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Vehicle extrication is the process of removing a person from a vehicle that has been involved in a motor vehicle accident when conventional means of exit are impossible or unadvisable. This is typically accomplished by utilizing hydraulic tools, including the Jaws of Life.
Operations
The basic extrication process consists of five steps:
- the protection of the zone, to avoid a risk of collision (marking out the zone, lighting) and of fire (switching off the ignition, disconnecting the battery, absorbing powder on oil and gasoline pools, fire extinguisher and fire hose ready to use) ;
- the stabilisation of the vehicle, to avoid the movements of the vehicle itself (e.g. falling in a ditch), and the movements of the suspension (risk of worsening of an unstable trauma) ;
- the opening of the vehicle and the deformation of the structure (such as removing a window) to allow the intervention of a first responder, of a paramedic or of a physician inside the vehicle and also to release a possible pressure on the casualty;
- removal of the section of the cabin (usually removal of the roof or door) to allow an extrication in good conditions, especially respecting the head-neck-back axis (rectitude of the spine).
- removal of the patient from the vehicle
In less complicated cases, it is possible to extricate the casualty from the side door such as removing a patient from another part othe vehicle without actually "cutting" the car.
As soon as possible, best before beginning the mechanical operation, a rescuer enters the cabin to perform the first aid to the casualty: assessment, stopping the bleeding, putting a cervical collar (these operation are likely to provoke vibrations), providing oxygen first aid. In France, this rescuer is called the "squirrel" (écureuil). In most all rescue environments, whether it is an EMS Department or Fire Department that runs the rescue, the actual rescuers are Medical First Responders, Emergency Medical Technicians, or Paramedics, as a motor vehicle accident has a patient involved.
The deformation of the structure and the section of the roof take several minutes; this de-extrication time can be used for medical or paramedical acts such as intubation or placing an intravenous drip. When the casualty is in cardiac arrest, cardiopulmonary resuscitation can be performed during the freeing, the casualty being seated. The use of this incompressible duration is sometimes called play and run, as a compromise between scoop and run (fast evacuation to a trauma center) and stay and play (maximum medical care onsite).
The last step is usually performed with a long spine board: the casualty is pulled up on it. An extrication splint (KED) can help immobilising the spine during this operation.
Additional risks with new technologies
Active systems such as airbags make the operations more complicated: when they did not explode (e.g. shock from the rear or vehicle on the roof), the activation can occur any time during the operation, and cause additional trauma to the victim or to the rescuers. This is one of the reasons rescuers disconnect the battery and wait the correct airbag deactivation times before cutting the vehicle. These deactivation times can take anywhere from 5 seconds to 20 minutes to deactivate, even after the power source has been disabled.
New hybrid technologies also include additional high voltage batteries, or batteries located in unusual places. These can expose occupants and rescuers to shock, acid or fire hazards if not dealt with correctly. Some references to the actual nature of the Hazards : Honda Toyota Ford News Summary More.
Some vehicles have an additional LPG tank; as the system was not built in, there is a risk of damaging the pipe which is often under the car, releasing the pressured fuel.
See also
External links
- Vehicle extraction technics (PDF file, 70p, 4.9 Mb)
- Hydraulic Tool Manufacturers
"Vehicle extrication"