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Barry Kidd 2010 1
Vehicle Extrication
Barry Kidd 2010 2
Overview
What is Vehicle Extrication?
• EMR’s role in extrication
• The different groups involved in
vehicle extrication
• Hazards involved in extrication
• Types of extrication
• Airbags
Barry Kidd 2010 3
Vehicle Extrication
The process of
removing
patient(s) from a
vehicle who have
been involved in an
accident
Barry Kidd 2010 4
Vehicle Extrication
Why is vehicle extrication an
important skill?
 Since NO TWO accidents are the
same, it is important to possess the
knowledge required to extricate
patients quickly and safely
Barry Kidd 2010 5
Vehicle Extrication
Remember…
The important thing when
approaching a motor vehicle crash
(MVC) is:
 DO NOT put yourself in a position
where you can be injured!!
􀃎 PERSONAL SAFETY!!
Barry Kidd 2010 6
Role of the Emergency Medical
Responder
Remember, use what resources are
available to you!
If you are alone on scene, your
FIRST PRIORITY is you and your
patients safety!!
Barry Kidd 2010 7
Role of the Emergency Medical
Responder
Once scene safety has been
determined, several things must be
accomplished:
 Assess Scene
 Assess Vehicle Damage
 Attempt to gain access to patient
 Provide treatment to patient
 Control Scene
Barry Kidd 2010 8
Assess Scene
 Ensure scene safety!!
 Determine mechanism of injury
 Determine number of patients involved
 Is there a need for additional resources:
 Additional ambulances
 Fire Department
 Police
Barry Kidd 2010 9
Assess Vehicle Damage
Damage to the vehicle, is an effective to determine what
injuries a patient may have received.
For example, if most of the damage is to the driver’s side
door, what injuries will the patient likely have?
 Fractured Pelvis
 Fractured Ribs
 Spinal Injuries
 Extremity Injuries
Assessing vehicle damage is especially important, if the
patient is unconscious or you have a small child who is
unable to communicate
Barry Kidd 2010 10
Assess Vehicle Damage
Barry Kidd 2010 11
Attempt to Gain Access to
Patient
Vehicles which are involved in Motor
Vehicle Crashes (MVC), may be in any
position.
Before trying to access any patients,
ensure the vehicle is stable, and there are
no dangerous fluids leaking
If any dangers are present, WAIT for the
fire department to arrive!
Barry Kidd 2010 12
Attempt to Gain Access to
Patient
Barry Kidd 2010 13
Attempt to Gain Access to
Patient
If the vehicle is
safe, try to reach
the patient(s) via
simple access
Open car doors, it
is important to try
all doors!
Barry Kidd 2010 14
Attempt to Gain Access to
Patient
Enter through
windows. Make
sure to clear away
all glass from the
frame before
entering the
vehicle!
Barry Kidd 2010 15
Provide Treatment to Patient
Once you have gained access to the
patient, the first thing you should do
is
CONTROL C-SPINE
Barry Kidd 2010 16
Control Scene
If you are unable to gain access to
the patient, or there is more then
two EMRs on scene, it is your
responsibility to ensure the scene
around the vehicle is safe for the
patient
Barry Kidd 2010 17
Groups Involved in Vehicle
Extrication
Police, Fire (EMO),
and Ambulance
work together to
control the scene,
extricate the
patient, and
provide
appropriate
emergency care
Barry Kidd 2010 18
Hazards Involved in Extrication
The following list of hazards are important
to be aware of, when dealing with a motor
vehicle crash (MVC):
 Vehicle
 Traffic
 Weather
 Other (H.O.M.E.)
Barry Kidd 2010 19
Vehicle Hazards
Several hazards can originate from the
vehicle while assessing the scene you need
to watch for:
 Leaking fluids - Battery Acid, Gasoline
 Unstable vehicle
 Charged Bumper – difficult to determine,
avoid working near bumpers if possible
Barry Kidd 2010 20
Traffic Hazards
If a Motor Vehicle
Crash (MVC) occurs
on a highway or any
other busy road, it is
important to remain
as visible as possible.
Wear bright clothing
to increase your
chances of being
seen!
Barry Kidd 2010 21
Weather Hazards
Extremes in weather can pose a
serious threat to both the EMR and
the patient.
Exposure to heat or cold can be a
serious threat.
Attempt to keep the patient and
yourself as warm or cool as possible
Barry Kidd 2010 22
Other Hazards
Structures such as
power lines, gas
lines etc. that have
been struck by a
vehicle can pose a
threat to the EMR
and the patient.
NEVER approach a
vehicle that may
be in contact with
a downed line!!
Barry Kidd 2010 23
Types of Extrication
Types of extrication are dictated
mostly by either the condition of the
patient, or the condition of the
vehicle.
There are generally two types of
extrication used in the pre-hospital
setting:
 Kendrick Extrication Device (KED)
 Rapid Extrication
Barry Kidd 2010 24
Kendrick Extrication Device
(KED)
One of the most under
used pieces of spinal
equipment.
All EMRs are trained
to use the KED and it
is important be well
practiced and familiar
with this device
Barry Kidd 2010 25
Rapid Extrication
Barry Kidd 2010 26
Rapid Extrication
First Step:
 Maintain manual C-spine
Second Step:
 Move patient into a neutral, in-line
position
Third Step:
 􀃎Measure and apply C-collar
Barry Kidd 2010 27
Rapid Extrication
Fourth Step:
 Place spine board under patient as far as
possible
Fifth Step:
 Move patient on to spine board
Sixth Step:
 Maintain C-spine throughout the process
Barry Kidd 2010 28
Airbags
Typically vehicles have three sensors
that detect rapid deceleration during
a collision.
At least two out of three sensors
must be activated for the airbag to
deploy
Barry Kidd 2010 29
Airbags
EMRs and other EMS practitioners need to
be aware of:
 If there is significant damage to the front
end of the vehicle, and the airbag has not
deployed, NEVER position yourself
between the steering column and the
patient
Serious injury or DEATH can
occur if struck by an airbag
Barry Kidd 2010 30
Airbags
Did you know…
 Many newer vehicles may have up
to 10 airbags!
 An airbag can generate enough
force to propel a 200 pound person
six feet off the ground!
 Airbags deploy at a speed of 200
mph or 320km/hr!
Barry Kidd 2010 31
Barry Kidd 2010 32
Airbags
Barry Kidd 2010 33
Airbags
Barry Kidd 2010 34
Conclusion
 What is Vehicle Extrication?
 What is an EMRs role in extrication?
 What are the different groups involved
in vehicle extrication?
 What are the hazards involved in
extrication?
 What are the two types of extrication?
 What are airbags?
Barry Kidd 2010 35
ANY QUESTIONS?

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Vehicle extrication

  • 1. Barry Kidd 2010 1 Vehicle Extrication
  • 2. Barry Kidd 2010 2 Overview What is Vehicle Extrication? • EMR’s role in extrication • The different groups involved in vehicle extrication • Hazards involved in extrication • Types of extrication • Airbags
  • 3. Barry Kidd 2010 3 Vehicle Extrication The process of removing patient(s) from a vehicle who have been involved in an accident
  • 4. Barry Kidd 2010 4 Vehicle Extrication Why is vehicle extrication an important skill?  Since NO TWO accidents are the same, it is important to possess the knowledge required to extricate patients quickly and safely
  • 5. Barry Kidd 2010 5 Vehicle Extrication Remember… The important thing when approaching a motor vehicle crash (MVC) is:  DO NOT put yourself in a position where you can be injured!! 􀃎 PERSONAL SAFETY!!
  • 6. Barry Kidd 2010 6 Role of the Emergency Medical Responder Remember, use what resources are available to you! If you are alone on scene, your FIRST PRIORITY is you and your patients safety!!
  • 7. Barry Kidd 2010 7 Role of the Emergency Medical Responder Once scene safety has been determined, several things must be accomplished:  Assess Scene  Assess Vehicle Damage  Attempt to gain access to patient  Provide treatment to patient  Control Scene
  • 8. Barry Kidd 2010 8 Assess Scene  Ensure scene safety!!  Determine mechanism of injury  Determine number of patients involved  Is there a need for additional resources:  Additional ambulances  Fire Department  Police
  • 9. Barry Kidd 2010 9 Assess Vehicle Damage Damage to the vehicle, is an effective to determine what injuries a patient may have received. For example, if most of the damage is to the driver’s side door, what injuries will the patient likely have?  Fractured Pelvis  Fractured Ribs  Spinal Injuries  Extremity Injuries Assessing vehicle damage is especially important, if the patient is unconscious or you have a small child who is unable to communicate
  • 10. Barry Kidd 2010 10 Assess Vehicle Damage
  • 11. Barry Kidd 2010 11 Attempt to Gain Access to Patient Vehicles which are involved in Motor Vehicle Crashes (MVC), may be in any position. Before trying to access any patients, ensure the vehicle is stable, and there are no dangerous fluids leaking If any dangers are present, WAIT for the fire department to arrive!
  • 12. Barry Kidd 2010 12 Attempt to Gain Access to Patient
  • 13. Barry Kidd 2010 13 Attempt to Gain Access to Patient If the vehicle is safe, try to reach the patient(s) via simple access Open car doors, it is important to try all doors!
  • 14. Barry Kidd 2010 14 Attempt to Gain Access to Patient Enter through windows. Make sure to clear away all glass from the frame before entering the vehicle!
  • 15. Barry Kidd 2010 15 Provide Treatment to Patient Once you have gained access to the patient, the first thing you should do is CONTROL C-SPINE
  • 16. Barry Kidd 2010 16 Control Scene If you are unable to gain access to the patient, or there is more then two EMRs on scene, it is your responsibility to ensure the scene around the vehicle is safe for the patient
  • 17. Barry Kidd 2010 17 Groups Involved in Vehicle Extrication Police, Fire (EMO), and Ambulance work together to control the scene, extricate the patient, and provide appropriate emergency care
  • 18. Barry Kidd 2010 18 Hazards Involved in Extrication The following list of hazards are important to be aware of, when dealing with a motor vehicle crash (MVC):  Vehicle  Traffic  Weather  Other (H.O.M.E.)
  • 19. Barry Kidd 2010 19 Vehicle Hazards Several hazards can originate from the vehicle while assessing the scene you need to watch for:  Leaking fluids - Battery Acid, Gasoline  Unstable vehicle  Charged Bumper – difficult to determine, avoid working near bumpers if possible
  • 20. Barry Kidd 2010 20 Traffic Hazards If a Motor Vehicle Crash (MVC) occurs on a highway or any other busy road, it is important to remain as visible as possible. Wear bright clothing to increase your chances of being seen!
  • 21. Barry Kidd 2010 21 Weather Hazards Extremes in weather can pose a serious threat to both the EMR and the patient. Exposure to heat or cold can be a serious threat. Attempt to keep the patient and yourself as warm or cool as possible
  • 22. Barry Kidd 2010 22 Other Hazards Structures such as power lines, gas lines etc. that have been struck by a vehicle can pose a threat to the EMR and the patient. NEVER approach a vehicle that may be in contact with a downed line!!
  • 23. Barry Kidd 2010 23 Types of Extrication Types of extrication are dictated mostly by either the condition of the patient, or the condition of the vehicle. There are generally two types of extrication used in the pre-hospital setting:  Kendrick Extrication Device (KED)  Rapid Extrication
  • 24. Barry Kidd 2010 24 Kendrick Extrication Device (KED) One of the most under used pieces of spinal equipment. All EMRs are trained to use the KED and it is important be well practiced and familiar with this device
  • 25. Barry Kidd 2010 25 Rapid Extrication
  • 26. Barry Kidd 2010 26 Rapid Extrication First Step:  Maintain manual C-spine Second Step:  Move patient into a neutral, in-line position Third Step:  􀃎Measure and apply C-collar
  • 27. Barry Kidd 2010 27 Rapid Extrication Fourth Step:  Place spine board under patient as far as possible Fifth Step:  Move patient on to spine board Sixth Step:  Maintain C-spine throughout the process
  • 28. Barry Kidd 2010 28 Airbags Typically vehicles have three sensors that detect rapid deceleration during a collision. At least two out of three sensors must be activated for the airbag to deploy
  • 29. Barry Kidd 2010 29 Airbags EMRs and other EMS practitioners need to be aware of:  If there is significant damage to the front end of the vehicle, and the airbag has not deployed, NEVER position yourself between the steering column and the patient Serious injury or DEATH can occur if struck by an airbag
  • 30. Barry Kidd 2010 30 Airbags Did you know…  Many newer vehicles may have up to 10 airbags!  An airbag can generate enough force to propel a 200 pound person six feet off the ground!  Airbags deploy at a speed of 200 mph or 320km/hr!
  • 32. Barry Kidd 2010 32 Airbags
  • 33. Barry Kidd 2010 33 Airbags
  • 34. Barry Kidd 2010 34 Conclusion  What is Vehicle Extrication?  What is an EMRs role in extrication?  What are the different groups involved in vehicle extrication?  What are the hazards involved in extrication?  What are the two types of extrication?  What are airbags?
  • 35. Barry Kidd 2010 35 ANY QUESTIONS?