Rescuers extricate 3 victims trapped after a tractor-trailer rolls onto their sedan By Steve Elliott & John Burruss
On Nov. 8, 2005, fire and rescue units from Albemarle County and Charlottesville, Va., responded to a spectacular crash involving a tractor-trailer that rolled onto a four-door sedan. The vehicle was crushed to a height of less than 36 inches. Amazingly, the three occupants were awake and talking, but they were encased in a space in the passenger compartment between 12 and 18 inches high. Rescue personnel would have to move quickly to save the trapped victims.
Training Pays OffThe Charlottesville-Albemarle Rescue Squad (CARS) provides primary rescue and emergency medical services to the City of Charlottesville, the University of Virginia and most of Albemarle County. Located in central Virginia about 120 miles south of Washington, D.C., and 60 miles west of Richmond, CARS is a volunteer rescue department with approximately 120 active members, and it is part of the Albemarle County Fire Rescue System.
For the past several years, CARS has sponsored a heavy truck rescue class. The class focuses on stabilizing and lifting large trucks and machinery, and specifically addresses removing heavy trucks that have rolled onto passenger cars.
Local heavy wrecker operators are invited to participate in the class alongside rescuers. While rescuers learn how to manipulate heavy loads and sling large trucks using heavy lift points, wrecker operators can practice heavy lifts. In the process, rescuers come to understand and appreciate the wreckers’ capabilities and knowledge, while the wrecker operators develop a better understanding of the needs of rescue personnel. The knowledge and experience exchanged was particularly critical during the 2005 class, as the above-described crash occurred just one month later.
The IncidentAt 1238 hrs, units were dispatched to Interstate 64 for a report of a tractor-trailer overturned on a passenger vehicle. Responding units included two engines, one heavy-rescue squad, one medic unit and two command vehicles. The first unit arrived on scene at 1242 hrs and confirmed that a passenger car was crushed under a tractor-trailer.
The truck’s load of wood had spilled, making it impossible to see the car from one side of the accident. Rescuers cleared a space in the load, and an off-duty battalion chief established communications with the vehicle’s occupants. The rescue duty officer requested a local wrecker service send a heavy wrecker to the scene immediately. Requests soon went out for two additional engine companies, two additional heavy-rescue squads, two additional medic units and several chief officers. The fire marshal also responded to address any potential hazardous materials issues.
Albemarle County Fire Rescue Battalion Chief Steve Elliott and CARS Rescue Duty Chief Brett Henyon initiated the incident management system (IMS). Chief Elliott assumed the role of incident commander and operational branches were established. Chief Henyon assumed command of the EMS branch, which was responsible for patient care, while Captain Tim Carr of Engine 6 assumed command of the fire branch, which was responsible for fire and hazard control. A technical rescue branch for extrication was established under Deputy Chief John Burress.
Implementing IMS was key in preventing bystanders from initiating rescue efforts. (One bystander actually wanted to use the front forks of a refuse truck to lift the trailer off the crushed car; failure could have resulted in the trapped patients being crushed.) Additional command staff arrived within 15 minutes of the first alarm and assumed the roles of public information officer and safety officer.
Fortunately, two factors worked in the patients’ favor: 1) The load the truck was hauling spilled away from the car, preventing an even greater amount of weight from further compressing the vehicle; and 2) the car came to rest in a swale over a drainage culvert, giving the vehicle additional room vertically.
Despite these positive factors, rescuers had to immediately address several issues to protect the victims. First, there was a small fire in the tractor’s engine compartment. Additionally, the three patients only spoke Spanish. Fortunately, one of the EMTs on scene spoke Spanish, so she calmed the patients and ascertained their injuries. The EMT also relayed to rescuers that the trailer continued to crush the car, and the victims’ space was shrinking rapidly.
After Engine 6 extinguished the small fire using AFFF, rescuers initiated a four-phase plan to relieve the car of the trailer’s weight.
Phase 1: Stabilize the vehicles and prevent the trailer from further sinking onto the vehicle. Rescuers used cribbing and low-pressure lifting bags to relieve the weight on the vehicle but not to lift it. The Rescue Division did not want to use the bags to lift the trailer, out of fear that the trailer could rock back onto the passenger compartment, further crushing the patients. As the bags were being inflated, the officer supervising the extrication listened for creaking sounds, which indicated that the trailer’s weight was transferring to the bags, preventing further sinking of the trailer onto the vehicle.
Phase 2: Position a heavy wrecker and lift the trailer from the rear. To gain attachment points for the wrecker cables, rescuers used a power saw to cut away a portion of the rear trailer gate. The operation went much faster and safer because this strategy did not require personnel to place lift straps around the trailer. Once the chains were in place, a slow lift was performed while firefighters monitored the trailer for load shifting or frame deformity. Had this operation failed, alternate plans included using air lifting bags to remove the weight of the trailer from the car.
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CARS operates eight advanced life ambulances (medic units), four advanced life support quick-response cars (zone cars), two heavy-rescue trucks (squads), a water-rescue vehicle with three boats, a technical rescue truck, a collapse rescue trailer, a mass-causality response vehicle and a special events bicycle response team with trailer. All current apparatus is owned by the department and was purchased primarily with funds raised through donations from the community.
CARS includes more than 100 personnel trained in ALS and more than 60 certified at the EMT-B level. ALS certification includes more than 600 hours of classroom training and months of practical rotations in the hospital, along with a minimum of 40 hours of continuing education annually. ALS-certified personnel can initiate complex medical and airway procedures for critically injured trauma and medical emergency patients. EMT-B providers receive 120 hours of schooling and are trained with basic intercessory procedures to react to most any emergency situation. These technicians can also assist patients with administering their own medications. In addition, local fire department engine companies are equipped with automatic defibrillators that recognize and convert life-threatening heart arrhythmias. |
This operation would have been more time consuming, possibly resulting in the deterioration of the patients’ medical condition. Fortunately, however, the operation was a success. Once rescuers could see daylight between the car and trailer, they initiated the next phase.
Phase 3: Use a wrecker to evenly winch the vehicle out from under the trailer. This strategy allowed rescuers to work in a safe area away from the trailer. After the car was winched out, the wrecker lowered the trailer to the ground but left it suspended evenly on the wrecker cables to prevent any load from shifting. At this point, rescuers feared the victims would try to self-extricate when they saw daylight, so the EMT made sure they knew to stay in place.
Phase 4: Remove the vehicle’s roof and extricate the patients. Rescuers used hydraulic tools and reciprocating saws during this phase, which took the longest to complete. With two of the victims in the front seat and one in the back seat, the victims had survived by leaning over as the trailer landed on their car; they were sandwiched on the floorboard between the seats and the dash.
During the extrication, rescuers and medics identified a good location for an EMS staging area and set it up. Chief Henyon briefed the medic crews, which were preassigned patients to assess and treat. Medics in turnout gear monitored the patients’ condition throughout the extrication. A critical care unit from the local helicopter service responded to provide additional advanced care in the event the extrication became prolonged.
The extrication was completed in just under an hour; the first patient was transported to the local trauma center at 1335 hrs, and the last transported at 1416 hrs. One medic unit stayed on scene to assist with any necessary rehab of the rescue personnel. Additionally, two engine companies and a command vehicle stayed on the scene for the recovery of the vehicles. In all, 40 personnel, four engine companies, three heavy-rescue squads, four medic units, five command vehicles and two wreckers were involved in the rescue.
Lessons Learned This was an unusual incident with many problems that required immediate action. Rescuers didn’t have much time to think—they just had to act. Following the incident, we developed a list of points that address some of the incident’s complexities.
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Think outside the box: The primary complicating factor in this rescue was the trailer’s weight and bulk. The technical rescue branch could have cribbed and stabilized the trailer, and then cut through a lot of metal to gain access to the passenger vehicle. Instead, lifting the trailer and moving the vehicle out and away from the trailer eliminated a significant hazard and transformed a difficult extrication to a single-vehicle extrication. It is also important to note that we never would have done this if it weren’t for our previous training in this type of operation and our great working relationship with local wrecker operators.
• Train often: The training conducted during the recent heavy truck rescue class gave the rescuers a solid knowledge base and skill set. The training class focused on the integration of heavy wrecker and recovery operators into operations at a motor-vehicle crash involving heavy trucks. Rescue personnel completed this class with an understanding of the capabilities of the operators and their equipment, resulting in the establishment of a preplan for the wreckers prior to the actual crash. Having this plan in place allowed rescue personnel to immediately deploy the wreckers upon their arrival on scene.
• Use IMS: The first-arriving chief officers established an incident management system immediately upon arrival, positioning command staff and branch commanders around the incident perimeter to monitor and control the operation. This was crucial in preventing fire or rescue personnel or bystanders from initiating their own rescue plans. Command also established branches and groups to address tactical functions, allowing command to concentrate on overall strategy and scene management. Support branches established early included a hazardous materials control branch and a public information branch. A command team approach ensured that all upper-level command functions were addressed.
• Address communication issues: Most incidents have some communication problems. This incident was no different. At the time, local fire units operated on a low-band VHF system. EMS and rescue units operated on a high-band VHF system. No interoperability existed between the two systems. To circumvent this problem, operational branches and command simply used face-to-face communications during this incident. Of course, this was possible only because the incident was contained to a small geographic area. Realizing the need to sync up, following the incident, fire and EMS agencies combined on a new 800-MHz, trunked radio system, allowing for interoperability between all fire, EMS and police agencies in Charlottesville and Albemarle County.
• Request adequate resources: Rescuers quickly realized this incident required many resources and called them in as soon as possible. Based on information he received while responding to the incident, the rescue duty chief was able to call for heavy wreckers while still en route to the accident. Because of the early request, the heavy wrecker arrived on the scene when the Rescue Division was ready to use the equipment. Had the lift with wreckers or airbag lift been unsuccessful, Plan C was to request a large crane to the scene to lift the trailer. We emphasized thinking ahead in our heavy truck extrication course. Furnish your dispatch center with a call-out list for heavy equipment and heavy wrecker operators. If you think you are going to need the resource, call for it early. Resources can always be turned around if they’re not needed.
• Work with other groups: The wrecker operators were essential to the successful outcome of this rescue. Establish relationships with area heavy equipment companies so they can provide this service if needed. Rescue personnel have come to know our local towing companies and include them anytime we conduct vehicle rescue training. At the end of the aforementioned heavy truck extrication class, the towing operators exchanged business cards and promised to meet for additional training amongst themselves. Contact the operators in your area, get to know them, train with them and use them as a resource. Ask their opinions, and learn to trust their judgment—this is what they do for a living.
• Work together every day: The departments responding to this incident work together every day on routine calls. This interaction develops familiarity between the different agencies, which pays off every time a major incident like this one occurs. Although multiple agencies were involved, all responding units operated fairly seamlessly for a successful resolution of the incident.
Success!
All three patients survived and were discharged from the hospital within 24 hours of the incident. The heavy truck rescue class was clearly beneficial for the rescue personnel and wrecker operators who responded to this horrific accident. As such, this incident should reinforce the importance of training with all the resources, departments and personnel you will respond with on actual incidents. Working together pays off for everyone involved!
Steve Elliott, BAS, NREMTP, is a battalion chief and EMS supervisor with the Albemarle County, Va., Department of Fire Rescue. Chief Elliott may be reached at selliott@albemarle.org.
John E. Burruss, BS, NREMT-P, is the deputy chief of special operations for the Charlottesville-Albemarle, Va., Rescue Squad. He is also a career firefighter and teaches heavy and technical rescue classes for the Virginia Department of Fire Programs. Chief Burruss may be reached at jburruss@ hotmail.com.
