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?
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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
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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.
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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.
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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.
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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.
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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.
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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
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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
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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.
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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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