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HomeMy WebLinkAboutSOG 204.02A REVISED 2-2014_Vehicle Extrication204.02A — Vehicle/Machinery Extrication Operations Effective. 11/16/2006 Revised: 2/5/2014 Replaces: I. Guiding Philosophy: Operations on busy roadways are inherently dangerous. We recognize, plan and train to manage these risks so that we keep responders as safe as possible. We also recognize the time constraints involved when a person is injured and trapped, striving to be as efficient as possible in extrication operations, so that our mission is achieved. II. Purpose: The purpose of this policy is to establish minimum standards and safety considerations to be followed during vehicle or machinery extrication operations. III. Goals: The goals of this policy are to communicate: A. General safety responsibilities to be followed during extrication operations. B. Standardized guidelines for sizing -up and securing the scene, making preparations for and implementing extrication operations. C. Limitations and expectations for medical treatment at extrication incidents. IV. Definitions: A. Action Area — Large imaginary circle with a radius of 15-30 feet surrounding the rescue zone. The tool staging area will be established in this area. B. Disentanglement — The part of vehicle extrication that relates to the removal and/or manipulation of vehicle components to allow a properly packaged victim to be removed from the vehicle. C. Extrication — Safely and efficiently freeing persons, pets, or livestock from entrapment in land based vehicles of all types. D. Extrication Zone — Area surrounding vehicle where responders are preparing for or performing extrication operations. Access to this area shall be limited only to those firefighters involved in the extrication process and those providing the 13/4" or larger, Class B foam -capable hose line. E. Incident Perimeters — Three areas or zones established around the incident location to allow for a more efficient and safer working environment. F. Parts Dump —This area will be established just outside the action area to dump components removed from the vehicle(s). G. Rescue — Part of vehicle extrication that relates to assessing, stabilizing, protecting, and removing a victim from entrapment. H. Rescue Zone — Imaginary circle with a radius of 10-15 feet around each vehicle(s). This area is to be kept clear of persons not directly involved with the rescue/extrication effort. V. Scene Safety Responsibilities: A. The Incident Commander is responsible for the safety of ALL individuals working in and around the emergency scene. B. All personnel working on the scene shall wear all protective clothing appropriate to the task they are performing. 1. Full protective clothing (PPE) for personnel working in the Rescue Zone or action area. 2. Gloves, helmet and eye protection (face shields down or safety glasses/goggles) must be worn. 3. Reflective safety vests are required for personnel working around the incident scene when not in full PPE. C. A Safety Officer shall be assigned to supervise operations when multiple vehicles requiring extrication are involved. In addition to standard Incident Safety officer duties, the Safety Officer is responsible for: 1. Ensuring proper placement of apparatus to protect personnel working in the area. 2. Maintaining situational awareness of approaching vehicles. 3. Implementing all possible precautions to warn motorists of personnel working in the area. 4. Ensuring adequate law enforcement personnel are present to assist with controlling traffic hazards. D. The Incident Commander shall work with the responding Law Enforcement and EMS and establish a Unified Command to ensure the safety of all personnel on the scene. VI. Size -up & Initial Reporting Responsibilities A. The ranking Officer on the first arriving fire unit is responsible for: 1. Assuming Command. 2. Performing an initial scene size up. 3. Communicating the initial report to responding units and Fire -EMS Communications. B. The size -up should answer the following questions: 1. How many vehicles are involved? 2. How many people are injured, entrapped or ejected? 3. What type vehicles are involved? (Car, truck, 18 wheeler or hybrid vehicle) 4. Is anything on fire? SOG 204.02A — Vehicle Extrication Operations Page 2 of 10 5. Is there any leaking fuel? Is it causing a potential fire or explosion hazard? 6. How stable are the involved vehicles? 7. Are there vehicle safety systems (such as air bags) and have deployed? 8. Are power lines or other electrocution hazards involved? 9. Is there hazardous materials involvement? Could there be? 10. Are there sufficient resources on scene? Responding? C. The initial report should concisely answer the pertinent size -up questions above and recommend the best: 1. Access to the scene, if this is an issue. 2. Placement of responding vehicles and apparatus to support protection of responders and efficient operations. VII. Securing the Scene & Extrication Preparations: A. The Incident Commander shall survey the scene for possible hazards. If utility hazards are present, utility company assistance shall be requested and/or confirmed. B. If additional resources are needed, the Incident Commander should request these as soon as possible. Additional units can always be cancelled if not required. C. Proper scene preparation before beginning operations is critical to overall success. Scene preparation should include but is not limited to: 1. Establishing a tool resource staging area and providing scene lighting when necessary. 2. Eliminating all ignition sources from the area. `he batteries qf all sxhi roles involved shall be disconnected lT power seats. 3. Stopping all fuel leaks, if possible. 4. Establishing an imaginary circle around the vehicle and conducting a walk around the perimeter, looking for victims possibly ejected from the vehicle. NOTE: 'The vial Intagi g C'tir eras (CII.; shrrtrld be irtili ed to locate I ecled pader tr ditring night fityte operations. 5. Initiating vehicle stabilization immediately and prior to any personnel making entry into the vehicle. D. Extrication can only begin AFTER: 1. The vehicle has been properly stabilized. 2. A charged Class B foam -capable pre -connect is positioned. 3. All personnel working in the Extrication Zone (Fire and EMS) have been briefed on the actions that will be undertaken. SOG 204.02A — Vehicle Extrication Operations Page 3 of 10 VIII. Implementing Extrication Operations A. In general, there are three (3) ways of gaining access to victims in vehicles: 1. Through a normal operating door. 2. Through a window. 3. By compromising the body of a vehicle. B. Keep in mind that simpler is better for all concerned; rescuers should try the easiest route available. (Try before you Pry!) C. The vehicle shall be stabilized to provide safety for emergency personnel, to prevent any further injury to patients. Consider deflating tires prior to/or in conjunction with cribbing. D. Before cutting into a vehicle, pry off the interior of AB/C, Peel and Reveal posts to check for the presence of: 1. Compressed gas cylinders 2. Pre -Tensioning devices for supplemental restraint systems 3. High voltage power cables (if the vehicle is a hybrid or all electrical) E. All glass should be removed from areas needing to be cut or pried prior to beginning extrication of patients. F. The extrication of patients shall begin with the appointment of an Extrication Group Supervisor. (The first arriving Company Officer should be considered for this position once a Chief Officer arrives on scene and assumes Command.) G. The Extrication Group Supervisor shall: 1. Establish an Extrication Zone. 2. Determine the most effective and efficient means of extrication. 3. Assemble the Extrication Group to be composed of the Group Supervisor and a minimum of two (2) First Responders trained in vehicle extrication. 4. Insure the safety of the extrication team and other responders working within the Extrication Zone. 5. Manage the extrication process. 6. Communicate with the Incident Commander on progress and resource needs. H. The use of full protective clothing by Fire and EMS shall be enforced when working in the Extrication Zone. (SCBA is an option to be considered by Command, the Extrication Group Supervisor and/or the Safety Officer). IX. Emergency Medical Treatment A. The rendering of emergency first aid shall be limited by the situation present, and is dependent upon the certification, credentialing, training, experience and available personal protective equipment of responders on scene. B. BFR personnel will not attempt to provide medical treatment beyond those skills approved by the Medical Director, as outlined in the BFR SOGs and performance benchmarks. SOG 204.02A — Vehicle Extrication Operations Page 4 of 10 Appendix A: Vehicle Design and Construction A. The massive developments in the area of vehicle safety construction have meant that both extrication techniques and equipment have had to change in order to keep up with the advances from the motor vehicle industry. B. Understanding the anatomy of safety improvements is a never-ending process. Safety features vary widely from year to year in their design and placement among makes and models. For this reason it is essential for rescuers to know how these safety improvements may affect their day-to-day rescue operations. 1. Reinforced wheel and engine deflection systems that, in the case of an impact, deflect the wheels and motor under the car away from the passenger cell. Cutting in this area for a dash roll may be difficult. 2. Crumple zones that absorb the energy of the impact make it possible for occupants of the vehicle to survive collisions they would not have survived a few years ago. 3. The reinforced dashboard was developed to protect the driver and passengers in case of a frontal or side impact. Conventional one-sided dash rolls may be more difficult. 4. Micro -alloy and boron steel are used for improved strength -to -weight ratio. Door removal will be more difficult if the impact bars are driven into the frame by impact. Located in the steering wheel, dashboard, and now any combination of the doors, seats, roof rails and even some seat belt systems, airbags present several challenges. Un -deployed airbags may bind an out-of-date cutter. Knowing which designs are electronically or mechanically activated is critical. Hazards include difficulty in identifying location of bags, sensors and the control module, accidental deployment during rescue, and accidental exposure of wiring chemicals. 6. Frame materials — To compensate for weight increase due to added safety features car manufacturers use High -Strength Low -Alloy (HSLA) or even Ultra High - Strength Low Alloy (UHSLA) steel to reinforce roof and pillar structures. 7. Side and rear window glass — Tempered glass is sometimes replaced in side and rear windows by laminated glass or rigid plastics, which unlike tempered glass, are highly resistant to "breaking" in the traditional sense of the word, and present a formidable barrier inag ining access to patients. Seatbelt pre-tensioners and G -Force limiters are designed to reduce blunt trauma as well as impact with airbags. Seatbelt pre-tensioners are activated by either a spring mechanism or an explosive charge. Their accidental deployment during extrication can cause serious injury to rescuers and patients. 9. Body materials —High -impact plastic, carbon fiber, aluminum and other composite materials are replacing sheet metal in all or parts of the exterior bodies. SOG 204.02A — Vehicle Extrication Operations Page 5 of 10 Plastic crumples or shatters instead of bending making it hard to find a sufficient purchase point for leverage. Composite materials can be difficult to cut. Carbon fiber is also hard to cut, and both its dust particles and combustion by-products are hazardous. C. Passive Safety Systems 1. Frontal Impact Airbags: designed to deploy in the event of a frontal impact these bags are commonly located in the steering wheel and various dash board locations. All airbag systems are not alike but do contain similar components. Exact location, volume and mechanism of deployment of the frontal airbag systems varies from manufacturer to manufacturer. Newer frontal airbag systems include the use of dual stage inflators. These dual stage airbags are designed to adjust the force of inflation according to such parameters as occupant position, crash severity, and seat belt usage. 2. Side Impact Airbags: side impact airbags will either be mounted in the door, in the seat edge closest to the door, or in the roof rails (inflatable curtain or tubular type). It is extremely important to avoid crushing areas that contain live airbags, sensors, or cutting through hidden bag inflators. 3. Pre-tensioners Pre-tensioners should be treated with the same amount of caution as you would when working around airbags. Taking the medical condition of the patient into consideration, removal of the seatbelt as soon as possible is recommended. Accidental triggering of the system will then not cause increased injury to the patient. Special consideration should be given to these systems when flammable liquids or vapors are present. There are four main locations for the pre -tensioning system: lower B pillar, mid B pillar, inner front seatbelt buckle area and rear deck area. 1nftk11 5ta;t,P, Pr tens-ib:srr Ope ate SOG 204.02A — Vehicle Extrication Operations Page 6 of 10 dry% &*r4iu7q ;, SOG 204.02A — Vehicle Extrication Operations Page 6 of 10 4. G-force limiters G-force limiters are built into most seatbelt systems with pre-tensioners. They allow some leeway in the belt at a certain point in the collision timeline. This decreases the effect of the internal injury by reducing the amount of deceleration and thus the amount of G-force acting on the body. 5. Crumple zones These are zones in the car body and chassis developed to absorb the impact energy of a collision and to prevent energy from being absorbed into the passenger cell and thus into the occupants of the vehicle. The use of crumple zones has dramatically increased the ability of vehicle occupants to survive massive impacts. Ironically, these very crumple zones that increase survivability can complicate rescue efforts, due to the strength of the deformed metal structures. 6. Battery Locations The most common battery location is in the engine compartment of most passenger vehicles. However it is important to be aware that some new vehicle designs make use of alternative locations. These alternative locations include but are not limited to the following: a. Under the rear passenger seat b. In the trunk c. In the front wheel well SOG 204.02A — Vehicle Extrication Operations Page 7 of 10 Appendix B: Vehicle Collision Kinetics A. Metal that is bent (flexion), stretched (tension), or twisted (torsion) requires caution when cutting or spreading as rapid, unexpected movement may occur. The rescuer must understand the mechanical reactions and potential reactions in the body of a vehicle that occurs due to the deformations of the car after a collision. To work effectively it is often necessary to eliminate the unstable or potential elastic points in order to avoid an unwanted return of material during cutting or spreading. It is necessary to find the stable points that will serve as a solid base on which spreading tools can be positioned. In cases where there are no hard Points, you must create them by installing a support. B. Types of Vehicle Collisions 1. Frontal Collisions Modern safety systems make it more likely that occupants of vehicles will survive major impacts. The challenges that rescuers face in frontal collisions include the reinforced dashboard area as well as the side impact bars mounted in the doors that will very often be pushed backward or forward further jamming the door. 2. Side Impact Side impacts result in high mortality rates as there is so little space between the outside of the vehicle and its occupants. In most cases deformation of the passenger cell results in very little space in which to work around the patient. When possible, concentration of extrication efforts on the undamaged side will often allow for a more effective extrication. 3. Roll Over Collisions In these cases the most important aspect of a good extrication is proper stabilization. Extrication may be further complicated if the occupants of the car are lying in awkward positions or suspended from restraint devices. It is particularly important in this type of crash that movement of the patient is minimized. 4. Under Runs and Crush Incidents Extremely confined working space and in many cases complicated entrapment make these types of incidents very difficult to handle safely. It should be remembered that good stabilization of the crushing load is paramount and that heavy lifting operations may need to be performed. Rescue activities may affect stabilization. For this reason, stabilization must be continually monitored as the extrication progresses. Shoring devices may enhance stabilization efforts. 7 SOG 204.02A — Vehicle Extrication Operations Page 8 of 10 Appendix C: Specific Newer Vehicle Hazards A. Cutting the Seats Many new design vehicles have airbag components mounted in the seats' upholstery. Airbag sensors, mini gas cylinders, and in some case airbags themselves should not be cut through. To avoid this first always remove the upholstery with a knife to investigate for hazards before cutting through with a hydraulic cutter. B. Cutting the Pillars/Posts Various pillars contain components that should be in C avoided. Reinforcement for the mounting of the seatbelts can cause damage to cutter blades. Seatbelt pre-tensioner systems can also damage "� hydraulic cutters. The most hazardous however is to cut into an airbag inflator. This can be very dangerous as the release of the compressed gas inside the cylinder or fragment of the cylinder itself can cause serious injury. For these reasons, it is imperative that we always expose and investigate pillars before we cut through them. It is also advisable to use a flexible cutting shield for patient protection during any cutting. This will protect against the tools slipping as well as providing some protection against exploding cylinders in the unlikely event that they have not been seen. C. Automatic Roll -Over Protection Systems (ROPS) These systems deploy as the vehicle begins to roll over. They are typically stowed behind the seats in the rear deck area where cervical spinal management often takes place. This presents a significant risk to rescuers and emergency care providers if deployment accidentally occurs during rescue efforts. Steps to controlling this hazard are disconnection of the battery where possible and avoiding the deployment path. SOG 204.02A — Vehicle Extrication Operations Page 9 of 10 Appendix D: Gasoline -Electric Hybrid Vehicles A. Hybrid vehicles make use of both an electric motor and a gasoline engine for vehicle propulsion. Electric power is used for low speed movement and is powered by a high voltage battery pack, typically located in the rear of the vehicle. B. In Hybrid vehicles, high voltage cables are identifiable by orange insulation and connectors. While you need to be aware of these cables, they are routed underneath and inboard the floor pan reinforcement, in an area that is not generally accessed by rescue personnel. C. It is important to note that hybrid vehicles, which may appear to be inactive when the gasoline engine is not running, may still be in the "ready state" and capable of motion at any time. To prevent this from happening, in addition to disconnecting the twelve volt battery, rescue personnel should also check to make sure the main i'-nition switch is turned to the off position and the key is removed disabling the electronic drive system. D. Never touch, cut or open any high voltage power cable or high voltage components! E. Except for the precautions as noted above, hybrid vehicles may be approached using standard vehicle extrication principles and techniques. Additional information can be obtained from rescuer's guides published by the various vehicle manufacturers. 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