1.  Ensure the scene is setup for a safe successful outcome  Request the necessary resources  Access and extricate the injured  Transport all patients to the hospital in 1 hour  Demobilize resources I/C - Manage the scene, the work and the clock 1

2. Vehicle extrication incidents are high risk. When working at these incidents our goal is to keep responders safe and get the patient(s) to the hospital within the “golden hour”. 2

3. Night operations are more hazardous!  Drivers are not as alert  Responders are harder to see  Hazards may not be as visible  Work is harder to get accomplished Light the scene and use high visibility traffic warning devices (flares and pucks) 3

4. What are the weather conditions?  Drivers may have reduced visibility  Vehicles are moving too fast for the conditions  Stopping distances increase  Work is harder to get accomplished 4

5.  Traffic control zone  Inner and outer circle  IC 360  Command and control 5

6.  Setup starts with the first arriving unit (PPE)  Get traffic slowed  Get your blockers in place  Ensure there is an adequate buffer between the work area and moving traffic  Ensure the termination area returns traffic to normal operation 6

7. 7 Lane 2 Lane 3 Lane 4 Lane 1

8. 4H-8 Advance Warning Area Transition Area Activity Area Termination Area Buffer Space Incident Space

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12.  Consider adding units for safety  Block the most dangerous first  Use a second upstream blocker if needed  Make sure that adequate resources remain on scene so you can clear units safely  Don’t leave personnel exposed  Slow traffic down!! The most dangerous period is early and late! 12

13.  Do a size-up  Initiate or assume command  Name and locate it  Determine resource needs  Start your timer  MCI considerations 13

14.  Typically done by the first arriving officer  Big Picture survey  Identify hazards – wires, unstable obstacles, etc.… (were patients thrown from the vehicles?)  Ensure a safe work area is being established 14

15.  Survey the crash site (ground zero)  Leaking fluids  Smoke or fire  Number of patients  Is the engine running  Patient contact  Mechanism 15

16.  Scope of the problem  Mechanism  Resources  Number of patients 16

17.  Conduct a windshield IRR (if first arriving)  Request your timer (this is a 15 minute timer)  Setup your command structure  Remember TLO  Give a more detailed follow up report  Provide periodic updates – location of the transportation corridor, patients extricated, all reds transported, all patients transported…  Terminate 17

18.  Triage – total patients and colors  Make assignments (access the most severely injured first)  Divide the incident up as needed:  Groups and or divisions Company officers have the responsibility of creating the disentanglement plan but you need to know what it is and buy off on it. STAY AHEAD OF THE WORK. 18

19.  Rapid transport  First arriving company should identify an MCI and secure transportation corridor (mechanism of injury could drive this)  Scale Patient tracking with the size and complexity of the incident  Updates are required every 15 minutes  Tactical benchmarks – All patients extricated (extracted), all reds transported, all patients transported 19

20.  Position your treatment area adjacent to the transportation corridor  Assign the first arriving medic to establish a treatment area (MGS) and transition those responsibilities to the first arriving MSO - (TLO) 20

21.  Ensure safety control zones are in place  Identify MCI early and call for resources  Divide the incident as needed  Stay ahead of the work  Get the patients to the hospital within the golden hour 21