Quick Tip: Why the Roof?

If you have attended my Tactical Extrication Course, you know that I strive for thinking operators. Not all entrapments will be the same. They will range from a quick job to downright challenging ones. While traveling nationwide, many departments use set tactics on every call regardless of entrapment type, damage, and vehicle orientation.

If you follow the “Extrication Quick Tip” series at all, then you know I am a fan of efficiency, operational plans, and orchestrated operations. However, is one set tactic always the best method for the patient? For example, you have a trauma arrest patient that has a foot trapped by the dash. You are operating with limited manpower and the patient is critical. Is the best tactic to go straight to a full roof removal? Now if you are manpower/tool heavy or there is little to no occupant space for the patient, sometimes it’s a great one. However, with a critical patient, would a quick door pop and dash displacement is a faster option?

In my district, we commonly use a method referred to as a total side removal (side-out). Is it our go-to on every call? No, but with limited manpower it is very quick option and many times limits our need for roof removal. Why you may ask? Let’s look at the facts.

Roof Removal (photo 1)
Typically, an 8 cut move, post dependent (Both A’s-2 cuts, Both B’s-2 cuts, Both C’s-4 cuts-typical 2 cuts per post due to width.
Need decent manpower numbers and equipment to complete.
More challenging as posts are reinforced with high strength steels and thicker than days past.
Removal of door(s) still necessary to facilitate extrication.
Very good if there is little to no occupant space in the vehicle.

Total Side Removal (Side-Out) (photo 2)
Will consist less movements consisting of a rear door pop (1 spread), lower b cut (1 cut), lower spread (1 spread), upper cut (1 cut), prior to rotating the whole side out and laying the seat back (may have to notch to recline seat).
Can be completed with a two person team and two tools.
Now we have a large working area and the patient is be brought out horizontally on a backboard.
Add 2 cuts if taking hinges to facilitate a dash lift.

Am I saying don’t take the roof? Absolutely not, as I believe there is a time and place. I am just saying look at all viable options and don’t ALWAYS jump to one method. See the upcoming article Roof vs. Side Removal for further details and comparison.