Hyattsville Volunteer Fire Department Basic Unified Extrication Guidelines

Definitions • Working Area/Hot Zone/Inner Circle- 10 ft. radius around vehicle • A, B, C Posts, etc. - Vertical structural member of the vehicle connecting the roof to the vehicle’s body. Post designations are from the front of the vehicle to the rear, starting with the two posts that are connected to the front windshield and the roof (Driver side A-Post and Passenger Side A-Post • SRS- Supplemental or Secondary Restraint System • SIP- Side Impact Protection • “IC”- Impact curtain…automobile manufacturers have adopted this icon to identify hidden side-impact curtains. This icon is usually at the outer edge of the interior roof liner trim. • Pressurized Vessels- “Piston Rods” can be a component of the vehicle’s energy absorbing bumper and/or a unit that may serve as a hinge for a trunk or hood of a vehicle.

Rescue Squad Crew • Officer - Directs ALL operations within Hot Zone • Driver - Responsible for Hot Zone logistics and all equipment to come off Rescue Squad • Senior Squadsman – Tool and Team Assignments, primary rescue tool • Squadsman (1 -5) – Stabilization, vehicle prep, extrication

Engine Company • Officer – Oversees squad company support functions (batteries, suppression efforts, initial patient care) • Driver – Water supply, charges hoseline • Line – Operates safety hoseline • Back-up – Vehicle battery, assists lineman, patient care • Hall/Layout – Initial patient care

BLS/PA Companies • Tech/Officer – Primary Patient Care Provider (assesses patient, makes face to face with Hot Zone Supervisor) • Driver – Vehicle positioning, supports patient care • 3 rd – Assists tech • Observer – Camera…stays out of Hot Zone!

General Scene Safety • Specific Considerations to take on any motor vehicle accident include: – Other motorists – Hazmats – Powerlines – Trees – Ditches – Trenches

Basic Vehicle Placement Basic Fend Away Position blocking traffic from motor vehicle accident Demonstrates location of other vehicles within incident perimeter

Resources Needed for Safe Scene • Given aforementioned considerations who or what might we need to request? – Power Company – Gas Company – Heavy Wrecker – Crane

PPE • All members operating within Hot Zone must be in full PPE and don safety glasses THIS INCLUDES EMS PERSONNEL!!! Your turnout gear should always be with you to begin with, and definitely donned for an extrication • Suppression crew must be prepared with SCBA as well

Incident Zones Hot Zone – Only authorized operational personnel enter, must be in required PPE Warm Zone – Companies serving in a support role are here. Hoseline, EMS (stretcher and backboard) prior to extrication completion Cold Zone – Vehicle staging, command post, patient care area

Scene Control • Rescue Squad OIC is responsible for extrication game plan • That information needs to be conveyed to key players on scene for a smooth operation • Key Players are: Command, Primary EMS Provider, Extrication Group Supervisor, Suppression Group Supervisor

Vehicle Assessment • • How do we stabilize based on what we see? Where are the patients? What might we need here? The Rescue Squad OIC must have a steady stream of plans. As the scene evolves a continuous size-up must happen. A new size-up may reveal a need to change the plan.

Patient Assessment • Once the scene is stabilized (including the vehicle) a patient assessment can take place. • A C-Spine injury can be aggravated or worsened by slight movements in the vehicle. • Suspension should be isolated before anyone enters the vehicle even to hold C-Spine

Stabilization • Patient Access should be limited until proper stabilization • Eliminate Suspension Travel • Ensures vehicle is 100% fixed in its location • Must be continuously reassessed as the vehicle is dismantled.

Patient Assessment Cont… • Done by first arriving personnel (triage all patients in vehicle) • Ongoing, determine trauma status (GCS) • Identify Mechanisms and Intrusions to the vehicle. What did the vehicle hit, drive through, and where did it come to stop? Where are the intrusions? Passenger compartment vs. front or rear impacts?

Modern Vehicle Concerns

Alternative Fuels • Symbols to Identify

Completion of Extrication • Squad crew removes any unnecessary equipment from the Hot Zone • EMS is primarily responsible for actual patient removal and should determine method or removal based on how squad left vehicle • Assistance with victim should be requested immediately through squad officer