Purpose: To establish general extrication preparations and guidelines to be executed during emergency situations requiring extrication of personnel involved in automobile accident.
Scope: These guidelines have been developed to provide Three Star Fire Department personnel with an operational procedure to extricate victims from vehicles and to minimize the risk to rescue personnel working at the scene of an emergency. These guidelines do not address the medical treatment of patients nor does it address specifics extrication techniques to be executed. All personnel using hydraulic extrication tools will have attended and been certified in State of Tennessee Basic Vehicle Extrication course and shall execute appropriate techniques for the situation at hand. The extent to which emergency medical treatment is given will be limited to the individual personal protective equipment and medical training of department members.
Upon arriving at the scene of a vehicle accident with an entrapment, the Officer shall determine the best placement for the responding vehicles to ensure the protection and safety of all personnel operating on the scene. The first arriving Officer shall size up the situation and establish command. The Officer/IC should evaluate the following criteria:
A. The number of vehicles involved;
B. Number of persons injured or entrapped;
C. Type of vehicles involved such as car, truck or Hybrid vehicle;
D. Actual fire present;
E. Leaking fuel causing a potential fire or explosion hazard;
F. Stability of vehicles involved;
G. Presence of vehicle safety systems such as air bags and whether they have
H. Involvement of electrical power lines or other electrocution hazards;
I. Involvement of any actual or suspected hazardous materials.
Emergency Medical Treatment
If medical assistance is not present at the time of the Fire Department's arrival, medical assistance shall be requested and/or confirmed. The rendering of emergency first aid shall be limited to the situation present and upon the training education, experience and available personal protective equipment of firefighters present. Only qualified EMS personnel should have direct patient contact! Patient and firefighter safety is paramount.
Scene Preparations and Securement
The Incident Commander shall survey the scene for possible hazards. If utility hazards are present, utility company assistance shall be requested and/or confirmed. Contact shall also be made with personnel rendering medical assistance to determine the extent of extrication required. If additional resources are available, Incident Commander shall request for more immediately.
Proper scene preparation before operations begin is critical to the overall success of the operation. Scene preparation should include but is not limited to establishing a tool resource staging area (placed on tarp) and providing scene lighting when necessary.
All ignition sources shall be eliminated from the area. The batteries of all vehicles involved shall be disconnected UNLESS power is needed to activate windows, door locks or power seats.
Extrication can only begin after the vehicle has been properly stabilized, a 1¾" handline is pulled and positioned, and all personnel working in the extrication zone (fire and EMS) have been briefed on the actions that will be undertaken.
An imaginary circle should be established around the vehicle and a walk around the parameter shall be conducted, looking for victims possibly ejected from the vehicle. If trees are in the area, it might deem necessary to look in trees as well.
Vehicle stabilization is paramount and should be initiated immediately and prior to any personnel making entry into the vehicle.
The extrication of patients shall begin with the appointment of an Operations/Extrication Officer. Operations working in conjunction with the EMS provider shall establish an extrication zone. Access to this area shall be limited only to those firefighters involved in the extrication process and those providing the 1¾" handline. Operations, again working with EMS, shall determine the best and most efficient means of extrication.
The extrication team shall consist of an Operations/Extrication Officer and two firefighters minimum. The use of full protective clothing by the team with protective EMS gloves worn under the fire gloves shall be enforced (SCBA is an option to be considered by command and the appointed safety officer). It will be the duty of the Operations/Extrication Officer to oversee the extrication process and also inform Incident Commander of progress of the extrication. If at anytime Operations feels that the extrication may require more specialized tools, he should not hesitate in making this request to the Incident Commander.
When the need for extrication exceeds the resources of our Department, additional vehicle rescue tools shall be requested from the nearest extrication capable fire department (Munford or Covington).
The Incident Commander is responsible for the safety of ALL individuals working in and around the emergency scene. All personnel working on the scene shall wear all protective clothing appropriate to the task they are performing which normally includes full protective clothing. Gloves, helmet and eye protection (face shields down or safety glasses/goggles) must always be worn. Reflective safety vests are required to be worn when working in or around the incident scene.
A Safety Officer shall be assigned to supervise the operations, which includes awareness of approaching vehicles. It is critical that all precautions are taken to warn motorists of personnel working in the area. The proper placement of apparatus, to protect the responders on the scene, is one of the critical precautions that shall be addressed. Adequate Law Enforcement personnel will be present to assist with controlling traffic hazards. It is imperative that the Incident Commander or the Safety Officer work closely with the responding Law Enforcement and EMS agency to ensure the safety of all personnel on the scene.