Have you ever watched someone who is a master of his or her trade? Take, for example, a top chef. When they get a knife in their hands and start chopping, it’s incredible how fast they move (and that they don’t lose any fingers).
When we think of vehicle extrication, we should strive to be like the chef. There are strategic evolutions we can all master that will improve the outcome of our rescues.
With this in mind, I’d like to discuss one of a few tried-and-true methods for the successful removal of trapped patients from vehicles, this one based on the A-B-C rule.
As you know, the A-B-C rule specifies that we cut the vehicle’s posts in that order: A, B then C. The vehicle roof usually serves as an entry point for rescuers to gain access to the patient. We know the C post is the largest post, and we know if the A and B posts are cut first (as the A-B-C rule tells us), we will have to commit personnel to hold the pillars while the C post is being cut. Furthermore, if a reciprocating saw is used with this approach, the weight of the roof will bind the blade during the cut.
However, there is another method used effectively in both the field and extrication competitions — the C-A-B method. I have spent a lot of time training and participating in vehicle-extrication competitions nationally and worldwide, and I’ve found that C-A-B is the preferred method.
Make the first cut to the C post with a reciprocating saw. Be sure to clear the C post of plastic molding and check for the side impact curtain systems before making the cut. It will be a fast cut — 20 to 30 seconds max. I suggest using a demolition blade with 10 to 14 teeth per inch. Your first cut should be fast and cause no vibration to the car or patient.
Next, move to the other C post and cut it in exactly the same manner. It should be a mirror image of the cut you just made. Have the heavy hydraulic cutters ready on the A post. When the second C post is cut, immediately start the cut on the A post. The reciprocating saw can be set up on the B post farthest from the patient. The move the cutters to the other A post. The last cut is made to the post over the patient with the hydraulic cutters. At this point, you’ll need help removing the roof.
This process can be accomplished in 5 minutes or less. But it must be systematic and practiced regularly. It is imperative that the hazards in the car are identified immediately and caution is used while cutting around them. For example, the hatchback piston will spray hydraulic fluid if cut in the cylinder. The cut portion could spring violently (since it doesn’t have weight on it) and strike the rescuer in the face. This happened to a firefighter in Great Britain and caused serious injury to his face that required surgery.
When structuring training on the C-A-B method, there are three critical elements to incorporate into the exercise:
1) “Realistic damage” — Have someone do damage with a front-end loader to the roof and doors of the car. Don’t waste your time cutting on a car that has no damage to it. You’re setting yourself up for problems training like this.
2) “Stress” — A realistic scenario with the pressure of a critically injured patient. This can be accomplished with a stopwatch or friendly competition between units or shifts.
3) “A patient” — Have someone in bunker gear position themselves in the car like they are trapped. This is an excellent tool for your new members and a good way to evaluate the crew’s skills.
The last component of the evolution is managing the glass. It has to be done safely. In most serious crashes that I’ve responded to, the impact of the crash removed all the glass but the windshield. The preferred method to remove the windshield is to use an aggressive wood blade or demolition blade on a reciprocating saw. Remember to change out the blade if you’re going to go back to cutting metal.
This strategic evolution has been done tens of thousands of times throughout the world, and it generally works like a charm. If you’re having difficulty cutting through the B post, cut above the post at the drip edge. Many new cars have a piece of boron steel in the B post that most cutters can’t cut through. Practice this strategic evolution using the C-A-B method and you will see how much quicker the roof can be removed.
Work Safe. Never Forget
