Vehicle Extrication: Side Lifts

You arrive on scene to find a passenger vehicle on its side with victims trapped partially under the vehicle. In my opinion, this is one of the most precarious lifting sequences we perform and it can have dire consequences for the victims if we approach it the wrong way. I say this because I have done it the wrong way. Early in my career, I had two calls within a few months of one another that involved this scenario. I attacked both of them with the wrong approach and neither event went the way I would have hoped. Both vehicles were sedans and came to rest on the driver’s side. I will lay out each event and then discuss the valuable lessons I learned and how I applied those lessons moving forward. image

Scenario One

A young male driver flipped his car onto its side in the middle of a two-lane road. His arm had extended out of the driver’s side window and his lower arm had been separated. His upper arm was pinned under the door. In order to free him, we determined that the vehicle had to be lifted to get the door off of his arm and the roof removed to properly manage his extrication.

Wrong Solution: We placed an airbag under the B post on the driver’s side with two struts on the roof side to the A and C post high side and one strut to the undercarriage in the middle of the vehicle. As the airbag performed the lift, we continuously struggled to prevent increasing pressure from being applied to his arm. This was occurring because the lifting point of the upper B post creates a rolling motion of the vehicle more than a vertical lifting motion.

Scenario Two

An elderly female driver lost control of her vehicle and veered off of the road over a guard rail. She flipped her vehicle onto the driver’s side and was in a wooded area headed down into a ravine. She was partially ejected from the vehicle as she was unrestrained and her upper torso were hanging out of the driver’s side window. The vehicle was leaning towards the roof side and the roof was pinning her neck and head and lower arm to the ground.

Wrong Solution: Having just completed the previous scenario, I didn’t want to make the same mistake, so we set up a single point lifting column with stacked airbags under the driver’s side rear bumper. We placed two struts at the rear of the vehicle with one on the undercarriage and one on the C post. We also had to secure the vehicle with a chain hoist back to the guard rail because it had the potential to slide down further into the ravine with the front of the vehicle facing down the terrain slope. This produced a very vertical lift at the rear of the vehicle but was very time consuming and resulted in a lot of “over rescuing.”

Lessons Learned and Right Solutions:

1. Identify what is actually pinned and choose the proper lifting point.

  1. In scenario one, the victim appendage was pinned under the door. When the area of pinning is under the side wall of the vehicle, the vertical lifting approach is optimal because we get a clean upward movement of the load with very little shifting or rolling. This obviously requires proper strut management and tensioning between struts as well as proper orientation and rigging to the vehicle. Details regarding strut applications will be reserved for a future article. The lifting point of the rear of the vehicle is the most efficient because it is typically the lightest part of the vehicle and allows the heavier front end of the vehicle to remain pinned to the ground as a pivot point.
  2. In scenario two, the victim is pinned under the roof line. This naturally sets up a very fast and efficient rolling lift where simply relocating or rolling the roof line will free up the victim. The lifting point in this scenario should be the upper B post and or roof line. This approach can also be performed by pulling the upper portion of the vehicle back towards the undercarriage. This would use ratchets or hoists anchored between the vehicle and an appropriate anchor on the undercarriage side of the vehicle. In both options, proper struts and tensioning elements need to be in position and managed.

2. Identify the victim’s severity of injury and choose the proper lifting tool.

  1. Evaluate the window of time quickly that is required to provide the best chance for survival. If speed is of the essence, the tool of choice may be a hydraulic spreader with cribbing capture and a singular strut as a point of opposing safety. In scenario one, the spreader can be placed between the ground and the rear bumper and initiate the lift while the airbags are being put into service. The spreader may complete the lifting sequence but if they don’t develop the amount of space required and generate too much crush, they have still created some space for both the victim and the insertion point for the airbags and can be quickly changed out to airbags when needed.
  2. In scenario two, the victim was actually in worse shape than the victim with no arm. A tourniquet was quickly applied to victim one and the bleeding was controlled but the victim in scenario two had lost consciousness and had agonal respirations because the roof line was crushing her carotid artery. Again, the spreader could have been quickly placed under the B post and effectively lifted the roof line off of the victim with cribbing capture and single strut set on the undercarriage.
  3. Lifting struts can also help transition from stabilization to lifting quickly without having to add another piece of equipment to the equation. You would have to preplan this quickly as it will affect the placement angle and tension rigging of your struts. Also, be cautious about the anchor points or lifting points you choose for the struts. You will need a more structural or reliable lifting point of the struts generating the lift or you may have to basket the vehicle with chain.

I have used this simple assessment for all of the sideways vehicle I have encountered in my career since my early botched approaches. It has proved to be very reliable. Remember that speed techniques often require less redundancies to be built which ultimately translates to less margin for error and more risk. I always choose the speed route cautiously. If I can create a little bit of space to improve the condition of the victim and buy time, and then implement more equipment and technique to improve safety and redundancy, I will always do so. Only the truly dire situations should call for the minimalist approach rescues. We have several videos on our Rescue Methods YouTube channels that review these lifting techniques. Stay safe and train hard.

Dalan Zartman is a 20-year career veteran of the fire service currently assigned to a Heavy Rescue. He is a certified rescue specialist, fire and rescue instructor, public safety diver, and paramedic. As president and founder of Rescue Methods llc, he and his team of instructors have delivered technical rescue courses around the world. Zartman and team Rescue Methods are also active competitors in global rescue competitions and are passionately focused on serving emergency services, military, FEMA teams, NATO teams, and Industrial organizations. He is also a team leader for a nationally deployed type 1 dive and swift water response team and oversees global alternative energy fire testing programs. He has served on NFPA committees and is closely connected to Bowling Green State University as an adjunct faculty member and advisory board member.

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