I’m not an expert (run the other way when anyone claims they are) in extrication techniques. I’m just a firefighter who likes cars; I’ve cut up a few in my career, and even though I’ve promoted and they took the cutting tool out of my hands, I still got game. (Well, maybe.)
I also still read, listen and seek knowledge from others, because regardless of who you are, the day you stop learning is the day you should retire.
The following are some simple tips I’ve learned over the years–mostly by trial and error–that can improve and enhance the safety and efficiency of your extrication operations.
Time, Distance & Shielding
The concepts of time, distance and shielding aren’t reserved for hazmat incidents; they should also be incorporated into extrication ops, particularly when dealing with supplemental restraint systems.
Specifically, give yourself enough time to shut down the electrical system, allowing the capacitors to drain down. Create space, or distance, between you, your patient and the hazard. And wear the proper PPE to protect or shield yourself and the patient, if appropriate.
Stabilization
If you have limited amounts of cribbing, prioritize your stabilization around the patient. Are you lifting the car and shoving step-chocks underneath it? If so, stop! Why take extra hits on your back and knees? Instead, insert step-chocks and deflate the tires. Done.
Taking Glass
Several tools are available for taking glass, such as the Res-Q-Me tool and spring-loaded punches. Tip: If you use a large tool, strike in the corner of the window where your follow-through is limited, and swing for contact, not a home run.
Also remember to stand off to the side, and warn people around you that you’re about to break glass so they’re prepared. Remember to warn the internal personnel and the patient(s) so they can be prepared and protected. Depending on the circumstances, respiratory protection may be appropriate.
Once you’ve broken the glass, use a tool–not your gloved hand–to clear it from the area.
Laminated Side Windows
Side-laminated safety windows are becoming more common; we even see them in economy cars now. Tip: To identify a safety window, look for labeling, such as “LAMISAFE,” on the glass.
I cut a side window from a 2007 Lexus LS460 and found that the LAMISAFE glass reacted like a thin windshield. It cracked easily but stayed intact. Tools that are successful with windshields are usually options with LAMISAFE glass. A Whizzer saw with a diamond cut-off wheel (40/50 grit) worked well. The reciprocating saw with a Milwaukee torch 10-tpi blade was also effective; however, I had to make a starter hole because the glass was slippery.
Taking Tires
Depending on the severity of the wreck and your department’s standard operating guidelines, you can deflate a vehicle’s tires to lessen the movement of its suspension and therefore complement your stabilization efforts.
Tip: Keep in mind that you have several different options–air chucks, core pullers, pliers/cutters, Halligans and knives–when it comes to tire deflation. The damage each can cause ranges in severity from no damage to complete tire destruction.
Pulling Trim
Remove interior coverings to expose hazards and vehicle construction. Ask yourself: Where are the inflators? The seatbelt anchors? Why cut through four layers of material or obstructions when you can bypass all this? We can no longer make blind cuts in today’s vehicles.
Some say you should make a V-cut where the B-post meets the roof when taking a roof, but this cut could be right in line with the side curtain inflator. The message: Pull trim, pull trim, pull trim.
The Side-Door Blowout
This maneuver is also known as the Rip & Blitz, Maxi-Door and the Jackson Swing. When performing this maneuver, keep in mind that some vehicles have their B-post spot welded to the rocker panel while others have the whole side stamped in one piece. With the stamped one-piece construction, you have a greater potential of ripping the rocker panel. Tip: If possible, don’t rip the rocker panel. In unibody-constructed vehicles, ripping the rocker panel may compromise the integrity of the vehicle, especially if the doors, the roof and the B-posts are being removed.
Depending on vehicle construction, tools and talent, the side-door blowout maneuver may take a while, and responders may feel that they’re in over their heads and not able to figure out how to overcome the oddities of this maneuver. This is why it’s important to master the basics and become proficient at taking doors off one at a time before you start taking shortcuts. Remember: The side-door blowout doesn’t work all the time.
Beware the Salesmen
Lately, I’ve seen a trend I don’t like. A lot of people are prematurely cutting hinges and other fixtures because some salesmen convinced them they needed a new cutter. As a result, firefighters are prematurely using their cutters on objects that we could possibly soften first or go around (i.e., cutting through a hardened door impact beam–things that are usually anchored in soft metals).
Tip: If possible, use your spreader to weaken items before you cut. If you don’t, you’ll have a new respect for the limitation of your cutters after you’ve had a couple break on you while trying to use them.
The 360-Degree Scan
After extricating the patient(s), take your time. Do an additional 360-degree scan of the scene, evaluating it for additional hazards and victims. If the car rolled three times, where did the wreck start?
Also, check the trunk for meth labs and additional patients, use your thermal imager, and stay until the wrecker has removed the rolled car from the ditch to ensure there are no victims trapped underneath.
A Final Note
As I said at the beginning, I’ve never claimed to be an extrication expert, but I’ve been around long enough to collect the tips discussed in this article, and to know that you should never think you know enough. There’s always something more to learn.
Remember: You don’t have to be an expert, but you must be effective and know the basics. Otherwise, your actions and ineffectiveness could cause more harm.
