20 Vehicle Extrication

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Section 20 - Vehicle Extrication

VEHICLE EXTRICATION

INTRODUCTION

Southern California's highly mobile life-style and its magnificent freeway systemare the natural setting for an abundance of vehicular accidents. From major, multi-vehicle smash-ups to minor fenderbenders, firefighters are called upon to extricatevictims and render aid in a variety of situations. Appropriate scene management aswell as competent, efficient use of rescue tools and techniques are vital to the successof the rescue effort. Confidence in one's ability to effectively use various pieces ofrescue equipment comes with practice and experience; with this in mind, firefight-ers should avail themselves of every opportunity to hone their vehicle extricationskills.

Safety must be of paramount importance in all rescue operations, as firefightersmust be part of the solution to the extrication emergency and not part of the problem.

OBJECTIVES

Describe initial steps to be taken upon arrival at the scene of avehicle accident.

Describe methods of and safety precautions related to:

a. Forcing entry through doors.

b. Removal of a windshield or other auto glass.

c. Folding a sheet metal roof back to gain access to the interiorof the vehicle.

d. Removal of steering wheel, dash, or foot pedals from vicinityof a victim.


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Describe air bag usage and safety procedures.

SCENE MANAGEMENT

Arrival At SceneUpon arrival at scene, stop apparatus uphill and upwind of the incident. If policeofficers are not at scene and are needed, request them through F.C.C.. If on afreeway, it will be important to place the apparatus so that it affords protection tothe firefighters, ambulance crew, and victims. Stop far enough back to allow roomfor the ambulance and consider rescue rig placement. If the incident is off thefreeway traffic lanes, place the apparatus off the freeway but still in a position toprotect the crews.

Size-UpBegin sizing up the situation as soon as it can be seen. Report on conditions, andrequest additional equipment and services. Initiate traffic control; consider hazardssuch as downed electrical wires, fuel, unstable vehicle, fire, underground electrical,hazardous cargo, debris, etc. For accidents occurring at night, position vehicles touse lights for scene illumination; if necessary, use portable flood lights or requestLight and Air. Check the area. Account for all victims in all vehicles and orderadditional ambulances as needed.

Scene Protection

Prepare for the possibility of fire by laying two hose lines, a working line and abackup line. Engage pumps and have foam systems and a dry chemical extinguisherready for use. Use caution in placing traffic flares, keeping them as far away aspractical. Remind police officers of the fire danger. Use traffic cones and bannerguard to your advantage when necessary.

Flammable Liquid ControlStop or control any leaking flammable liquids. Warn everyone about sparks and firedanger. Turn off the vehicle ignition. Disconnect the vehicle battery starting withthe ground terminal. In the event of a large spill request Haz Mat through F.C.C.describing the nature and quantity of the spill.

Rescue TeamRescuers should plan their operation. Rescuers should use available personnel tomake a check of all victims. If a large number, set up triage areas, and considercalling for a medical strike team.

Rescuers should triage and treat injured victims according to first aid priorities.Whenever a victim is trapped inside or under a vehicle, extrication will be required.The rescuers must determine whether the rescue can be performed with the


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resources available or if additional resources must be ordered.

Identifying Airbag-Equipped VehiclesIf the bag has deployed, it can be seen drooping from the steering wheel hub or theinstrument panel on the passenger side. If the bag did not deploy, the presence of an

airbag can be determined in several ways. The steering wheel hub is large andrectangular and covered with a scored, soft plastic material. The words Supple-mental Inflatable Restraint, Air Bag, or initials such as S.I.R., or SRS may beembossed on the surface. In most cases, the vehicle identification number (VIN) canbe used to determine the presence of an airbag. Some manufacturers place placardsunder the hood or on the drivers side windshield pillar. If unable to determinewhether the car is equipped with an airbag, assume that it is so-equipped and followrescue guidelines for airbag cars.

For vehicle rescues involving a deployed airbag use normal rescue procedures andequipment. Do not delay medical attention. Deployed airbags are not dangerous,

but they do produce a dust which may cause minor skin or eye irritation. Gloves andeye protection should be worn. Keep the dust away from the victims eyes andwounds. Remember to wash hands after exposure to the dust (usually corn starchor talcum powder).

Vehicle Rescue with an Undeployed AirbagAn undeployed airbag is unlikely to deploy after a crash. Most incidents will notrequire rescuers to work in what would be the deployment path of the airbag (norshould they place themselves or any objects on the airbag module or in its deploy-ment path); therefore, rescue operations can begin without delay.

In those rare incidents where a victim is pinned directly behind an undeployedairbag, special procedures should be followed:

Disconnect or cut both battery cables, using approved methods.

If circumstances permit, wait for the system to become fully deacti-vated before attempting to remove the victim.

Do not mechanically cut through or displace the steer ing column untilthe system has been deactivated.

Do not cut or drill into the airbag module.

Do not apply heat to the area of the steering wheel hub.

StabilizationStabilize the vehicle in the position it was found. If a vehicle is on its wheels set theemergency brake, and place the transmission in gear. The objective is to increase thearea of contact with the ground as much as possible. Do not roll a vehicle back over,push or shove back onto wheels or the rest of the way over. Stabilize in place using


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whatever material is available, Occasionally, a vehicle will be over an embankmentand/or other complications. This may require cribbing, shoring, attaching chainsand ropes, use of a winch, but the rule remains the same - STABILIZE BEFOREENTRY OR EXTRICATION. A safety officer should be assigned to watch for anysigns of vehicle movement during rescue.

Stabilizing with cribbingand Come-along

Stabilizing with rope and truckers hitch


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In general, access to the interior of the vehicle should be considered in the followingorder:

1. Through the doors.

2. Through the windows.3. Through the body of the vehicle.

In a collision, especially in newer vehicles, safety regulations have called forconstruction of doors that will not fly open. Because of this feature, rescuers arefinding more and more incidents where entry into a vehicle requires force. How-ever, in most accidents both doors are seldom damaged severely and entry may beaccomplished by simply opening the opposite door (TRY BEFORE YOU PRY).

Attempt to pry the jammed doors with hand pry tools. But if doors cannot be openedwithout the use of the jaws, immediate life-or death entry may be made by crawling

through a window. In most accident situations entry through a window cangenerally be made quickly and with little difficulty, especially if any of the windowshave been broken at the time of impact. Before any glass is broken, rescuers shouldensure that the victim is adequately protected from flying particles of glass bycovering with a rescue blanket or debris carrier. Whenever possible, break thewindow farthest from the victims in order to prevent glass shards from reachingthem.

Opening/Removing Automobile DoorsTo open a jammed door, work the doors sheet metal away from the separation of

door and body at the midpoint of the door, Using pry bars, halligan tool and sledgehammers, attempt to work alongside the latching mechanism (usually the midpointof the door).

If a door does not open to prying efforts, it is probably because the doors safetymechanism (commonly known as a Nader Pin) is doing its job. There is a solid steelbolt which engages a corresponding receptacle when the door is closed. This systemprevents the door from flying open in a crash. If the bolt is engaged, it will benecessary to force the bolt mechanism open with power tools.

To open a door with the power spreaders (Amkus or Holmatro), look for a gap

large enough to fit the jaw tips between the rear portion of the door and the carbody. If this gap is not wide enough to position the tips, open the jaws, grab thedoor from the top and pinch the door approximately 6 inches in front of thelatching mechanism. This will create a gap for the jaw tips.


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Grab the door from the top and pinch ahead of the latch. Insert the spreader tipsat the midpoint of the door and spread the door from the latch.

Force the opening with the jaws until the latch pin releases. A second rescuer shouldact as a safety monitor and assist the operator. The assistant should position his/herbody on the door to prevent the door from swinging open uncontrollably when thelatch releases. The assistant should use extreme caution not to put any portion ofhis/her body between the tool and the door, or the door and the ground.

After opening the door, additional room can be achieved by manually forcing thedoor slowly forward. Position your back against the door and use your legs to push.When the door cannot be forced forward manually the come-a-long can be used topull the door open.

If forcing the door is ineffective, or a larger opening is needed, removing the doormay be called for. In most cases it is quicker to remove the door than to force the doorout of the way.

The hinges can be forced with the spreaders from the inside or outside of the door,depending on accessibility. Force the top hinge first, then the bottom hinge. Forcingthe bottom hinge, with the jaws just above it, will cause the door to be forced into theground and not into the air when the hinge breaks. A second rescuer should holdonto the door to prevent it from flying uncontrollably when the hinge breaks.


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Forcing upper hinge Forcing bottom hinge Forcing upper hingefrom top

Automotive Glass RemovalTwo kinds of glass are used in motor vehicle windows: laminated and tempered.Both kinds are safety glass. However, each one has a different breaking character-istic that influences the manner of removal at an accident scene.

Laminated glass is composed of two sheets of glass bonded to a sheet of transparentplastic at high temperature and pressure. Laminated glass is most often used for

automobile windshields.

Plate glass subjected to a special tempering, or hardening process is called temperedglass. This type of glass is extremely tough and break- resistant. Tempered glass isused for the side and rear windows of passenger cars.

Even if the window is broken carefully, there will be some glass particles that willfall, creating a potential hazard for rescuers and victims. When rescuers performglass removal, they must be completely protected with a helmet, turnout gear, eyeprotection, and gloves. Whenever possible, cover the victim with a debris carrier ordisposable blanket for protection from flying glass.

When breaking tempered glass, strike a lower corner close to the body or frame witha sharp-pointed tool. Considerable force will be needed to break the window. Agood technique is to strike the glass increasingly harder until it breaks. If just enoughforce is used to break the glass, the spraying of particles from the break area isminimal, and there is less tendency for the entire window to fall out. Those piecesof glass which do fall out will fall straight down, into the door or between the doorand the seat.


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If the glass is broken carefully, there will be a small hole made in the window. Witha gloved hand you can remove handfuls of glass and drop it into a salvage bucket.All of the glass should be removed. When possible prior to breaking the window,cover the glass with duct tape to reduce the hazards of flying glass particles. Afterbreaking the glass the rescuer can remove the duct tape and glass together.

Breaking a laminated windshield can be difficult. Before attempting to cut thewindshield, rescuers should ensure that the persons in the vehicle are adequatelyprotected from flying pieces of glass. It may be possible to spread a rescue blanketor disposable blanket over the victims face and head to prevent injuries from glassparticles.

Removing a windshield may best be accomplished using a pry axe. Using the pickhead of the axe, make a hole about midpoint at the top of the windshield. Make thehole large enough for the serrated head of the axe to enter. Make short pulls, movingthe axe up and down over the serration. Cut the windshield at the midpoint, where

the glass meets the frame, then continue across and around to the bottom of thewindshield. Cut across the bottom of the windshieldmoving away from thedriverand back to the middle. It is not necessary to cut across the center of thewindshield; when the glass is folded outward, it will crease easily. When the cut iscomplete, there will be an opening through which one can easily pass.

Pull pry axe through the window moving the serrated edge up and down as youpull the blade through the glass.


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Fold the windshield over to the opposite side. If the glass does not break whenfolded, a gentle tap with the axe will break the windshield, allowing it to crease.

When a pry axe is not available a fire axe can be used to chop out the glass in a similarway. Chopping out a windshield is not a neat operation, but it is a technique whichcan be used effectively when time is short.

A baling hook can be used to pull away sections of laminated glass when speed ingaining access is important. Force the point of the baling hook through the glass atthe upper midpoint of the windshield. A hammer or perhaps a piece of woodcribbing may be used to drive the point through the glass. Forcefully move the hookin and out with a sawing motion so that the point breaks the glass and the curve ofthe hook separates the pieces. Continue until the windshield is broken from top tobottom.

Re-insert the hook at the top of the cut and continue to break the glass across the top(moving away from the driver) and down the side of the windshield. Pull the brokensegment of windshield out from the top and remove it.

It cannot be emphasized too strongly that when rescuers perform glass removal,they must be completely protected with a helmet, turnout gear, eye protection, andgloves.

Whenever possible, prior to any glass removal operations, a protective rescueblanket should be placed over the victim(s). Occasionally, a windshield mounted inrubber can be removed intact by cutting the rubber and lifting the window out. Caremust be used so that victims are not harmed by flying glass.


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Cutting a Steering WheelFrequently in a collision rescue, the victim is

pinned behind a steering wheel, collapsedagainst a seat, or has a foot caught in the floorpedals. In this situation, the seat may bereleased and moved back, thereby releasingthe victim, or the seat may have to beuntracked and slid back. Without a come-a-long or hydraulic rescue tool, the steeringwheel itself is difficult to pull out of the way.However, a ratchet cutter or bolt cutter canbe used to cut the steering wheel ring on bothsides of the T bar to gain more room.

Cut the steering wheel ring on both sides ofthe T bar with either ratchet cutters (ifavailable) or bolt cutters.

Forcing Back Automobile SeatsWhen the seat needs to be forced back with the spreaders, open the arms until onetip is on the door opening and the other tip on the seat frame. Pushing on the seatframework will force the seat back in the track. Use caution, as movement of the seatmay increase the pain of a victim's injury.


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Pushing the DashWhen a victim has become entangled in the dash and/or the steering wheel it maybecome necessary to push the dash off the victim. Cut the windshield (A) pillar, thenmake a cut in the lower front corner of the door opening (these cuts allow movementof the dash area and take little time to cut with the hydraulic cutters). Place thebottom end of the ram (with aluminum base) into the lower rear corner of the door

opening. Open the ram until the piston pushes against the front upper door opening(about dash height) and extend the ram, pushing the dash.

Rescue crews will frequently encounter vehicles utilizing unibody construction.While most extrication procedures are similar to those for rigid frame-constructedautomobiles, unibody construction is somewhat "softer" and may require additionalcribbing. Extend the ram until the dash has been pushed clear of the victim. The ramcan be disconnected from the power unit and left in place to maintain the positionof the dash.

Removing the Top

In some accident situations, it may be desirable to completely remove the top of thevehicle. Such a case might exist when a patient must be rigidly immobilized on a fullbackboard.

A top can be most easily removed with an Amkus or Holmatro tool and its shears.When the cutting attachment is not available an air chisel can be used with littleincrease in operating time. Rescuers should be stationed around the car so that assoon each pillar is cut, a rescuer can support the roof until it is completely free.


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Cut both the front pillars first (removing the windshield is not necessary), then therear ones. Have other firefighters support the roof as the pillars are being cut. Afterall the supports are cut, lift the roof off the car. It may be necessary to cut the seatbelt shoulder straps to remove the roof. These operations should be completed inabout 2 minutes or less, and the entire interior of the vehicle will then be exposed.Emergency care personnel will be able to enter and work without hindrance.

Some cars, especially certain luxury hardtop models or station wagons, have

extremely wide rear pillars or long roofs that pose a problem for rescuers who mustremove the roof. In thesecases cut the front pillarsfirst. Have otherfirefighters support theroof. Make a right-anglecut into the curved part ofthe roof just ahead of therear pillar on one side.When the shears are beingused, the cut should be as

deep as the shears will al-low. Repeat the cut on theother side. Have one res-cuer push down on the roofin line with the two cuts.This will prevent the roof from buckling. Have the rescuers supporting the roof liftupward and backward; thus, they will fold the top back and expose the entireinterior of the vehicle.


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Fold the roof back out of the way. Bend sharp edges out of the way or cover witha debris carrier; secure the top to prevent its blowing back in windy conditions.

If the vehicle is on its side, extrication should be made through the roof. Roofingsheet metal is fairly weak and can be opened with the air chisel somewhat like a canand can opener. Working the sheet metal cutting tool, start with a puncture, then cutuntil three sides are opened, making sure the corners are round. Bolt cutters or ahacksaw may be needed for cutting beams used as additional roof support. Somevehicles have double layers of sheet metal in the roof, so it will be necessary to cutthrough both layers with the air chisel.


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Use caution when working around the freshly cut metal, as the edges are very sharp.A debris carrier can be laid over them to help protect victims and rescuers.

There are situations when vehicles or heavy objects must be raised where there is

little space to insert jacks or large tools. Rescue and selected trucks have highpressure air bags which work well in these situations.

AIR BAGS

Air bags are inflated with the Scott 4500 psi air bottles reduced to a working pressureof 118 psi. These bags require only 1 inch of clearance between parallel surfaces forplacement, prior to inflation. They can be used in many types of extrications, inaddition to their primary use as a lifting device.

Place the air bag between a flat surface on the vehicle and cribbing on the ground.If edges are sharp on the vehicle, protect the air bag with a folded debris carrier. Asthe air bag lifts the vehicle, place cribbing to prevent falling. Two air bags can becombined to increase the lift distance (never use more than two air bags together).

Crib as you lift and pad the air bag when sharp edges are going to be in contactwith the air bag.


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Two air bags can be stacked, one on top or the other, to increase lift. (NOTE: donot stack more than 2 air bags.)

MAXIMUM CAPACITY HEIGHT INFLATIONBAG SIZE IN TONS OF LIFT TIME

15" X 15" 12 8" 3 seconds

15" X 21" 17 9" 4 seconds20" X 20" 22 11" 7 seconds24" X 24" 32 13" 11 seconds42" X 15" 35 9" 12 seconds28" X 28" 44 15" 28 seconds36" X 36" 74 20" 53 seconds

Air Bag Safety Procedures

All personnel involved in the rescue must wear full protective

clothing.

All non-essential personnel must be kept clear of the operating `area.

Always crib and secure the load as it is being lifted.

Never work under a load that is supported only by air bags.


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Remain clear of operating area of bags, stand off to the side.

Never operate the air bags without the safety controller.

When shoring using box cribbing, make sure the bag is placed onsolid top layer. Do not leave a hollow center as any movement ofthe load may cause the cribbing to shift and collapse.

Never inflate the air bags against sharp objects or on a surface inexcess of 220OF. When necessary, protect the surface of the bagfrom damage by using cribbing or protective materials.

Two air bags may be stacked on top of each other to gain additionallift, but never more than two because the center one may slip out.Line up the centers of the yellow Xs on the bags to ensure they are

properly centered. If two different-sized bags are used, alwaysplace the smaller bag on top. Two bags may also be used to lift thesame load at two separate points to maximize surface contact.

Use cribbing large enough to assume the load. Crib as you go.

Before raising an object, careful evaluation should be made to pre-determine desired height or load movement. This allows one toobtain, in advance, all the necessary cribbing before committing thebags.

Make sure all valves are in a closed position before turning on theair source. This will reduce the risk of an uncontrolled lift.

Always open high pressure air bottles slowly.

Always inflate bags slowly to minimize the chance of load shifting.

Always inflate under load. Do not overinflate.

Uneven surfaces should always be cribbed until almost parallel.

Always crib up to the surface until you can just get the bag in so asto retain the maximum lift of the bag.

Quite often a driver will become trapped by the foot pedals after a collision. The footmay be broken and the driver in a great deal of pain. Any work done on the pedal,even though it reduces pressure on the foot, will seem to cause the driver even morepain. Because of this, rescuers should adopt a plan and use their visual and sensoryinformation to determine if their efforts are successful. Any open wounds should


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be protected against contamination. It may be possible to splint in place a broken legwhile waiting. If the decision is to attempt extrication, suitable pry bars should begathered and placed in such a way as to give a firm bite and secure fulcrum. A slipwhile prying could cause increased injury and shock.

If working on an embankment, use ropes to guide rescuers and to support thetransportation effort.

If the responding truck company or Rescue 4 is reasonably close, it would be properto stabilize the victim and delay extrication until their arrival.

Collision victims may often be thrown considerable distances. Search the area.Attempt to account for occupants by asking the less injured how many were in theirvehicle and then count heads.

Consider the incident under control when all victims requiring medical aid have

been transported to the hospital. Tow trucks are responsible for the removal ofdebris and vehicles, but it is the fire departments responsibility to ensure thevehicles can be towed without presenting a hazard; that is, to ensure that flammableliquids are safely contained, and that hidden or remaining fire is out.

Remember, when a rescuer first enters a vehicle in a rescue situation involvingspilled flammable liquids, the area the rescuer is entering is similar to a bomb. Theremust be a team at work alleviating the potential of fire and ready to keep a suddenfire away from the rescue team.

In extrication the experience and training of the crew at hand will determine whatcan be done. If no one has ever pried a door, removed a window, or cut open a roofit is doubtful that they will be able to do it at an actual incident. There are manywrecking yards in the city, and several of them are very cooperative in allowingfirefighters to train on their wrecks. While training, try to perform various extrica-tions first with only the tools available on an engine company. Finally, the rescuerigs are always available for training exercises and familiarity with their equipmentmay help the decision to extricate now or to await the arrival of Rescue 4.


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20 Vehicle Extrication