What’s your first thought when you think of extrication? If you answered motor vehicle collisions (MVCs), you may be forgetting an all-too-common form of entanglement.
“People find all kinds of ways to get themselves in trouble,” says Mark Gregory, an FDNY lieutenant and instructor with PL Vulcan Training Concepts, a training team of 12 firefighters from around the country. Today at FDIC, Gregory presented the popular Man vs. Machinery class, focused on extrications performed off the roadway—involving equipment from printing presses to snowblowers—and the unique approaches and methodologies that come with them.
Keeping It Simple
“You have to be a thinking firefighter,” says Gregory, explaining the deliberation called for with machinery extrication. It’s important not to fall into what he calls “tunnel vision”—the tendency to look at a situation in only one way and fixate on the most apparent solution without ever considering alternatives, some of which may often be easier and more efficient.
Gregory witnesses this kind of narrow mindset all the time in training exercises. “The young guys especially are quick with an answer. They say ‘Oh, we’ll cut here and here and here,’ when you can just take a socket wrench, loosen a few bolts, drop a piece of the machinery out of the way and our job is done. I tell them—if a machine was put together, that machine was meant to be taken apart.”
But even what seems like the most obvious first step is not always so easy: turning the machine off. Especially in the case of industrial equipment, most every machine is outfitted with some form of backup power system. To ensure the victim’s safety as well as that of the rescuer, it’s important that responders fully inform themselves about the machinery involved in the situation. This means performing an inspection and size-up, as well as communicating with industry personnel on the scene.
“If a firefighter gets injured on this kind of job, they become part of the problem, not the solution,” Gregory says. “Preventing this can be as easy as taking the key out of a snowblower—or better yet, just removing the sparkplug.” Firefighters should take every precaution available to ensure that the situation won’t be further complicated by oversight.
“That’s what makes you a professional,” says Gregory, “the ability to see the big picture—to slow down, think, and decide upon the best and safest way to operate.”
Every Action Has a Reaction
Just as important as a thoughtful size-up is continuous anticipation of the intended and unintended effects at each step of the chosen extrication strategy. “Every action has a reaction,” says Gregory.
One of his examples involves a victim impaled by a tree branch. “Because the object is wood, the first answer from many is to proceed with a wood saw.” But he’s quick to note that the large teeth on such a saw would cause intense vibration and additional pain for the victim. “A band saw meant for cutting metal isn’t the most obvious option, but it’s much better—smaller teeth, smoother cut, less vibration, less pain.”
While the size of saw teeth may seem like minor consideration, they make a big difference for the victim. “If you’ve got someone impaled on a piece of rebar close to their spine, the slightest movement during extrication could mean that person living a normal life or them being further injured or killed,” Gregory says. “You always have to think about what’s happening on the other end of what you’re working on.”
Depersonalize the Situation
Of course, the human factor weighs particularly heavy in machinery extrication—the nature of situation makes for some gruesome sights. Says Gregory, “There’s a reason why we use pig’s feet in our training exercises.”
But a responder needs to prepare for this, he says, and be able do the job regardless. Whether that means putting a sheet over the victim or just blocking the body from your mind, “sometimes you have to be able to treat the call as if it’s an object in order to take the emotional element out of it.”
Gregory notes how the incidents that are most psychologically traumatic for first responders are the calls involving children. While they may not operate heavy machinery, kids can find plenty of ways to get themselves entangled. “If you’re out there rescuing a kid, the first thing you’re going to think of is your own children—what if this was one of them? Those situations, especially, it’s important to depersonalize.”
Extricating children may also involve securing the victim’s parent as well. And interestingly enough, the mothers are the biggest asset.
“A mother may be hysterical when you get there, but once we arrive and outline what needs to be done, mothers are a great resource in keeping the kid calm while we work,” Gregory says.
For children and adults alike, another source of comfort during extrication is explaining to victims exactly what is going to happen at each step of the process. Even letting the victim grow accustomed to the sound of extrication tools is a good idea. “A lot of the tools we use in the fire service, like air tools for example, they sound like a dentist’s drill—the most feared tool to all mankind,” Gregory says. “If you let it run a little first and explain what’s going to happen, it can help the victim immensely.”
Though some of these factors may apply to all forms of extrication, Gregory believes machinery extrication features a key difference in approach. “At an MVC, you’re basically disentangling the vehicle from around the person, whereas with machinery, you’re disentangling the person from the object.” This, he says, requires a unique level of trust from the victim, and a way of thinking outside-the-box to provide the best service possible.
“You never know what to expect on one of these calls,” says Gregory. “You hope you’ll never have one, but chances are you will, so it pays to be prepared.”