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Roadway Extrication. Introduction. 40 hour course minimum attendance is 90% end of course exam 80% or better practical examination-must pass all evolutions State Certification Practical passed at 100% State written exam at 70% Firefighter 2 certified. General Safety Principles .
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Introduction • 40 hour course • minimum attendance is 90% • end of course exam 80% or better • practical examination-must pass all evolutions • State Certification • Practical passed at 100% • State written exam at 70% • Firefighter 2 certified Roadway Extrication
General Safety Principles • Must protect the patient and rescuers during the extrication process • Three factors that contribute to overall safety of an accident scene • The environment • The incident itself • The vehicle itself Roadway Extrication
Personal Safety • Protection of the Rescuers • This is our number one priority • Full protective clothing with eye and ear protection • Proper lifting and working techniques • Proper evaluation of scene hazards Roadway Extrication
Patient Safety (victim) • Protect patients physical and mentally • Physical protection • Cover patient with blanket • Protect with backboard or barrier • Utilize eye and ear protection equipment? • Mental protection • Early communication between rescuer and victim • Protect from unpleasant visual sights • Protection of personal property Roadway Extrication
Scene Safety • Eliminate, Control, or Neutralize Hazards • DO NOT TRADE LIVES FOR LIVES • Scene Safety Priorities • 1st Priority -- Rescuers • 2nd Priority -- bystanders, Good Samaritans • 3rd Priority -- victims • Use apparatus as scene barrier-100ft away Roadway Extrication
Scene Safety • Hazardous Materials incidents-minimum of 2000’ uphill and upwind of incident • Night operations require special considerations • Do not use headlights • More scene lighting makes operations more effective • Vehicle stabilization is paramount Roadway Extrication
Scene Safety • Plastic fuel tanks in use • failure within 30 seconds of fire • Handlines and extinguishers are a must • 2 pole rule for downed power lines • Use action circle and safety zones Roadway Extrication
Anatomy of a Vehicle • 1973 was start of vehicle construction changes • Iron and steel to plastic and aluminum frames • Bolted to spot welded and glued • Three types of frames • Full frame • Uni-Body-integrity depends upon roof, posts • Space Frame-cage like construction Roadway Extrication
Anatomy of a Vehicle • Posts • A Post; divides engine compartment from passenger compartment, extends to roof • B Post; divides passenger compartment in half or is rear post in 2-door vehicles • C Post; divides passenger compartment from trunk in 4-door vehicles Roadway Extrication
Anatomy of a Vehicle • Wheels • Steel, aluminum, plastic, composite, alloy • Catalytic Converters • 1300 to 2000 degrees • airbags damage at 200 and will melt at 330 • Potential ignition source • Drive Shafts • hollow and will explode as projectile Roadway Extrication
Hazards of Vehicles • Catalytic Converters • Alternative Fuels • CNG • LPG • Fuel Emission Control system • Vapor holding canister • Fuel Tank • 10-25 gallons, located between frame rails Roadway Extrication
Hazards of Vehicles • Bumpers • Spring loaded bumper (5 mph impact in 1970s) • Piston fluid filled (2 1/2 mph impact) most popular in use today • Egg crate • newest concept, 2 1/2 mph impact • Assume all are loaded and ready to rebound • Chain or drill 1/4” hole in narrow piston • Bumper strike zone up to 300’ Roadway Extrication
Hazards of Vehicles • Batteries • Most common hazard at scene • Key component in electrical system • Cut NEGATIVE cable in 2 places first • make sure power is not needed first; seats or windows • assure key off or fuel pump in EFI may keep running Roadway Extrication
Hazards of Vehicles • Steering Columns • Old ones were solid one piece rods • New ones have hollow joints with up to 4 knuckles for various adjustments • Wrap wheel low if you must pull • Cut spokes of wheel to allow more room Roadway Extrication
Supplemental Restraint Systems • Minimum of 3 sensors in place on vehicle • 2 must activate before system can deploy • Needs about 12 mph impact • Identification of unactivated system is key to rescuer safety • Look at steering wheel and dashboard • Assume at least 1 in place after 1990 • Maybe in headliner, seat and doors in new cars Roadway Extrication
Supplemental Restraint Systems • Uses 12 volt charge to ignite SODIUM AZIDE canister which burns producing nitrogen gas to inflate bags rapidly • Alkaline substance which may cause minor irritation • Mostly non-toxic • Caution on FORD, Potassium Nitrate used • Key is to disable electrical system immediately • SRS can stay active up to 30 minutes Roadway Extrication
Windows • Front windshield is laminated glass • 2 pieces of safety glass bonded to plastic material between • Made to resist shattering on highway • Side and rear are tempered glass • Shatter to pieces the size of fingernail • Reduce the severe lacerations? • Rescuer should control breakage of glass Roadway Extrication
Vehicle Rescue Life CycleStage 1 - Readiness • Readiness of Personnel • Training and experience • tools, equipment and SOG’s • Readiness of Equipment and Apparatus • Maintained and functioning • Back-ups of primary systems Roadway Extrication
Vehicle Rescue Life CycleStage 2 - Accident Stage • No control over this step • Golden Hour begins • 60 minutes to reach appropriate health care facility • Into surgery if indicated Roadway Extrication
Vehicle Rescue Life CycleStage 3 - Notification Stage • Starts when accident is reported • Response SOG’s • Information recieved about accident • Size-up enroute • conditions • traffic patterns • Dispatch tones and additional information Roadway Extrication
Vehicle Rescue Life CycleStage 4 - Response Stage • Vehicle responds in safe manner • Obey traffic law • Use of visual and audio devices • Position of apparatus Roadway Extrication
Vehicle Rescue Life CycleStage 5 - Arrival • Staging should be 100’ from incident • Assessment of immediate threat • Rescuer caution exiting and operating around scene • May be most hazardous time for rescuer safety Roadway Extrication
Vehicle Rescue Life CycleStage 6 - Size-Up • Begin to gather information • 360 degree view of scene • Assessment of known hazards • Wires • Fuel • HazMat • Prediction of possible hazards • Assessment of capabilities Roadway Extrication
Vehicle Rescue Life CycleStage 7 - Incident Command • Essential to success of operations • Establish Command • Stay out of work and run the show • Stay in outer action circle Roadway Extrication
Vehicle Rescue Life CycleStage 8 - Scene Safety, Stabilization and Support • Action circle - 10’ around car • Only those doing ems or rescue • Outer circle - 10’ - 15’ outside • Tool and equipment staging on tarps • ICS • Identify and control the hazards Roadway Extrication
Vehicle Rescue Life CycleStage 9 - Patient Access • Pathway to get to patient • Door • Window • Qualified EMS provider inside to assess the patient and the effects of the rescue process • Begin care inside, calm, reassure and talk to patient • Communicate needs Roadway Extrication
Vehicle Rescue Life CycleStage 10 - Treatment • Triage • Colors and priorities • Call for additional help • Begin treatment according to policy Roadway Extrication
Vehicle Rescue Life CycleStage 11 - Disentanglement • The actual removal of the car from the patient • goal is not to cause additional harm and injury • protect patient throughout • stop actions that are causing harm • evaluate progress often Roadway Extrication
Vehicle Rescue Life CycleStage 12 - Extrication • Remove the patient from the vehicle • Proper splinting and immobilizations • Exercise rescuer safety • back injury frequency high here Roadway Extrication
Vehicle Rescue Life CycleStage 13 - Transportation • Appropriate level of care • Trauma center • Regional hospital • Medivac Roadway Extrication
Vehicle Rescue Life CycleStage 14 - Termination • Wrap-up of equipment • clean and service • secure scene with police • Completion of documentation • Review incident with participants • learn from every experience • learn from doing Roadway Extrication