Hot Topics Vr Webcast 07 Final

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Hot topics in Vehicle Rescue for today's rescuer

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  • Sanson: high percentage of entrapped patients require advanced life support (ALS), including on scene intubation and chest decompression. Aggressive field resuscitation and immediate transport to a level 1 trauma centre is associated with a mortality lower than that predicted by TRISS in spite of the prolonged prehospital time
    Reines: TRC felt prehospital care was beneficial in 85% of cases
    Lies EurNCAP
    Segui-Gomez: 1206 eligible drivers in newer vehicles presented significantly fewer and less severe injuries than their 3827 pre-1998 model year counterparts
  • Hot Topics Vr Webcast 07 Final

    1. 1. Me?Me?  David DalrympleDavid Dalrymple  24 years in emergency services24 years in emergency services  Career- RWJUH EMSCareer- RWJUH EMS  Volunteer- Clinton EMS/RescueVolunteer- Clinton EMS/Rescue  Rescue Instructor for 14 years-Rescue Instructor for 14 years- Vehicle Rescue is my specialtyVehicle Rescue is my specialty  TERC US – Education ChairTERC US – Education Chair  International certified ExtricationInternational certified Extrication judge-judged & lectured in US,judge-judged & lectured in US, Canada, UK, Europe & SACanada, UK, Europe & SA  Member of iETRI, serves as theMember of iETRI, serves as the RTA guru on their ETABRTA guru on their ETAB  International registered SAVERInternational registered SAVER instructor by ICETinstructor by ICET  Extrication Tactics columnist FireExtrication Tactics columnist Fire Engineering MagazineEngineering Magazine  Team Captain-World ChampionTeam Captain-World Champion Vehicle Rescue Team 1998Vehicle Rescue Team 1998  Educator- RoadwayRescueEducator- RoadwayRescue
    2. 2. What are we going to talkWhat are we going to talk about?about? •TechnologyTechnology •OperationsOperations •TrendsTrends •SummarySummary •Q & AQ & A
    3. 3. NVTNVT NNewew VVehicleehicle TTechnologyechnology  Vehicle materials, components,Vehicle materials, components, construction and concerns that willconstruction and concerns that will directly impact emergency respondersdirectly impact emergency responders while providing emergency services andwhile providing emergency services and pre hospital care.pre hospital care.  Vehicle materials, components,Vehicle materials, components, construction and concerns that willconstruction and concerns that will directly impact emergency respondersdirectly impact emergency responders while providing emergency services andwhile providing emergency services and pre hospital care.pre hospital care.
    4. 4. SRSSRS SSupplementalupplemental RRestraintestraint SSystemsystems  Occupant protection devicesOccupant protection devices – AirbagsAirbags – Seat belt pretensionersSeat belt pretensioners – Roll over protection devicesRoll over protection devices – GlazingGlazing  Occupant protection devicesOccupant protection devices – AirbagsAirbags – Seat belt pretensionersSeat belt pretensioners – Roll over protection devicesRoll over protection devices – GlazingGlazing
    5. 5.  What do you feel is the biggest concern withWhat do you feel is the biggest concern with vehicles of today?vehicles of today?  Is an airbag “spent” if it has been deployed?Is an airbag “spent” if it has been deployed?  What methods, if any, can be used to ensure yourWhat methods, if any, can be used to ensure your safety at a vehicle related incident and orsafety at a vehicle related incident and or emergency?emergency?  Are there vehicles on the street today that do notAre there vehicles on the street today that do not make any noise when running?make any noise when running?  Do the tool evolutions we’ve learned in the pastDo the tool evolutions we’ve learned in the past work on today’s vehicles?work on today’s vehicles? A Question for you ……A Question for you ……
    6. 6. Pedestrian protection SRS
    7. 7. Take a look!Take a look!
    8. 8. Fuel AdditivesFuel Additives  NOS for gasolineNOS for gasoline  Propane for dieselsPropane for diesels  Towing/performance additiveTowing/performance additive  Fire/Crash related issuesFire/Crash related issues
    9. 9. Shut downShut down  Each vehicle has unique emergencyEach vehicle has unique emergency procedures-however-if you do theprocedures-however-if you do the following 2 actions they will disable thefollowing 2 actions they will disable the HVHV circuitcircuit && disarm/discharge the SRSdisarm/discharge the SRS system(s):system(s): – Turn the key to the OFF position and removeTurn the key to the OFF position and remove the key and keep itthe key and keep it AWAYAWAY from the vehiclefrom the vehicle – Disconnect the 12V battery (both + & -)Disconnect the 12V battery (both + & -)
    10. 10. A Stabilization thought…A Stabilization thought… Ever thought about “run flat” tires..Ever thought about “run flat” tires.. Two thought processesTwo thought processes Solid insertSolid insert Stiffened sidewallStiffened sidewall How low will the tire deflate now?How low will the tire deflate now?
    11. 11. Hybrid 101Hybrid 101  All hybrids start on electric power aloneAll hybrids start on electric power alone  Some travel on electric power alone up toSome travel on electric power alone up to certain speedscertain speeds  HV power is direct current DCHV power is direct current DC  Some hybrids also generate 110 ACSome hybrids also generate 110 AC  HV circuit is self contained – does not groundHV circuit is self contained – does not ground out to the vehicle chassisout to the vehicle chassis  Drivetrain power is computer controlled andDrivetrain power is computer controlled and managedmanaged  A crash and/or a change in voltage in the HVA crash and/or a change in voltage in the HV results in a shutdown of the HV systemresults in a shutdown of the HV system
    12. 12. Hybrid 101Hybrid 101  All Hybrids have a HV drivetrain circuit asAll Hybrids have a HV drivetrain circuit as well as a normal 12v automotive electricwell as a normal 12v automotive electric systemsystem  Gas/Diesel side of drivetrain is loadGas/Diesel side of drivetrain is load dependantdependant  Even when the hybrid is shut down andEven when the hybrid is shut down and secured there will ALWAYS be power in thesecured there will ALWAYS be power in the HV batteryHV battery  As emergency responders there is NO NEEDAs emergency responders there is NO NEED to interact with the HV battery – leave itto interact with the HV battery – leave it alone!alone! 
    13. 13. Stay away fromStay away from BRIGHT ORANGEBRIGHT ORANGE
    14. 14. Use aUse a goodgood cuttingcutting shieldshield
    15. 15. Side impact barsSide impact bars more spreading & cutting may be neededmore spreading & cutting may be needed
    16. 16.  All HybridAll Hybrid models have amodels have a guide forguide for emergencyemergency responders toresponders to deal with variousdeal with various emergenciesemergencies  How to shutHow to shut down, extricationdown, extrication concerns,concerns, firematic &firematic & towing concernstowing concerns
    17. 17. Training ….Training ….
    18. 18.  What are we training on?What are we training on?
    19. 19.  How are you training?How are you training?
    20. 20.  Do you use live patients as part ofDo you use live patients as part of your training?your training?
    21. 21. Material & ConstructionMaterial & Construction  Construction advances don’t preventConstruction advances don’t prevent entrapmententrapment  Entrapped patients require aggressiveEntrapped patients require aggressive managementmanagement Sanson G, et al. Italy, 1999 ; Reines H D, et al. USA, 1988Sanson G, et al. Italy, 1999 ; Reines H D, et al. USA, 1988  Construction advanced do effect majorConstruction advanced do effect major injuryinjury Lie A, et al. Sweden, 2000 ; Segui-Gomez M, et al. Baltimore, 2002Lie A, et al. Sweden, 2000 ; Segui-Gomez M, et al. Baltimore, 2002
    22. 22. B-Post reinforcementB-Post reinforcement
    23. 23. B-Post reinforcementB-Post reinforcement
    24. 24.  CuttingCutting hinges/latches is ahinges/latches is a good tactic todaygood tactic today  Less “stress” onLess “stress” on patientspatients  Can be easier toCan be easier to facilitate thanfacilitate than spreading apartspreading apart  Need to get bladesNeed to get blades around devicearound device  Can the tool do theCan the tool do the job?job? ““Cutting” Hinges/LatchesCutting” Hinges/Latches
    25. 25. ““WHY WE EXTRICATE”WHY WE EXTRICATE” – Physical EntrapmentPhysical Entrapment  Encasement in metalEncasement in metal  Pinned VS TrappedPinned VS Trapped – Nature of Injuries and RestrictedNature of Injuries and Restricted SpaceSpace “Medically Entrapped”“Medically Entrapped”  Making space in order to preventMaking space in order to prevent further injury by manipulating thefurther injury by manipulating the patient during removalpatient during removal
    26. 26. Interior Considerations • Cockpit • Seats? • Seating positions • Vehicle concerns • Injury patterns /considerations • Packaging concerns
    27. 27. Let’s summarize….Let’s summarize….  Safety systems are becoming more wideSafety systems are becoming more wide spread & comprehensivespread & comprehensive  Construction, materials & components willConstruction, materials & components will effect rescue efforts more & moreeffect rescue efforts more & more  Rescue teams will need to “think & workRescue teams will need to “think & work smart”smart”  More background information will be neededMore background information will be needed about vehicles & their componentsabout vehicles & their components  Training issues & concernsTraining issues & concerns

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