Seeing into the future is very important when performing extrications on vehicles and machinery. What do I mean by seeing into the future while performing extrication? When performing extrication we should always be looking at the step we are about to perform and how that will affect the vehicle/machinery.
In my early days, and even cases now, sometimes I catch myself cutting at a piece of a vehicle and not considering how that is going to impact the overall goals and objective of the effort. At times this does not have much effect. And in other times it can prove to have disastrous results.
So why does seeing into the future during extrication matter.
During extrication safety is a big issue. We must ensure proper personal protective equipment. We also must ensure that where and what we are cutting does not immediately injure the patient. We have heard those many times.
Sometimes you can foresee that an action you are about to perform could be more dangerous than it is worth.
By disregarding looking into your actions further you could reduce stability of the vehicle, further intrude the car into the patient, or cause items to fall or further injure the patient or other responders.
When doing extrication it should be realized that it is generally includes steps to reach a goal. Generally there is multiple steps required which could includes cribbing the vehicle, removing glass, and cutting/spreading in separate parts of the car.
By looking into the future we can be more efficient in removing entrapped/pinned patients.
In one incident I was involved in we had a vehicle that was impacted in the passenger’s side door with some damage to the driver’s side door as well. The driver was removed rather easily as the driver’s side door’s damage was minor. However, the damage to the passenger’s side door was heavy.
Instead of immediately starting to cut and spreading to get the patient out. We let EMS quickly assess the patient. While this was happening a fellow firefighter, who was involved with the extrication, and I did a 360 degree walk around the vehicle for the second time. We quickly discussed our options and how they would change the car and our future steps. We decided to pry the front and rear passengers doors away from the A and C posts. This left the doors hanging by only the B post. We then cut the B post and were able to “roll” the door unit down and remove thus giving EMS a big amount of access to the patient.
These steps were not what we initially planned on doing. We had initially planned on just popping the front passenger’s door. Upon further review we realized that this would only complicate things due to the way that the door was damaged.
This extra minimal time allowed us to ensure we were as most efficient as possible under the circumstances.
Due to better efficiency, we would likely be using our tools less. When we use our tools less they are less likely to break and wear. This is not to say that they will not break or wear otherwise due to the situations they have to work in and the stress put on them. Thus the less that they are in this stressful environment the less likely it is that they will break and wear.
Extrication of patients from vehicles and machinery is a very specialized and technical aspect of rescue services. It is a very intense situation for fire and rescue personnel to be part of. Not every effort will result in easy success. So continue to train, pre-plan, and learn from experiences.
Keep up the good work. Be safe!