreader crushes into the wooden base plate, the surface area is expanded, which allows for a more secure lift. Remember, when using the spreader, do not overextend the tool. Only lift what is required to disentangle the victim, and crib as you go to support the lift.

Truck companies and rescues carry many extrication tools. But what tools does the engine company have? Many times, the engine company is first on scene because of its responses to EMS calls. Time is of the essence when a victim is trapped. Many firefighters use the ground ladder and high-rise packs or wheel chocks (photos 9 and 10) to successfully lift a vehicle.

Photo 7: “Man Under”: Handling Victims 
Trapped Under Vehicles

When performing the “ladder lift,” the high-rise packs or wheel chocks act as the fulcrum point while the ladder is the lever. Although you can use a straight ladder to lift a vehicle, I recommend an extension ladder for its strength. Do not use fiberglass ladders to execute this evolution. When lifting a vehicle, place the fulcrum point as close to the vehicle as possible to gain the maximum lift. Use step chocks/cribbing to capture your progress. Halligan tools supported by a 4 × 4 (photo 11) have also been effective in providing a stable fulcrum point.

Photo 8: “Man Under”: Handling Victims 
Trapped Under Vehicles

When I am teaching, a student will often say, “But the ground ladder was not designed to operate in this manner!” As students of the trade, we adapt tactics when a lifesaving situation is required and resources are limited. Have you ever used a hoseline to retrieve a down firefighter from a hole in the floor or set up a ground ladder to act as a high-point for your 2:1 rapid intervention evolution? If you have, then you have crossed the line to the “dark side.”

Photo 9: “Man Under”: Handling Victims 
Trapped Under Vehicles

Fire hose does not have a man-lift rating, nor is a ground ladder specifically designed to act as the anchor or high point to remove a firefighter from an upper floor. These are street-smart fire and rescue tactics that have been proven effective across the nation. Firefighters must know the pros and cons of any piece of equipment they use for lifesaving purposes that may be outside of its intended use. If you use any piece of equipment for a lifesaving evolution that you feel may have been compromised, perform proper inspection and testing of the equipment before placing it back in service to ensure structural integrity.

Photo 10: “Man Under”: Handling Victims 
Trapped Under Vehicles

As firefighters, we are called on to handle a multitude of incidents where the public may be entrapped in a life-threatening predicament. The need to drill on these incidents is critical. It is not a matter of “if” these incidents will occur in your district but “when” they will occur. Are you and your crew ready for the challenge?

Photo 11: “Man Under”: Handling Victims 
Trapped Under Vehicles

Mark D. Gregory has more than 30 years of firefighting experience and is a captain in the Fire Department of New York (FDNY) assigned to Division 15 in Brooklyn. Previously, he served as a captain in Ladder 142 and Division 13, a lieutenant in Tower Ladder 111, and a firefighter in Brooklyn’s Rescue 2 and Ladder 132. He instructs for the FDNY Academy in the Annual Education Day and Flashover Training programs. He also instructs at the Suffolk County (NY) Fire Academy and is the lead instructor for FDIC International’s H.O.T. evolution “Man vs. Machinery,” taught by P.L. Vulcan Fire Training Concepts LLC.

Mark D. Gregory will present “Man vs. Machinery: Are You Prepared?” at FDIC International in Indianapolis on Wednesday, April 25, 10:30 a.m.-12:15 p.m.

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