This month’s Quick Drill uses a set of photos from a recent incident that the Fort Worth Fire Department (FWFD) responded to.
This type of incident is one that any fire or EMS organization in this country has the potential to respond to. But it’s challenging because it’s a very low-frequency incident and not something most firefighters will have previously encountered.
Dispatch Information
Your single-engine company and an ambulance have been dispatched to a motor vehicle accident (MVA) on a major highway. Your communications center says a passing motorist called from their cell phone to report a single-vehicle accident, possibly an overturned van.
Look at the photos included here and determine how you would complete the following tasks:
- You arrive at the scene to find an overturned Sheriff’s Department transport van on a highway divider. Provide your initial-arrival radio report.
- Based on your initial size-up, develop your incident action plan.
- Determine what special needs will be required that you may not normally need at a MVA.
Note: There are no right or wrong answers because each of our organizations will respond differently based on our resource level and if we’re operating in an urban or rural environment. The important part is that you are prepared to handle the incident within the parameters of your system.
1. The Radio Report
Everyone’s initial radio reports are a little different, but we’re all trying to do the same thing: provide a verbal description of the incident, or simply paint a picture.
Always try to cover three main points in your radio reports: What do I have? What do I need? What am I doing? The initial report allows other responding units and your communication center to get more reliable information than what was provided by the initial caller. Clear communications allow our response systems to begin to send additional help or adjust the system to meet the needs of the incident.
In this case, your initial dispatch information told you there was a report of a van involved. When you give the initial radio report, provide additional information that a Sheriff’s Department prisoner transport van was involved; this should alert other responders about the possible problems you’re facing, and that will affect how they proceed.
2. The Action Plan
We’ve determined that it’s a prisoner van, but we don’t know how many patients we have or the extent of their injuries. Van accidents scream out “mass-casualty incident!”
Vans like the type pictured here are widely used by churches, schools and law enforcement to transport people. They can carry 16 or more passengers, which will quickly overwhelm most EMS systems. Such vans have been involved in many serious incidents throughout the United States due to their handling characteristics and the skill level of their drivers.
In this case, the incident is even more complicated because the van is carrying prisoners. Even if you don’t have a jail or prison in your response area, you could still face this type of incident because such vans may pass through your area while transporting prisoners to court appointments or different facilities.
A quick 360-walkaround will help to determine what kind of resources you’ll need. Some organizations use simple rules of thumb to determine the number of first responders per patients (e.g., two responders for each patient). Use your department’s rescuer-to-patient ratios and request additional resources early. Make sure you request ground and air ambulances if needed.
3. Special Resources
This incident offers some challenges different than a normal MVA due to how the van has come to rest and the folks riding in it.
This is not a stabilization job for your standard step chock; you need some serious stabilizing tools that most engines and ladders don’t carry. Make sure you request the right equipment to help get this van stabilized before you have additional problems.
Your patients could also pose some real problems that are out of the norm. This could be a van full of college students arrested for public intoxication or a group of violent felons. Therefore you should immediately request law enforcement to respond to the scene to help you handle the patients.
In addition, the patients will more than likely be handcuffed together and possibly be leg shackled to deter possible escapes. Does your organization have a policy on treatment of handcuffed patients? How will you prioritize rescuer safety against patient treatment, especially if more than one patient is seriously injured?
What Really Happened
In this incident, FWFD crews used a commercially produced stabilization kit to quickly stabilize the van. Take time to review these kits and conduct hands-on training as often as possible. Law enforcement vans often feature exterior locks and expanded metal grating to cover windows and doors. Make sure you have the right tools to defeat these barriers when you must.
FWFD crews also requested law enforcement presence early in the incident to mitigate any risk posed by caring for the prisoners.
Even if you never face this specific incident, preparing for it now will build your crew’s skills in dealing with other unexpected, unusual calls. Such incidents require decision making that goes beyond rote response to take into effect all of the associated hazards.
