Training for vehicle extrication incidents, similar to any emergency services discipline, should begin very structured and slow paced with the intent to develop basic skills and set a minimum standard for more advanced, scenario driven sessions. Many times departments ask two specific questions regarding the ability to conduct this basic training.
- How do we maximize the potential of one vehicle? Departments may be faced with limited budgets or resources. To complete extrication training, some departments have to pay for vehicles, while others may have to pay towing costs. In certain parts of the country, especially as the price of scrap increases, departments may only have access to one or two vehicles per year.
- How do we maximize the exposure of new firefighters to as many tactics and situations as possible with one vehicle? Randomly completing disentanglement tactics or allowing the training session to be a “free for all” will surely result in some parts of the vehicle not being utilized or students not able to complete tactics with variations.
To address these concerns, we developed a process to both maximize the potential of the vehicle and the exposure of the student. This process is presented from the context of a wheel resting vehicle; however, it can also be applied to a roof resting and side resting vehicle with slight variations. For roof resting vehicles, floorboard tactics and strut lifts with roof removals can be incorporated. For side resting vehicles, floorboard tactics and controlled rolls for low side tactics can be incorporated. It should be noted this process covers specific disentanglement tactics. It is the responsibility of the instructor to emphasize the steps of the extrication process, vehicle construction, stabilization options, patient contact and treatment, interior rescuer interaction, tool usage and positioning, etc. If the vehicle has been damaged or you choose to create some damage, clearance tactics should be addressed. Determine the tools and tactics needed to create a reasonable amount of space between the vehicle components and the patient. This will lessen the mental and physical stress, as well as provide more space to administer care.
The process begins by addressing the driver’s side of the vehicle because there is more likelihood a driver will be entrapped than a passenger and there are more secondary components that can be manipulated. Instead of removing all the glass at this point it is more realistic to address which glass should be managed applicable to a driver’s side removal. The driver’s side should then be removed based on tactics preferred by the department and the structure of the vehicle. With multiple vehicles a variation of these tactics can be completed. They include removing all doors then the Bravo Post, a side out, the front door then the Bravo Post and rear door, third door side out, front door then third door, etc. Next the driver’s side dash should be displaced by using a ram or spreader. With the side of the vehicle removed and dash displaced, emphasis can be placed on interior tactics on that side including front seat tactics, steering rim and column tactics, and pedal tactics.
Next the applicable glass should be managed and students guided through the tunneling process from the rear. By addressing this tactic next, the roof structure is still intact which would be a major consideration to why tunneling should be completed in the first place. Second it allows students to clearly see what is happening inside the vehicle from the driver’s side which has been exposed, but also the confined work area still presented by the intact passenger side. Students not participating completing the tunnel evolution should not be allowed to assist from the open driver’s side. Once access has been made to the patient compartment area, students can complete front seat tactics on the passenger front seat and a middle dash displacement.
Here the students have completed a tunnel evolution, but still have the front passenger seat and dash displacement to finish.
Now it’s time to move to the roof. After managing what’s left of the glass, a partial roof removal and roof flap can be completed before a complete roof removal. Next the passenger doors and Bravo Post can be removed, preferably in a manner other than that used on the driver’s side. Lastly, the passenger side dash can be displaced with whichever tool was not used on the driver’s side. An advantage of removing the passenger side after the roof is the variance in tactics and difficulty by not having a roof line to assist versus the driver’s side.
As essential as basic skills development is, organizations should subject responders to complex, real world challenges that require them to develop and demonstrate potential solutions. These scenarios should start relatively simple, but progressively get more difficult and detailed as responders show signs of comprehension and demonstration of necessary skills. The training should be aimed at using the power of problem solving to engage responders and enhance their learning and motivation. An instructor’s role is to primarily guide and coach the team through the learning and assessment process. Unless there is a safety issue, the instructor should allow responders to work through problems, in some instances not succeeding provides many valuable lessons. Establishing an open climate is essential and every student should feel free to express any ideas or comments without being criticized. When encountering a real incident with a unique set of challenges responders have the confidence to make educated decisions based on experience that was reinforced during training. A special thanks to Bossier City Fire Rescue.