"Best Practices" Vehicle Rescue
 
"Best Practices" Vehicle Rescue
Me? David Dalrymple 26 years in emergency services Career- RWJUH EMS Volunteer- Clinton EMS/Rescue Rescue Instructor for 16 years- Vehicle Rescue is my specialty TERC US – Education Chair International certified Extrication judge-judged & lectured in US, Canada, UK, Europe & SA 2007 Harvey Grant award recipient International registered SAVER instructor by ICET Extrication Tactics columnist Fire Engineering Magazine Team Captain-World Champion Vehicle Rescue Team 1998 Educator- RoadwayRescue
NVT   N ew  V ehicle  T echnology Vehicle materials, components, construction and concerns that will directly impact emergency responders while providing emergency services and pre hospital care.
 
 
 
Command & Control
Command & Control Officer identifies any NVT concerns and/or issues. Communicates information to the crew  Ensures all personnel are aware of hazard(s) Officer identifies & documents debris containing NVT hazard(s).
Access to NVT information is during training & scene operations.
 
 
All Hybrid models have a guide for emergency responders to deal with various emergencies How to shut down, extrication concerns, firematic & towing concerns ERG Emergency Response Guide
Safety
Safety All personnel, especially those performing size up & evaluation, inspect vehicles completely for NVT concerns/hazards. Such hazards, when identified, are communicated to the rest of the crew
Space is observed as possible when interacting with SRS and patients.
 
DUAL STAGE
 
 
 
 
 
 
 
2011 Ford Rear Seatbelt SRS
 
As part of power isolation, the vehicle is shut down & keys removed & secured. Such action is documented.
Shut down Each vehicle has unique emergency procedures-however-if you do the following 2 actions they will disable the  HV circuit  &  disarm/discharge the SRS system(s): Turn the key to the OFF position and remove the key and keep it  AWAY  from the vehicle Disconnect the 12V battery (both + & -)
Vehicle Pwr Button No Mechanical  Key System
Where are the keys?
 
 
 
40% of batteries live outside engine compartment
 
Power Shut Down ASAP!
When severing wires, use of a hand cutter – not a power hydraulic cutter – is indicated.
Cut wiring with a HAND cutter-not a power hydraulic tool!
Interior trim is displaced to evaluate if potential NVT hazards are present. If such hazards are present their identification is made to the entire crew & documented.
 
 
 
Where do we cut?
When vehicle components are displaced/removed care is given due to potential NVT concerns.
 
 
Use of pertinent personal protective equipment at all times.
 
Use of respiratory protection is required when performing glass management.
 
 
 
Tool Usage/Evolutions
Rescuer Safety – Tool Handling Always be situationally aware DO NOT get between the vehicle & tools -  Especially power hydraulics! Always unplug electric tools prior blade/bit changes! Treat air chisels as a loaded gun when pressurized Watch where your hands/arms/feet are at all times Warn interior rescuer when operating tools that will intrude and/or have effect on patient care Always use a tool-not your hands-when removing glass
Management of vehicle stabilization during the incident and especially during tool operations.
 
A Stabilization thought… Ever thought about “run flat” tires.. Two thought processes Solid insert Stiffened sidewall How low will the tire deflate now?
Attention given to appropriate space making evolutions in relation to patient care/outcome.
“ WHY WE EXTRICATE”   Physical Entrapment Encasement in metal Pinned VS Trapped Nature of Injuries and Restricted Space  “Medically Entrapped” Making space in order to prevent further injury by manipulating the patient during removal
Interior Considerations Cockpit Seats? Seating positions Vehicle concerns Injury patterns /considerations Packaging concerns Safety/protection
Creating Space Medically entrapped = space needed Creating Space is important Creating Space is your insurance that no further harm will done to the patient Think Space to…… Have adequate room to work Have adequate room to provide patient care Have adequate room to properly remove the patient
Door pop or side removal Is this enough space today?
Rescue Real Estate concept Who "owns" what on the vehicle Engine Co Hazard control Rescue Team Extrication EMS Patient Care
Whenever using tools in the area of the passenger cell appropriate protective barriers are placed between the patient(s) and the interior rescuer.
 
Use of strategic cutting evolutions to enhance space making operations.
Cutting hinges/latches is a good tactic today Less “stress” on patients Can be easier to facilitate than spreading apart Need to get blades around device Can the tool do the job? “ Cutting” Hinges/Latches
 
 
When performing tool operations, you need have both spreading & cutting tools available & ready for use.
Door “Shred” “ Outer” door materials tear easy When they do, they leave little to push against We need to get the spreader tips past the hinges/latch to minimize tear Have cutters ready to go
Concern given to cutting material(s) with possible NVT concerns with respective tools
Material & Construction Construction advances don ’ t prevent entrapment Entrapped patients require aggressive management  Construction advanced do effect major injury
B-Post reinforcement
B-Post reinforcement
Carbon Fiber Body Panels
 
 
Care & concern given to vehicle design and component concerns in relation to space making.
Crush Zones
 
What tool Evolutions will be difficult? Does this look familiar?
 
70% of incidents Hybrids & Alternative Fueled Vehicles
 
Stay away from BRIGHT ORANGE CABLE
Stay away from BRIGHT BLUE cable!
Review - Hybrid 101 All hybrids start on electric power alone Some travel on electric power alone up to certain speeds HV power is direct current DC Some hybrids also generate 110 AC HV circuit is self contained – does not ground out to the vehicle chassis Drivetrain power is computer controlled and managed Gas/Diesel side of drivetrain is load dependant All Hybrids have a HV drivetrain circuit as well as a normal 12v automotive electric system Even when the hybrid is shut down and secured there will ALWAYS be power in the HV battery As emergency responders there is NO NEED to interact with the HV battery – leave it alone! Crayola colors to remember > bright orange = HV power Bright blue = “intermediate” HV power (GM products)
Impact disarms Hi-Voltage
Tool Evolutions are NOT an issue!
2010 Prius Solar Roof Use caution in cutting/spreading  in this area if curtain is undeployed
 
 
 
 
 
Let’s summarize…. Safety systems are more wide spread & comprehensive Construction, materials & components will impact rescue efforts more & more Motive power will make dramatic strides in the next 33-38 months Rescue teams will need to “think & work smart”  “ Silent”cars are NOT just hybrids and electrics More background information will be needed about vehicles & their components Vehicle size issues Training issues & concerns
 
In the time we have spent together today 172 people have died in road traffic accidents worldwide

Best practices in vehicle rescue fdic 2010 pp03

  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
    Me? David Dalrymple26 years in emergency services Career- RWJUH EMS Volunteer- Clinton EMS/Rescue Rescue Instructor for 16 years- Vehicle Rescue is my specialty TERC US – Education Chair International certified Extrication judge-judged & lectured in US, Canada, UK, Europe & SA 2007 Harvey Grant award recipient International registered SAVER instructor by ICET Extrication Tactics columnist Fire Engineering Magazine Team Captain-World Champion Vehicle Rescue Team 1998 Educator- RoadwayRescue
  • 6.
    NVT N ew V ehicle T echnology Vehicle materials, components, construction and concerns that will directly impact emergency responders while providing emergency services and pre hospital care.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
    Command & ControlOfficer identifies any NVT concerns and/or issues. Communicates information to the crew Ensures all personnel are aware of hazard(s) Officer identifies & documents debris containing NVT hazard(s).
  • 12.
    Access to NVTinformation is during training & scene operations.
  • 13.
  • 14.
  • 15.
    All Hybrid modelshave a guide for emergency responders to deal with various emergencies How to shut down, extrication concerns, firematic & towing concerns ERG Emergency Response Guide
  • 16.
  • 17.
    Safety All personnel,especially those performing size up & evaluation, inspect vehicles completely for NVT concerns/hazards. Such hazards, when identified, are communicated to the rest of the crew
  • 18.
    Space is observedas possible when interacting with SRS and patients.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
    2011 Ford RearSeatbelt SRS
  • 29.
  • 30.
    As part ofpower isolation, the vehicle is shut down & keys removed & secured. Such action is documented.
  • 31.
    Shut down Eachvehicle has unique emergency procedures-however-if you do the following 2 actions they will disable the HV circuit & disarm/discharge the SRS system(s): Turn the key to the OFF position and remove the key and keep it AWAY from the vehicle Disconnect the 12V battery (both + & -)
  • 32.
    Vehicle Pwr ButtonNo Mechanical Key System
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
    40% of batterieslive outside engine compartment
  • 38.
  • 39.
  • 40.
    When severing wires,use of a hand cutter – not a power hydraulic cutter – is indicated.
  • 41.
    Cut wiring witha HAND cutter-not a power hydraulic tool!
  • 42.
    Interior trim isdisplaced to evaluate if potential NVT hazards are present. If such hazards are present their identification is made to the entire crew & documented.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
    When vehicle componentsare displaced/removed care is given due to potential NVT concerns.
  • 48.
  • 49.
  • 50.
    Use of pertinentpersonal protective equipment at all times.
  • 51.
  • 52.
    Use of respiratoryprotection is required when performing glass management.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
    Rescuer Safety –Tool Handling Always be situationally aware DO NOT get between the vehicle & tools - Especially power hydraulics! Always unplug electric tools prior blade/bit changes! Treat air chisels as a loaded gun when pressurized Watch where your hands/arms/feet are at all times Warn interior rescuer when operating tools that will intrude and/or have effect on patient care Always use a tool-not your hands-when removing glass
  • 58.
    Management of vehiclestabilization during the incident and especially during tool operations.
  • 59.
  • 60.
    A Stabilization thought…Ever thought about “run flat” tires.. Two thought processes Solid insert Stiffened sidewall How low will the tire deflate now?
  • 61.
    Attention given toappropriate space making evolutions in relation to patient care/outcome.
  • 62.
    “ WHY WEEXTRICATE” Physical Entrapment Encasement in metal Pinned VS Trapped Nature of Injuries and Restricted Space “Medically Entrapped” Making space in order to prevent further injury by manipulating the patient during removal
  • 63.
    Interior Considerations CockpitSeats? Seating positions Vehicle concerns Injury patterns /considerations Packaging concerns Safety/protection
  • 64.
    Creating Space Medicallyentrapped = space needed Creating Space is important Creating Space is your insurance that no further harm will done to the patient Think Space to…… Have adequate room to work Have adequate room to provide patient care Have adequate room to properly remove the patient
  • 65.
    Door pop orside removal Is this enough space today?
  • 66.
    Rescue Real Estateconcept Who "owns" what on the vehicle Engine Co Hazard control Rescue Team Extrication EMS Patient Care
  • 67.
    Whenever using toolsin the area of the passenger cell appropriate protective barriers are placed between the patient(s) and the interior rescuer.
  • 68.
  • 69.
    Use of strategiccutting evolutions to enhance space making operations.
  • 70.
    Cutting hinges/latches isa good tactic today Less “stress” on patients Can be easier to facilitate than spreading apart Need to get blades around device Can the tool do the job? “ Cutting” Hinges/Latches
  • 71.
  • 72.
  • 73.
    When performing tooloperations, you need have both spreading & cutting tools available & ready for use.
  • 74.
    Door “Shred” “Outer” door materials tear easy When they do, they leave little to push against We need to get the spreader tips past the hinges/latch to minimize tear Have cutters ready to go
  • 75.
    Concern given tocutting material(s) with possible NVT concerns with respective tools
  • 76.
    Material & ConstructionConstruction advances don ’ t prevent entrapment Entrapped patients require aggressive management Construction advanced do effect major injury
  • 77.
  • 78.
  • 79.
  • 80.
  • 81.
  • 82.
    Care & concerngiven to vehicle design and component concerns in relation to space making.
  • 83.
  • 84.
  • 85.
    What tool Evolutionswill be difficult? Does this look familiar?
  • 86.
  • 87.
    70% of incidentsHybrids & Alternative Fueled Vehicles
  • 88.
  • 89.
    Stay away fromBRIGHT ORANGE CABLE
  • 90.
    Stay away fromBRIGHT BLUE cable!
  • 91.
    Review - Hybrid101 All hybrids start on electric power alone Some travel on electric power alone up to certain speeds HV power is direct current DC Some hybrids also generate 110 AC HV circuit is self contained – does not ground out to the vehicle chassis Drivetrain power is computer controlled and managed Gas/Diesel side of drivetrain is load dependant All Hybrids have a HV drivetrain circuit as well as a normal 12v automotive electric system Even when the hybrid is shut down and secured there will ALWAYS be power in the HV battery As emergency responders there is NO NEED to interact with the HV battery – leave it alone! Crayola colors to remember > bright orange = HV power Bright blue = “intermediate” HV power (GM products)
  • 92.
  • 93.
    Tool Evolutions areNOT an issue!
  • 94.
    2010 Prius SolarRoof Use caution in cutting/spreading in this area if curtain is undeployed
  • 95.
  • 96.
  • 97.
  • 98.
  • 99.
  • 100.
    Let’s summarize…. Safetysystems are more wide spread & comprehensive Construction, materials & components will impact rescue efforts more & more Motive power will make dramatic strides in the next 33-38 months Rescue teams will need to “think & work smart” “ Silent”cars are NOT just hybrids and electrics More background information will be needed about vehicles & their components Vehicle size issues Training issues & concerns
  • 101.
  • 102.
    In the timewe have spent together today 172 people have died in road traffic accidents worldwide

Editor's Notes

  • #77 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