Extrication Tactics: Are You a Butcher or a Surgeon?

Over the past several years, many trade publications, blogs and manuals have emphasized the importance of responder positioning in relation to hydraulic tools and tactics on the extrication scene. While I do advocate understanding these principles, I also believe that responders should have an even better understanding of why our tools react the way they do during use, and how we can take advantage of these reactions (and how we can learn to avoid them when necessary).

After observing some inappropriate techniques at a recent training session, a friend and I began comparing the differences between a bad tool operator and a good tool operator to the differences between a butcher and a surgeon. In short, we need to ensure that our crews understand blade design and how it can affect overall performance. With that in mind, this article will focus on proficient hydraulic cutter use. In a future column, I’ll concentrate on the operational specifics of hydraulic spreaders.

Pulling Into Cut
We often need to use the spreader to displace material enough for the cutter to sever parts (i.e., hinges, nader pins); however, the cutter operator often can’t see the blade tips surrounding the material being severed. This increases the risk of loading the tips and breaking a blade. When the blades surround the material being severed, the responder should feel the cutter pulling into the material due to the arc of the blade.
The pull is minimal, and the cutter may only move approximately 1 inch, depending on blade design. This is also important when initially cutting through other material, such as sheet metal, seats, upholstery, etc., to get to a pin, hinge or something similar. (Note: This is not the same as a blind cut; the material being cut can be seen but the cutter tips cannot.)

Path of Least Resistance
It’s not uncommon to hear stories of responders getting their hands trapped between the cutter handle and seat during Alpha post relief cuts for dash displacements. Although the operator may place blame on the tool or vehicle parts, the problem is really improper blade positioning. Because each blade moves at the same rate of speed and power, they have a natural tendency to want to meet each other. When one blade contacts a harder area, it will stop until the other blade cuts through lighter material and meets it. This reaction causes the rear of the tool to move in the direction of the blade still moving. With that in mind, it’s sometimes better to hit preexisting holes and/or move cut locations up or down slightly.

Movement to Flat Surface
Several situations (i.e., pedal removals, seat back removals and even some posts cuts) require the cutter to be positioned on a flat cutting area. This is also the basis for the cutter moving in an upward or downward motion when severing hinges and upper rails. Similar to the path of least resistance rule, the cutter moves in one direction or the other until the blades are flat against the area. The best course of action is to position the cutter so that it’s in line with the flat area at the beginning of the cut, rather than dealing with cutter movement.

Cutter Profile
Depending on which side of the tool is positioned against the cut or close to any obstructions, responders may be able to position cutters closer to a cut location. In certain situations, turning the tool 180 degrees may provide the clearance to make the cut. This is evident when looking at the cutter from the side.

Decrease Cut Time
Most cutters have a blade opening between 5 and 10 inches, but responders often need to sever a material that the blade opening cannot completely fit around. Some responders promote using a spreader to compress the material, making it possible for one cut to sever the material. And in some circumstances, responders take too long trying to make one cut when it could have been faster just to make two.

A responder can use the cutter to compress the material much like the spreader technique or to make a partial cut that allows for one final cut. The end result is one-and-a-half cuts vs. two cuts. This is advantageous because it reduces cutting time and the responder won’t have to switch back and forth between different tools.

Feel the Relief Cut
During tactics such as side removals, dash displacements and roof flaps, responders are required to make relief cuts that don’t completely sever vehicle parts. In these situations, it’s important to make sure that you get sufficient “relief” to complete the tactic. Although responders should never place themselves in a dangerous position, there are opportunities where they can contact the vehicle with a knee, hip or elbow to help them “feel” the vibration of the cut.

Movement of Loose Ends
Certain tactics require cutting loose ends. Because the cutter blades typically pass each other, the free end of the object being cut moves with the outermost blade. This movement may not be noticeable if the cutter is operated quickly, but it may still be substantial enough to cause injury to the patient if the movement is in an undesirable direction.

You can see this phenomenon when severing the steering column. If the steering column is against the patient’s legs, and the outer blade is positioned so that it’s moving upward during the cut, then the steering column will move upward with the outer blade. This may provide the relief necessary to free the patient’s leg. (Note: The term “outer blade” refers to the side of the blade closest to the loose end of the object.)

A Question for You
During a recent extrication competition, a member of the Darlington County (S.C.) Extrication Team used a cutter to complete a side removal. During the critique, a judge described his techniques as so smooth that the tool looked like an extension of his body. He was a surgeon with the tool. So what are you–a surgeon or a butcher?