Throughout the last two years this column has often discussed the movement of the patient vehicle and multiple ways to accomplish that based on the vehicle position, equipment available, and needs of the situation. At the time this concept was presented, there was limited information and tactics available. Since then, several tactics have been developed and/or refined to allow for a very controlled movement of the vehicle that facilitates an appropriate path of egress and decreased extrication time.
Until recently, responders only considered complete movement of wheel- and roof-resting vehicles. The movement of side-resting vehicles was limited to various forms of controlled rolls aimed at changing the angle of the vehicle in relation to the object that limited disentanglement tactics. The overwhelming consensus was the vehicle could not be horizontally moved due to the high center of gravity in relation to the base of support. But after some testing and development, the movement of a side-resting vehicle can be accomplished with several advantages over controlled rolls. For one, it is easier and quicker to accomplish and doesn’t require any pre-existing considerations before setting up stabilization equipment: the setup resembles typical side-resting stabilization with the struts on one side. One disadvantage, however, is the tactic does not expose the down side of the vehicle, in cases that call for a dash displacement.
Initially treat the incident like any other motor vehicle collision. Take the necessary steps to establish incident command, survey the scene carefully, call resources as needed, control hazards, and stabilize the vehicle in the position found before proceeding with the following:
- Place struts on the undercarriage side at the front and rear of the vehicle as with typical side-resting stabilization when placing struts on only one side. If there is a delay in setting up the pulling device, ensure there is a temporary tie back established on the strut side and/or cribbing between the vehicle and the immovable object.
- Connect the pulling device to the vehicle with a short chain or cable to capture the high and low side of the vehicle. When setting up the pulling device, try to keep the cable/strap relatively level in relation to the lower connection point. Utilizing both a high and low attachment point ensures a much smoother, even pull without the potential to roll the vehicle. Another advantage of attaching to the high side is keeping resistance against the strut heads. When using a short chain, a cluster can be used to avoid slippage.
- Place tension on the system and remove any temporary strapping and cribbing.
- Connect a short strap to the bottom of the strut on the end of the vehicle that will be moved. The strap will serve as a means to guide the strut during the movement to keep it fairly in line with the vehicle and from digging into any soft ground conditions. At a minimum this should be done on the strut that will be moved the most, but if manpower is available, place on both struts.
- Ensure proper coordination with the disentanglement supervisor, interior rescuer, pulling device operator, and responders minding the strut base(s).
- Begin the movement and observe for the intended results.
- Once the vehicle has been moved sufficiently enough to allow tactics to be completed, reinsert the cribbing and ensure the struts are tight utilizing the pulling device as a tie back.
- When beginning to assemble the pulling device, it is necessary to decide which end of the vehicle is going to be moved. The preferable choice would be to move the rear of the vehicle for two specific reasons: First, there is typically less weight at the rear of the vehicle which decreases the load on the anchor, rigging, pulling device, and rigging points. In situations where equipment such as pickets and small-capacity pulling devices are used, this may make a substantial difference. This also keeps the majority of the vehicle weight stationary and the vehicle less likely to have any gross movement during the operation. Secondly, movement of the rear more commonly opens up the path of egress. Patients are more likely to be removed inline towards the rear of the vehicle instead of the front. Tests have shown the entire vehicle can be moved at one time, but this requires additional manpower and equipment. A rigging system would have to be established with four connection points, two at each end.
- Technically, this tactic could be completed with struts on the opposing side. Yet considering the scenarios in which this method can be used, there is little likelihood the patient compartment side could be strutted and freely move with the vehicle.
- To decrease friction, place oil or dry, shattered tempered glass on the movement path of the vehicle and the base of the strut. This will make the overall movement easier and smoother as well as decrease the needed capacity of the pulling device and rigging. When completing the tactic on concrete or asphalt, a wedge could also be placed at the end being moved. The vehicle will “ride” on the wedge, decreasing the overall friction against the ground.
- With some training, a spreader can be used on the opposite side of the vehicle to begin the movement. This can make the initial movement smoother and/or be used when the pulling device is not sufficient enough to move the vehicle. The spreader should be placed at an angle to push the vehicle instead of raise it.
Responders continue to find new and innovative ways to not only move the patient vehicle, but also complete tactics necessary to establish an appropriate path of egress. With the addition of this tactic, responders now have several options to consider when trying to create space with a vehicle that has significant roof intrusion and is resting against an immovable object. Train on these options and decide what works best for your organization.