The cut team: the crew with the tools in their hands; the crew that will get dirty, bruised and banged up. These are the troops who can make or break an extrication operation. These are the go-to personnel who get the job done. As such, the cut team needs to be aggressive–not reckless. If you’re on a cut team, you need to have confidence in your skills, the plan and the equipment. After all, when on the extrication scene, it’s not time to learn; it’s time to perform.
Others Before Self
Like all firefighters, the cut team must put the needs of the patient before their own. I recently read two very different (and yet similar) articles in the local newspaper that made me reflect on this. One article was about the selfless heroism of a Medal of Honor winner serving in Afghanistan; the other was about a tragic fire where five people lost their lives. I read the articles and reflected on myself and my profession. I asked myself, “Do I have it in me to do what the Medal of Honor award winner did?” I hope my brothers and sisters and I demonstrate what he did–putting others before self–on every call. And I think we do.
Cut Team Tasks
When on a cut team, you’ll move objects away from the patient and/or create space around the patient, possibly in an effort to gain access to the patient’s lower extremities. You may need to create space just to allow first responders to get close to the patient. And, of course, you must do all this while working in close coordination with the responders administering patient care. Please, no fist fights or yelling matches. Sometimes ideas and plans simply aren’t shared, and not everyone is on the same page as far as how to remove the patient. Ask yourself, is EMS a third service over which you have no control, or is it your medic and captain who aren’t on the same sheet of music? A command structure will improve communication and establish who’s working for who.
As part of your cut team responsibilities, you may also be tasked with stabilization and addressing electrical system shut-down. It helps to stabilize the vehicle before you go after the batteries, especially if you have to bang and pry on the hood. Shutting down the electrical system will reduce your exposure to supplemental restraint hazards and little fires that may start up. If you have electrical creature comforts (seats, windows, tilt steering wheels, etc.), manipulate these to your advantage before you disconnect the batteries.
In the end, the success of an extrication may come down to where you cut the B-post–or how you remove a door. Are you diligently pulling trim and exposing weaknesses and hazards of vehicle construction? One inch too low or too high can lead to ineffective cutting or an unsafe practice. This is why training is key.
Are You Prepared?
Cut team actions are like dancing. At first you’ll step on toes and run into each other. And if you don’t practice, you’ll continue to scuff shoes. Don’t get me wrong, I don’t set my TiVo for Dancing with the Stars–it’s just an analogy. A lot of people think that they have skills down-pat and that they can “turn it on” when the bell sounds. They may get lucky once in a while, but to have consistent success, you need to be prepared.
Being able to successfully extricate patients from a vehicle goes back to what happened long before the actual accident. With this in mind, ask yourself: Are you up to date on the most recent changes to vehicle construction and technology? Do you attend classes and seek out knowledge on the subject? Who is the weakest member of your crew, and do you spend time helping them improve their skills? Do you train in the rain and cold? Last time I checked, you won’t wilt. Are you engaged or are you more concerned about your second job? Are you a grizzled veteran who’s “been there and done that” but refuses to give your rookie the time of day, assuming that all he’s good for is to get coffee? Get over yourself. I’m sorry if doing your job well is hard. But remember John Wooden’s personal definition of success: “Success is peace of mind, which is a direct result of self-satisfaction in knowing you made the effort to become the best of which you are capable.” Are you able to say that you were “successful” at each extrication–that you did your best?
An example of success from the fire side: The night before I wrote this, I responded to a mutual-aid house fire, and the first-in three-person crew fought the fire aggressively and made a great stop. They worked hard, ran a safe operation and delivered a good service to the community. Five hours into the incident, the team was vacuuming up water in the non-affected part of the house. Job well done. Would an observer be able to say “job well done” about your cut team work?
Numbers & Tools
The cut team may be predetermined (e.g., the truck company or a rescue squad), but unfortunately, most organizations don’t have this luxury. An effective team usually includes two to four responders. Depending on experience and your numbers, you may have a lead and an assistant. One person may be on the tool with the others moving power units and feeding hoses. You may also be preparing the next tool for the next step. Note: You should always have multiple Sawzall blades in your pockets.
If you have experienced, talented folks, the better approach may be to split the team so you can perform multiple tasks at once (e.g., the cutter working the driver’s side and the Sawzall humming on the passenger side). In short, you don’t want tools on the ground, producing downtime. Some of my most successful cut jobs have been those where I had an assistant who was anticipating my needs. Downtime was reduced and communication was minimal because everything was flowing so well–just like long-time dance partners.
Leadership at the Scene
The cut team gets the overall strategy from the incident commander or the extrication group supervisor, if one has been established. The members of the cut team may adjust the tactics, but if they do, they need to keep their supervisor informed.
Overall, it comes down to this: As leaders, we must take responsibility. Yeah, you may not be on the tool, but did you set the team up for success? John Wooden once said, “I’ve spent hours trying to evaluate where I fell short, because the ultimate failure to win must rest with the coach who creates the program and directs the game plan.”
For successful extrication operations, cut teams need to be solid at the basics and current with techniques and technology. Effective actions come from proactive preparation and diligence to give your best effort. If you choose not to do this, you might want to start looking for another career.
Want More Extrication?
Check out Les Baker’s most recent In-Depth Extrication column, Spanning the Gap in Extrications from Ditches, at http://tinyurl.com/spanningthegap.
