2-firefighter coordinated extrication in 6 steps
Well-firefighters can free trapped victims faster with synchronized cuts and spreads; here's one six-step example
How the two firefighters in the back of the rig perform is a key to any vehicle extrication. There are tremendous staffing variables across the country; many departments may not have three- or four-person responses within a single apparatus.
Regardless of how the manpower arrives, a structured approach with roles and responsibilities can still be implemented. If the response is limited to a three-person company, however, the officer will have to fulfill the role of rescuer two.
While en route, rescuers should be processing the dispatch information and formulating their plan of attack. Knowing the job before arriving on scene helps rescuers process information quicker and make better decisions.
The rescuers are responsible for primary stabilization and extrication.
Coming off of the rig, the rescuers should have irons in hand and large wedges or step chocks for primary stabilization. By the time this gear is assembled, the officer should have the 360 completed, window access established and the vehicle in the process of hazard management (hood access, battery management, ignition off, vehicle in park, etc … ).
The rescuers should look to the officer for initial mode of operation. That could be rescue, recovery, rapid extrication, C-spine extrication or simple entrapment without C-spine extrication.
Stabilize the vehicle
Once this basic approach is communicated, the rescuers can work as a team to perform primary stabilization. For a vehicle on all four wheels, this should involve four points of contact under the outside posts or pillars.
One option to pressurize the points of contact is for both rescuers to place their wedges on the ground at the insertion points. Then, one rescuer lightly lifts the vehicle with his back to the vehicle and knees bent. The other rescuer advances the chock under the rocker while the load is lifted before the vehicle is lowered onto the chock.
While the rescuers perform this first step, the driver shuttles more chocks and wedges to the immediate scene. The additional stabilization material should be placed under the front and back of the wheels to prevent any lateral movement.
If the initial assessment reveals a high probability of fire or if manpower is limited and additional companies are not right around the corner, then at least one rescuer should have on the full complement of PPE.
This rescuer may elect to deploy a line and have it charged and in position. If the fire hazard is low, other support personnel can do this at a more appropriate point in the operation.
Once the vehicle is stabilized and the three Ms have been applied to the hazards, the rescuers should split up and deploy the two primary extrication tools – the cutter and spreader. The driver may already have this accomplished.
Either way, do a quick tool check. This is a lot like bleeding a hand line before making entry into a structure. Make sure that the tool is operating properly with a quick open and close on your way to the vehicle.
We had a great saying in the Marine Corps that always rendered good results: "Slow is smooth and smooth is fast." You are already thinking and moving at warp speed because of the event, so telling yourself to slow down puts you in a more cerebral place that leads to better decisions and smoother, more efficient actions.
So, take a deep breath, think about the action plan and go to work as a team.
The goal is to keep two tools operating at all times. To pull this off, the two rescuers have to have rehearsed techniques that complement one another. If these tandem techniques aren't rehearsed, then the two rescuers have to communicate throughout the extrication to maintain coordination.
The second option will always be slower, but may be unavoidable. When the techniques and applications that were practice don't work, the best crews can problem solve together in a safe and rapid manner.
Let's walk through a basic side out and dash displacement to illustrate how the two rescuers can work simultaneously. We will use a rip and blitz for the example.
1. Clear the cabin
Both rescuers work quickly to identify safety restraint components and pull all necessary interior cosmetics.
2. Pop the rear door
The firefighter operating the cutter approaches the B post and makes a complete high cut including both door window frames, while the spreader operator performs a rear door window spread and gaps or pops the rear door latch. Be careful to coordinate this timing.
If the cut is going to be slow or challenging, let the spreader go first so that the rear door window frame separates from the B post. As soon as that separation occurs, the cutter can go to work without attempting to cut the rear window frame. If the latch does not pop due to door skinning or other obstacles, quickly move the cutter to the latch and cut the material.
3. Pinch the fender
Once the rear door is open and the top of the B post is cut, move to the rear door opening and make the relief cut on the bottom of the B post. While this cut is being performed, the spreader can work up to the fender.
Pinch the fender above the wheel well and skin the body panel off to the suspension hub to expose the front hinges and the inner structural fender rail. Once the body panel is separated, pinch the fender rail between the suspension hub and the firewall.
4. Finish the B post
The cutter will move to the fender rail and make a complete cut where the spreader pinched the material. The spreader relocates to the rear door opening and spreads or shears out the relief cut on the bottom of the B post.
By this point in the operation the driver should have reciprocating saws and rams out. These are the alternative tool options if the shear is not successful with spreaders.
The cutter has access to the front hinges at this point. If timing permits, cut the bottom hinge. This allows the B post to shear out with a little less resistance but maintains door control with the top hinge still attached.
5. Make A post cuts
Once the B post shears out, the cutter can take the top hinge. With the entire side being removed, the cutter can pull the side material away from the vehicle while the spreader pinches the A post between the dash assembly and the rocker.
Avoid the remnants of the hinge when pinching. The cutter can perform the mid-to-high A post cut while the spreader is performing this pinch.
The next step is to make a complete cut where the lower A post pinch was performed. The spreader can remove the windshield or make an H cut while the cutter makes this lower A post cut.
6. Make the lift
The cutter can now retool with a ram and get positioned between the rocker and the upper A post. The spreader can orient that tool to the lower A post cut and prepare to chase the roll with a lift.
Once the ram is maxed out on the roll, the spreader can take over with the lift.
There are many ways to perform this extrication sequence; this is one example of having a well-coordinated attack. Remember, the best performances are a result of training. Set up your own coordinated sequences as a company and refine them through practice.
I often change my approaches. The more you practice, the more experience and insight you will gain to streamline your operations. Always test your concepts in the field.
Do not just read things and assume they will translate to your organization. The variables of individual skill sets, communication skills, resources and equipment capabilities play major roles in defining what is effective. Customize your operations, work as a team and train hard.
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