1. Vehicle Extrication and Rescue Operations
Unit 52
Vehicle Extrication
and Rescue Operations

2. Overview Phases of the rescue Vehicle extrication Water rescue
Search and rescue

3. Introduction
Many common hazards and rescue situations are seen in every day
Every community should have a for how to respond to these types of emergencies
Training and preparation required before EMT attempts rescue

4. Phases of the Rescue
Rescue typically takes place in environment or situation
Requires special knowledge and/or equipment to access, , and rescue patient
Establishing command: first-arriving emergency services unit should establish scene

5. Scene Size-Up Perform assessment Request additional resources
Ensure everyone is personal protective equipment
Perform triage

6. Confined Space Rescue Confined spaces are hazardous to workers
Rescue is dangerous
EMT must never enter space without training and equipment
Figure 52.2 Entry into a confined
space is limited to specially trained
rescue personnel

7. Management
Technical rescues: complex operations requiring highly trained rescue technicians using specialized equipment
Access: must patient; may require specialized rescuer
Residence: elderly “trapped” within home
Rescue: immediately perform lifesaving procedures once patient accessed

8. Treatment Severity of injury dependent
The longer patient goes untreated, the greater the degree of injury
Assume patient’s injuries more than usual based on amount of time required to access patient
Transport: to definitive medical care as soon as possible

9. Vehicle Extrication
Some patients entrapped in vehicle require use of rescue equipment
Preparation
Preplanning between rescuers can eliminate wasted time and confusion at emergency scene
Combined training and preplanning are keys to successful rescue operation and improved patient outcome

10. Command As first EMT approaches scene, medical command
Immediate concern is safety
Perimeters
Inner circle: area of danger for EMT
Outer circle: equipment and personnel

11. Scene Size-Up Motor vehicle can create hazards
EMT should perform “walk around” and check for spilled fluids
Keep safe from undeployed airbags
Look above and below motor vehicle for contacts with electric power lines or transformers

12. Hybrid Vehicles
Following crash, hybrid car can remain charged with 300 to 500 volts of electricity, posing a to EMTs
Battery must be before continuing with rescue operation and extrication of patient

13. Stabilization
Movement of damaged vehicle can cause patient to also be moved, creating injury
Car must be stabilized before patient care can
Blocks of wood (cribbing) can be used to lift vehicle’s frame off wheels and stabilize vehicle

14. Access First, try doors Windshield has safety glass
Not ideal for access
Other windows have glass
Shatters to allow access
Window punch
Glass-breaking tool
After access, make sure engine is off

15. Prioritization Patients in condition needs rapid extrication
May require Jaws of Life
Heavy rescue: tools used to open door, remove roof, remove , or peel away dash board
Patient safety: EMT should stay in vehicle with patient and provide shielding (e.g., wool blanket) from glass and debris

16. Figure The glass from the windshield can be cut away and peeled back to gain access to the patient
Figure The patient should be protected from flying shards of glass by using a heavy oil tarp or the like

17. Assessment
Following extrication, EMT should complete assessment and rapid secondary assessment
Look for signs of internal injury (bruising, point tenderness) and external injuries (burns, lacerations)
Transportation: typically to a center as soon as practical

18. Water Rescue Quick rescue can prevent
Establishing command: EMT must work together with other emergency services
Scene size-up: determine “flat water” (no current) or “swift water” (current)
Management: locate and attempt shore-based rescue, if possible
Access: determine where person last seen

19. Shore-Based Rescue— Flat Water
“Reach, throw, row, and go”
Offer and pull victim to shore
Throw bag (rope coiled inside cloth sack) can be thrown to victim
Personal device (PFD) may also be thrown out to victim
As last resort, specially trained EMTs can enter water

20. Shore-Based Rescue— Swift Water
Swift water rescue is , resulting in drowning of many rescuers
Upstream team: at river crossing
Downstream team: strings two or more ropes diagonally across water
Two shore-based teams: search shoreline for
Rescue attempted with throw bag/pole

21. Treatment and Transport
Even if victim appears drowned, they may recover if aggressive treatment started
Hypothermia from submersion in cold water may prolong window for recovery
Every effort should be made to near-drowning victim
Ambulance may be waiting in staging

22. Search and Rescue
Areas for search and rescue (SAR): woods, mall, building, cities
Person must be found (search) and carried out (rescue)
The longer person is , the greater the likelihood of injury
Search and rescue teams: identify high life hazards and plan rescue operations

23. Search and Rescue (cont’d.)
Establishing command: prepare for long-term post
Scene size-up: question witnesses, obtain detailed info about victim
Access: direct rescue personnel to staging area and assign teams
Hasty search: quick search along trails, roadways, and shorelines to look for clues

24. Figure 52.16 An EMT in a hasty search should look for clues

25. Search and Rescue (cont’d.)
Rescue: in , patient normally carried out by rescuers
Management: medical evaluation usually required
Transportation: consider patient’s condition and advantage of airlift versus ground transportation

26. Conclusion
Unique conditions of rescue require EMT to be creative and adjust plan of action to situation
Reckless disregard of obvious dangers can change role of EMT from that of rescuer to that of patient
EMT should participate only when there is adequate training to proceed safely