Vehicle Extrication Chapter 1

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Questions and Answers

Define extrication.

Extrication is the removal and treatment of a patient(s) trapped by machinery or equipment.

What are the phases of extrication? Choose the correct option.

Prevention & Mitigation

Hazard Assessment & Size-up; Hazard Control & Incident Stabilization; Gaining Access & Patient Assessment; Disentanglement; Patient Packaging; Extrication (correct)

Incident Detection & Reporting

Patient Treatment & Recovery

What are the two criteria that define the success of an extrication operation?

Effectiveness and Safety

Rescue involves placing a patient in an untenable or unhealthy situation. True or False?

False Signup and view all the answers

Define AHJ and SOPs/SOGs. AHJ stands for ___________.

Authority having jurisdiction Signup and view all the answers

Which standards relate to managing an extrication incident?

NFPA 1670 Signup and view all the answers

Operational assignments for personnel should consider competence, physical strength, and emotional stability.

True Signup and view all the answers

HSPD-5 directs federal, state, local, and tribal entities to operate with the NIMS-ICS system to ensure an incident management system will interface with _______ response agencies during an emergency.

outside Signup and view all the answers

Match the extrication group with their responsibilities:

Rescue Group = Vehicle stabilization, Patient access actions, Patient stabilization, Disentanglement, Packaged patient removal Law Enforcement Group = Traffic control, Crowd control, Investigation of accident/incident root-cause EMS Group = Evaluating (triage), treatment, & transportation of patients, Initiate treatment as soon as it can be done safely, Works with Rescue Group Fire Suppression Group = Fire protection for the incident, Controlling ignition & various energy sources, On-scene protection for rescue/extrication crews, patients, EMS personnel and others working in or around the hot zone Signup and view all the answers

What is the purpose of After Action Reviews?

Improve organizational operations and processes Signup and view all the answers

Which of the following are types of respiratory equipment commonly used at rescue/extrication emergencies?

PAPR – Powered Air Purifying Respirator Signup and view all the answers

Rescuers must develop the skills necessary for safe extrication. They should resist the urge to rush in and instead ______________ safety needs.

understand Signup and view all the answers

Size-up is defined as a one-time evaluation process of the incident and response efforts.

False Signup and view all the answers

What are some of the risks managed by rescuers during a rescue/extrication operation?

Training & experience of responders, probable outcomes for the actions considered, equipment reliability & application, built-in procedural safety margins Signup and view all the answers

What is the incident's medical component focused on?

Triage, treatment, transportation Signup and view all the answers

______ilitation stations should be established at every prolonged operation due to heavy labor, environmental conditions, accumulated activity, and other health & safety factors.

Rehab Signup and view all the answers

Incident Safety Officers (ISO) are required during extrication operations for ongoing assessment of incident actions and conditions.

True Signup and view all the answers

Match the following elements of emergency extrication response with their descriptions:

Pre-incident Planning = Standardized responses, call for help, ensure effectiveness Taking Charge = Establish tactical benchmarks, manage resources, evaluate progress Size-up = Decision if more resources are needed, assess specialized resources, observe variables Incident Management = Organizing response, enhancing safety, efficiency, effectiveness Signup and view all the answers

What are the three incident priorities in Extrication Incident Management?

Safety, Survival, Recovery Signup and view all the answers

What determines the level of Incident Management required for an extrication incident?

Complexity Signup and view all the answers

Command & Control groups are based on incident needs, while they may be ______ as needed.

modified Signup and view all the answers

Vehicle stabilization aims to prevent movement of the vehicle in only one direction.

False Signup and view all the answers

Match the following Control Zones with their descriptions:

Restricted (hot) Zone = High hazard area where the rescue operation takes place Limited Access (warm) Zone = Area immediately outside of the Hot Zone with limited risk or exposure to hazards Support (cold) Zone = Area surrounding the warm and hot zones with unlikely risk or exposure to hazards Signup and view all the answers

Which vehicle construction method is known as body-on-frame construction?

Full or Rigid Frame Signup and view all the answers

Unibody construction is also referred to as 'integral frame'.

True Signup and view all the answers

What is the primary purpose of a space frame in vehicle design?

Provide structural support while reducing weight for performance and fuel efficiency. Signup and view all the answers

Pretensioners instantly tighten the seat _ for maximum benefit.

belt Signup and view all the answers

What are some common types of passenger vehicles, cars, and light trucks?

Designed for 10 people or less Signup and view all the answers

Match the following airbag descriptions with their correct side:

Front impact air bags are intended to supplement seat belts. = DRIVER’S SIDE Head protection systems remain rigidly inflated after activation. = PASSENGER’S SIDE Signup and view all the answers

What are some types of medium and heavy trucks?

All of the above Signup and view all the answers

A Type A school bus has a seating capacity of approximately 8 people.

True Signup and view all the answers

Buses transport large numbers of people locally and regionally for _____ purposes.

Transit Signup and view all the answers

Match the heavy equipment/machinery with their names:

Backhoe = Excavation equipment Cement truck = Concrete transportation vehicle Fork lift = Material handling equipment Signup and view all the answers

What are the two main types of battery systems in use?

Wet / Dry Signup and view all the answers

BATTERY Locations - Under hood, Trunk, Rear seat, Wheel well. Hazards include acid, disconnecting, and cutting cables, under the ________.

hood Signup and view all the answers

The higher the center of gravity (COG), the less susceptible to rollover.

False Signup and view all the answers

Match the vehicle collision type with its description:

Front-impact collisions = Force occupants forward Rear-impact collisions = Create unique problems depending on speed of impact Side-impact collisions = Vehicle folds around point of impact Rollovers = Vehicle may roll several times Rotational collisions = Result in spinning vehicles Signup and view all the answers

What standard must helmets meet for extrication?

NFPA® 1971 Signup and view all the answers

What is the most common protection for the face during extrication?

Face shield Signup and view all the answers

Proper fit of foot protection is not important for responders.

False Signup and view all the answers

OSHA requires the use of hearing protection at or over ______ dB.

90 Signup and view all the answers

Match the respiratory protection with its description:

SCBA = Used in an IDLH environment with limited air supply APR = Cannot be used in an IDLH environment, needs ample oxygen supply SAR = Used in IDLH environment, work range based on air supply Signup and view all the answers

Study Notes

Introduction to Vehicle Extrication

Vehicle extrication is the removal and treatment of patients trapped by machinery or equipment.
Disentanglement is the manipulation of vehicle or machinery components to provide for the removal of a packaged patient(s).
Rescue is the removal of a patient from an untenable or unhealthy situation or atmosphere.

Phases of Extrication

Hazard Assessment & Size-up
Hazard Control & Incident Stabilization
Gaining Access & Patient Assessment
Disentanglement
Patient Packaging
Extrication

Organizations Specific to Extrication

USDOT: Develops and coordinates policies and programs designed to protect and improve the U.S. transportation system.
NHTSA: Sets and enforces safety standards, and funds state and local highway safety programs.
IIHS: Evaluates crash avoidance and crashworthiness of vehicles, and evaluates physical and environmental factors.
ANSI: Manages voluntary standardization and facilitates development of standards.
NFPA: Develops technical consensus standards, and develops fire training and public education materials.
Transport Canada: Primary regulatory agency of vehicle and highway safety in Canada, and works with other partners to provide vehicle safety information.
TERC: Provides guidance on transportation for emergency services, and has several goals.
NTSB: Responsible for determining probable causes of transportation accidents.

Rescue Organization Responsibilities

Conform to laws and regulations, and ensure member training is nationally recognized and appropriate.
Conduct hazard/risk assessment surveys, and develop written response plans (SOP/SOG).
Set minimum entrance requirements, and determine response/operational capabilities.
Provide training opportunities for personnel, and provide required equipment and PPE.
Establish a Safety Program.

AHJ and SOP Concepts

AHJ: Authority Having Jurisdiction, and SOP: Standard Operating Procedures.

Hazard and Risk Assessment

A formal review of potential and probable hazards and risks that may be encountered while performing key functions during a rescue/extrication emergency.
Identify potential hazards, assess the level of risk within the response area, and determine the possible and probable rescue situations that could occur within the response area.
Many levels of government perform Regional Vulnerability Studies.

Written Response Plans

Provide a method for implementing changes and revisions, and must be formally reviewed and adopted.
Updated as required, and provide a method for implementing changes and revisions.

Operational Capabilities

Hazard/risk assessment, personnel training, and internal/external resources.

Extrication Equipment

Identify equipment and resources available internally and externally, and acquire equipment applicable to the organization's response level and capability.
Maintain equipment in accordance with manufacturer's recommendations.

Extrication PPE

Must be selected and suited for the anticipated hazards and risks, and personnel should be trained in the capabilities and limitations of their PPE.
Personnel require training in inspection, care and maintenance, and use and operation of PPE.

Respiratory Protection

May be required for certain extrication incidents, such as WMD, fire & explosion potential, bio-hazards, and IDLH environments.
Types of respiratory equipment commonly used at rescue/extrication emergencies include SAR, APR, PAPR, and SCBA.

After Action Reports

Serve two main purposes: improve organizational operations and processes, and identify strengths and weaknesses.
Also known as Post Incident Analysis (PIA), and an evaluation tool used for project or incident improvement.

Size-up

Defined as an ongoing evaluation process of the incident and response efforts, and results in a dynamic plan of action.
Assesses all possible conditions, contributing factors, and resource requirements.

Size-up Considerations

Rescue or Recovery, risk/hazard analysis, and safety & survival priorities (self, fellow rescuers, bystanders, and patients).
An effective risk assessment and hazard identification and control process sets the stage for success.### Vehicle Extrication
Vehicle extrication involves most emergency response organizations, emphasizing the importance of following regional and national standards for safety.

Critical Skill Sets

Safe use of equipment and tools for rescuer protection
On-scene medical care and patient packaging
Accessing patients, assessing, and transferring them to EMS in safe condition

Extrication Incident Action Priorities

Life Safety: personnel safety, patients, and bystanders
Incident Stabilization: scene control, vehicle stabilization, patient stabilization, and hazard elimination
Property & Environmental Conservation: minimizing damage, implementing non-destructive methods, and securing unprotected property
After Action Review: evaluating response actions, identifying strengths and weaknesses, and learning from experiences

Incident Roles & Responsibilities

Rescue Group: vehicle stabilization, patient access, stabilization, disentanglement, and packaged patient removal
Law Enforcement Group: traffic control, crowd control, and investigation
EMS Group: patient evaluation, treatment, and transportation
Fire Suppression Group: fire protection, ignition control, and scene protection

Extrication Incident Management

Identify standards that relate to managing an extrication incident
Identify basic facts about safety requirements for extrication incidents
Describe the importance of training to extrication incident safety

Learning Objectives

Identify key components of an extrication operation
Describe the duties performed by extrication personnel
Identify facts about the early stages of an emergency extrication response
Describe the duties performed by outside agencies during an extrication operation

Extrication Standards

NFPA 1670: Training & Response Levels
NFPA 1006: Minimum standards for professional certification testing for Technical Rescue
NFPA 1500: Fire Department Occupational Safety & Health
NFPA 1561: Emergency Services Incident Management System

Presidential Directive

HSPD-5: directs federal, state, local, and tribal entities to operate with the NIMS-ICS system

Extrication Incident Safety

Success is defined by effectiveness and safety
A safe extrication environment begins with key elements that may expand during the operation
Incident Action Plans must be dynamic and flexible to meet the challenges of the incident

Training

Training provides essential knowledge and skill sets to rescue personnel
Working knowledge of strategies, tools, and techniques
How to function as a team member
SOPs and pre-incident plans must be practiced during training

Operational Assignments

Assignments are based on contributing factors related to the incident
Match the most qualified and capable crew members to the assigned task(s)
Ongoing assessment of progress

Medical Component

Risks are managed through training, experience, probable outcomes, equipment reliability, and procedural safety margins
Medical component is focused on triage, treatment, and transportation
BLS unit should be readily available to manage potential rescuer injuries

Rehabilitation (Rehab)

Rehab stations should be established at every prolonged operation
Contributing factors: heavy labor, environmental conditions, accumulated activity, and other health & safety factors
Rehab focus areas: rest, rehydration, medical evaluations, and crew rotation

Mitigating Potential Hazards

Common extrication hazards: traffic, utilities, vehicle fluids, hazardous materials, and damaged or involved vehicles
When addressing hazard management strategies, consider the patient(s) condition and exposure
Scene control is critical to prevent injuries and risks

Incident Safety Officer (ISO)

An Incident Safety Officer (ISO) is required during extrication operations
Performs an ongoing assessment of incident actions and conditions
ISO should have a working knowledge of hazards, strategies, tactics, tools, and equipment

Personnel Accountability

Required for effective and safe scene management
Accountability needs to become part of the organization's response culture
Use accountability procedures during training sessions

Emergency Extrication Response

Technology enhancements have increased the amount and level of information received during extrication emergencies
Implementing the response: pre-incident planning, standardized responses, and resource capabilities### Size-up and Incident Assessment
Observe variables on the scene to decide if more resources are needed
Assess for specialized resources (task force): Hazmat, Technical Rescue, Suppression
Consider vehicle(s): position, stability, condition, and mechanism of injury

Assessment of Patients

Requires a more detailed evaluation of injuries and entrapment factors
Patients can extend beyond the involved vehicle areas
Access to patients cannot begin until hazards are controlled and vehicles are stabilized
Requires a risk/benefit decision-making process

Triage

Key assessment areas: number of patients, injuries, and entrapment conditions
Establish medical priorities
Required transportation services: land, air, water

Extrication Assessment

Task/resource assessment process
Goal: execute a safe and quick extrication
Provides critical information to support response decisions
Resource management includes both personnel and equipment

Patient Removal Assessment

Two primary methodologies: normal (standard) extrication and rapid extrication
Normal extrication: concept of first removing the vehicle or machinery components away from the patient
Rapid extrication: used only in emergency life-threatening situations, removal of patient in the first priority

Incident Management

Purpose: organize the response to enhance safety, efficiency, and effectiveness
Working within an IMS should be routine to responders
The first arriving unit should initiate an IMS: Single Command Structure, Unified Command Structure

Incident Priorities

Provide for safety and survival regarding response personnel
Prevent further injuries to others
Rescue those who can be saved
Recover the remains of those who cannot be saved

Control Zones

Restricted (hot) Zone: high hazard area, limited access
Limited Access (warm) Zone: limited risk or exposure to hazards
Support (cold) Zone: unlikely risk or exposure to hazards

Command and Control

Groups based on incident needs: Rescue/Extrication, Medical, Suppression, Law Enforcement
The IC establishes the level of command and control

Managing Environmental Exposures

Identify possible shelter in pre-planning
Protect patients and responders from environmental hazards
Temporary shelters: provide protection from the environment

Apparatus Placement

Shadow vehicle: place apparatus in a safe location
Protect patients and responders from apparatus hazards

Traffic Control

Control traffic to prevent hazards to responders and patients
Route traffic into unobstructed lanes or areas
Be cautious when moving about the incident

Control Zones

Restricted (hot) Zone: high hazard area, limited access
Limited Access (warm) Zone: limited risk or exposure to hazards
Support (cold) Zone: unlikely risk or exposure to hazards

Extrication

Performed after all potential hazards are mitigated
Patient considerations: access, egress, disentanglement, and extrication
Develop an extrication plan: prioritize patient access and removal, develop a treatment and patient packaging strategy

Vehicle Stabilization

Goal: prevent unwanted movement of the vehicle
Utilize ropes, chains, cribbing, shoring, and chocks

Vehicle Access and Egress Points

Determine the best strategy to provide vehicle access for medical personnel
Determine the safest route for removing packaged patients

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