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Purpose

This procedure serves to outline the duties and responsibilities of fire personnel involved in vehicle extrication. Extrications require good judgment, proper training, creativity and coordination.

Objectives

It shall be the responsibility of the Incident Commander, with input from the Extrication and EMS officers, along with other resources to determine what extrication tactics are to be performed at an incident. Extrication operations need to be viewed as a medical/trauma incident that needs extrication, not an extrication that gets medical treatment afterwards. Training, expertise, scene hazards, patient condition, resources, and extenuating circumstances all influence the methods and pace of each incident.

Scene Management – Establish Sectors to better manage personnel

1. Command – First Officer on scene until relieved by a Battalion Chief. Command is responsible for the overall scene and coordinating sectors. Sector officers shall direct requests through Command.

• Arrive and safely position apparatus at the crash scene. Park to protect all personnel on scene.
  
  

1. Establish Command
   
   
   • Perform a complete 360 scene size up.
     
     
   • Scene Safety. Identify hazards…i.e. fuel spill, electrical lines, fire hazard. Before any extrication event begins, the scene must be secured.
     
     
   • Ascertain number of victims.
     
     
   • Triage victims.
     
     
   • Determine need of an extrication response, additional staffing for EMS, transports and equipment.
     
     
2. Designate an EMS Sector – Officer responsible for patient care.
   
   
   • Direct patient care. Access patient in vehicle if possible.
     
     
   • Coordinate care with Life Squad if appropriate.
     
     
   • Coordinate patient transport and victim information.
     
     
   • Request additional resources if needed through Command.
     
     
3. Designate an Extrication Sector – First Extrication officer on scene.
   
   
   • This Officer shall conduct a 360 while the crew prepares tools needed.
     
     
   • Scene Safety
     
     
   • Vehicle stabilization needs. Use cribbing, struts and/or wheel chocks. Extrication should only begin after the vehicle has been stabilized.
     
     
   • Method of extrication.
     
     
   • Coordinate with 2nd extrication unit.

2. Hazard Control

• Deploy a charged hose line staffed by a firefighter in full turnout gear.
  
  
• Battery / Electrical system shut down.
  
  
• Fluids / Dangerous liquids.
  
  
• Traffic / Crowd control.
  
  
• Establish lighting for night time incidents.
  
  
• Establish tool staging area.

3. Establish Working Zones - Once working zones are established, Command shall be the gatekeeper. Only Extrication and EMS in the Hot Zone.

• Hot Zone
  • Area around the effected vehicle large enough to allow the Extrication and EMS crews to work effectively.
    
    
• Warm Zone
  • Area around the Hot Zone large enough for:
    • Tool Staging.
    • Firefighter with charged hose line.
    • Personal and apparatus not currently involved in patient care.
      
      
• Cold Zone
  • People and equipment not directly involved in the rescue effort.

4. Extrication Team – Crews responsible for disentanglement

• Designated Extrication crews. Squad and Truck.
  
  
• The Officer from the first extrication unit on scene shall be designated the Extrication Officer and coordinate the efforts of both extrication crews.
  
  
• Precautions shall be taken to protect trapped or injured persons from further harm during the extrication. The use of blankets, short boards, and other devices should be utilized whenever possible.
  
  
• Request additional resources if needed through Command.

5. Safety – Unit 134 or designated Safety Officer. Responsible for overall scene safety.

• Proper gear and eye protection.
  
  
• Hazards eliminated.
  
  
• Proper techniques employed.
  
  

6. Access Patient

• Try opening doors before cutting
  
  
• Roll down windows
  
  
• Move seat(s) back
  
  
• Tilt/telescope steering column out of the way
  
  
• Perform glass management

7. Assess Patient

• Protect patient from breaking/flying glass
  
  
• Remove all non-laminated tempered glass before cutting
  
  
• Remove windshield independently, or with roof (use discretion) if performing a roof removal
  
  
• All breaking of glass shall be done in a controlled manner, with a spring-loaded center punch, if possible, with glass pieces removed away from the patient.

Firefighter and Patient Protection

Personal Protective Equipment (PPE) shall be worn while working in the Hot Zone, or in close proximity to extrication activities. At a minimum, PPE at an extrication incident shall consist of:

• Turnout Gear (bunker pants and coat)
• Safety glasses, Helmet with face shield
• Extrication or structural firefighting gloves
• Protective Boots and Reflective Vest (see Emergency Procedure C-83)

In addition, protective measures consistent with Blood borne Pathogens procedures shall be utilized during an extrication incident.

The deployment and placement of safety cones and the proper vehicle placement to protect the responders at the scene are some of the critical precautions that shall be addressed. Adequate law enforcement personnel must be present to assist with controlling traffic hazards. It is imperative that the Incident Commander or the Safety Officer works closely with the responding law enforcement agency to ensure the safety of all personnel on the scene.

See C-121 COT Environmental Services for guidance on when they should be notified.

See Also: