By Author(s): Kevin McGraw  and Paul Hasenmeier 
Published Monday, February 6, 2012
Shortly after 1700 HRS on Nov. 28, 2011, a garbage truck was rear-ended by a passenger vehicle, pinning a sanitation worker between the two vehicles. Rescue personnel from the Sandusky (Ohio) Fire Department (SFD) feverishly worked for 41 minutes to extricate the victim. Additional personnel and equipment from mutual-aid companies proved extremely helpful.
The Call Comes In
At 1723 HRS, the SFD received a call for a motor vehicle crash on a two-lane residential street (a 35-mph zone). At that time, no other dispatch information was given. It was dark out, and weather conditions consisted of light precipitation that became heavy and a temperature of 45 degrees F. Station 1 units (Command-942, Engine-921 and Ambulance-911) arrived on scene at 1727 HRS. Ambulance-911 arrived first and sized up the situation: A four-door sedan had rear-ended a garbage truck, and there was a man in his late 40s lying on the hood, pinned between the two vehicles and screaming in pain.
Rescuing the Worker
While assessing the impact zone, it was discovered that the car had pulled the victim’s legs under the garbage truck, and he was being pinned in place by the driver-side rear step of the garbage truck, which had been shoved forward when the vehicle struck the truck.
During the initial size-up, crews decided that Plan A was to use airbags and cribbing to lift the truck off of the patient. Engine-921’s crew immediately began building a 2 x 2 box crib as a platform for the airbags. The crew put the box crib as close to the patient’s legs as possible; however, this was difficult because the front of the car was only a couple inches from the lift point.
Incident command recognized the need for more resources and contacted mutual aid from the Perkins Township Fire Department and the Margaretta Township Fire Department for more cribbing, airbags and personnel. Additionally, SFD Ambulance-917 arrived on scene, and the IC was advised by law enforcement that a heavy wrecker was contacted.
The driver of the car was transported to the ER with minor, non-life-threatening injuries at this time, as firefighters put the first two airbags in place. Heavy-duty conveyor belt squares were used to protect the bags.
As the first two bags were inflated, firefighters quickly noticed that they were raising the suspension of the garbage truck and the car. Firefighters needed a greater lift to create enough of a void to free the victim, but both airbags were nearly maxed. The passenger car’s front passenger-side tire was deflated to match the flat tire on the front driver-side that was caused by the crash.
Perkins Township Fire Department personnel arrived on scene and immediately began mirroring the SFD’s box crib and airbags on the passenger side of the garbage truck. Their box crib was placed directly below the lifting point. It should be noted that the lifting point was not very wide and did not disperse equal load on the airbags, decreasing their lifting capacity.
As firefighters began to inflate the airbags on the second box crib, the pressure began to push the box crib apart because of a void in the top layer of the crib. Operations were immediately stopped, and the crib was taken apart and reinforced to prevent any further displacement. Lifting operations continued, and a slow coordinated inflation brought both lifting points to an equal height. Around this time, Margaretta Township Fire personnel arrived on scene and provided more cribbing and illuminated the scene with their light tower.
The lift continued as the airbags on both box cribs were inflated, which raised the load to a point where the car’s suspension was no longer a factor; however, there was minimal relief of pressure on the victim’s legs. Both sets of bags reached their maximum inflation, requiring a third box crib. This crib was built on the driver’s side of the garbage truck, directly below the step that was pinning the victim. This box crib was a few blocks higher due to the space created by the lifting already completed. The smallest airbag was placed on the third box crib. The small bag was filled to capacity, nearly freeing the victim.
Firefighters immediately put weight on the car to compress the suspension, achieving the needed clearance. The incident commander (IC) decided that the winch on the front of Margaretta’s engine would be used to pull the car out once the garbage truck was lifted from the victim. The car was winched clear of the garbage truck, and the victim was free of entrapment at 1804 HRS.
EMS in Action
Sandusky Fire EMS personnel immediately began oxygen and IV therapy upon arrival. Pain management along with crush syndrome protocol procedures were performed throughout the extrication. The patient remained alert and oriented during the entire operation. Obvious bilateral tibia and fibula fractures were noted during initial assessment with the right leg being an open fracture. Continuous vitals were taken to ensure that appropriate treatments were performed. Once extricated, both lower extremities were secured and the patient was fully immobilized to a long backboard.
Additionally, hypothermia prevention measures were taken due to the victim’s long exposure to the cold and wet conditions. No other injuries were found during EMS assessments or future assessments performed by hospital staff.
Most of us don’t respond to this type of rescue every day, but despite the challenges, it provides some universal lessons.
- Technical rescues require time: The safety of firefighters and the victim is of utmost importance, as the passage of time increases the intensity of the situation. Coordinated efforts with clear thinking are necessary to reach a successful outcome.
- Know your organizations heavy-lifting capabilities: The airbags on our apparatus have limits and we must compare them to known weights of anticipated heavy loads. For example, the loaded garbage truck in this incident weighed more than 50,000 lbs.
- Utilize mutual aid for complex and long-term incidents: It’s important for rescuers and ICs to quickly recognize the potential to be overwhelmed and request additional personnel, apparatus and/or equipment. We must have options available in case of equipment failure or firefighter exhaustion (photo 8). If the involvement of a heavy wrecker may be needed, request them early.
- Communications—use clear, concise and universal terminology: Lift slow, lift, stop. The rescue operations boss should make the calls and ensure those calls are heard by operating crews simultaneously.
- Vehicle stabilization and cribbing as you lift are necessary: Consider using stabilization struts to prevent the load from shifting and crib an inch for every inch lifted. The use of base pads similar to outrigger jack pads may help distribute the load on airbags when faced with a narrow lifting point. If your cribbing cache is limited, what are your options? Mutual aid? Lumber yard? 4 x 4s can be quickly cut into 2-foot-long sections with a chainsaw.
- Training—don’t get caught in the “it won’t happen here” mentality: Improve your abilities through regular training on stabilization, cribbing, lifting, airbag operations and heavy-wrecker coordination.
A Final Word
Heavy rescue operations bring with them many challenges and hazards that require well-trained and equipped personnel. When operating at a heavy rescue scene, have Plans B, C and D ready to go in case Plan A does not get the job done. With our knowledge, equipment and multi-agency coordination, these operations can be a success, despite the potential trauma and tragedy to those being rescued.
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