By Homer Robertson
Published Friday, April 1, 2011
In past Quick Drills, I’ve given you some tips to make vehicle extrication operations go smoother. Our response to motor vehicle crashes (MVCs) has changed so much in the past 25 or 30 years that it’s hard to believe we did things the way we did back then. Very few organizations had rescue tools, and we were basically jerking patients out of the car, scooping them up and sending them off to the hospital.
The bottom line: Everything has gotten better with regard to the extrication end of our business—tools, training, techniques and knowledge. My own fire department—in a large U.S. city—had only six sets of rescue tools in the early 1980s; today we operate almost 50 sets, and those tools are used somewhere each day to save a life. In fact, our rescue tools may be the most important life-saving tools we carry.
Why? There are just a lot more cars on the road today and, therefore, a lot more car wrecks that we respond to. In addition, today’s cars have many safety features that, while protecting the occupants, pose new challenges for rescuers.
This month’s Quick Drill focuses on vehicle stabilization. When you consider the high-priority tasks that need to be accomplished at extrications, stabilization of the involved vehicles is second only to making sure that the area around the scene is safe for the patients and the rescuers.
In fact, you can argue that stabilization is a critical step in making the scene safe. By stabilizing the vehicle, you improve the safety of the patient(s) by preventing the vehicle from moving, which can cause secondary injuries. You also improve the safety of the responders working the scene by preventing the vehicle from rolling or, if it’s on its side or top, falling onto a rescuer.
Vehicle Stabilization Tips
Regardless of whether your engine or ladder company has a set of rescue tools, you must be able to perform some basic vehicle stabilization. We really can’t start to treat the patient or start the extrication process without stabilizing the vehicle. For companies that don’t have a set of rescue tools, knowing how to stabilize the vehicle will allow later-arriving crews to perform other tasks related to the rescue.
Following are a few stabilization skills every member should possess.
Know where to crib: Not only do you need to know how to crib, but where. Many vehicle cribbing jobs will require two, three or more locations to stabilize the vehicle. Knowing the location and type of stabilization needed is just as important as knowing how to use the tools.
Build box cribbing: The box crib is the basic tool of stabilization for both auto extrication and building collapse; it can also be used with other tools such as air bags or shoring. Most box cribs are built using 4"x 4" or 6" x 6" lumber that is usually 18–24 inches long. Some fire departments have started using commercially produced plastic cribbing that will resist chemicals encountered at extrication scenes.
When training on building box cribbing, emphasize the importance of not exceeding more than twice the height of the length of the cribbing material being used. Example: If you’re using 18-inch-long cribbing, don’t build the box crib higher than 36 inches.
An important safety rule: When building the cribs, avoid putting your hands or legs under the load you’re trying to stabilize. Use pieces of the cribbing to push other cribbing into place. Stay out of the collapse zone.
Use step chocks: If you have the compartment space on your apparatus, step chocks are one stabilization tool that every company should carry and know how to use. They provide one of the quickest and safest ways of stabilizing vehicles that are still upright, and they’re useful in a number of other stabilization situations as well. Don’t see the need to stabilize an upright vehicle? If you have a patient who has a comprised C-spine or other injury that will be worsened by movement of the vehicle as rescuers work to treat them—or if movement could hurt the responders—the vehicle must be stabilized.
Use struts: There has been a huge improvement in the types and quality of struts being used to stabilize vehicles in the last few years. Most struts are metal, but some departments use wooden 4 x 4s. Struts work great on overturned cars or pick-ups that are on their top or side. They’re quick and easy to deploy—with the right kind of training before the incident.
One of the downsides of carrying struts: They take up a significant amount of compartment space on the truck for something that you might not use more than a few times a year. But that should be even more incentive to take them out and train.
A Final Word
Whether you’re using high-tech stabilization like struts or low-tech like box cribbing and step chocks, you must train to be able to perform successful vehicle stabilization. There’s a huge gap between having the right equipment and being able to use it when the time comes.
Vehicle accident response is on the rise for most of us. Ensure you and your crew know how to make the scene safe and stabilize the vehicle.
Comment Now: Post Your Thoughts & Comments on This Story