February 2008 - Tool Time - by Capt. Raul A. Angulo - Alternative Tools For Auto Extrications.

When it comes to auto extrication, there’s lots of state-of-the-art equipment out there, but some equipment essential to motor vehicle accident (MVA) extrications isn’t necessarily new and isn’t necessarily carried on the apparatus.

There’s a lot of ideas, techniques and resources which you may have forgotten about, but which are readily available to every fire department to support a quick, safe and successful MVA extrication.

First of all, many fire departments do not have truck companies or rescue companies, and not every apparatus, or even every department, has hydraulic extrication tools. Some fire departments may still depend on mutual aid for auto extrication equipment. Many fire districts around the country are also consolidating, forming a larger department.

All that being said, the need for cross training is essential. At any given time, for a variety of reasons – such as details, overtime, vacations, back fill, sick leave, large-scale incidents – a firefighter may end up at the controls of a hydraulic rescue tool.

tt1 Extra large forklifts can be used to move commercial vehicles and larger autos when necessary. Forklifts are sometimes quicker and easier to deploy than conventional lifting tools. (Fire Apparatus Photo by Raul Angulo)

Cross training will build the overall strength of a fire department if all members are trained at least to an awareness level so they can operate rescue tools, on a basic level, with confidence.

Agreements with wrecking yards are inexpensive and easy to arrange. They can deliver vehicles right to a training facility or fire companies can be given permission to train at the wrecking yard. Make the effort to get crews together and practice cutting up those cars. Firefighters are always enthusiastic about hands-on training.

Training should include size-up and apparatus positioning and will require detailed discussion at the fire station in a classroom-type setting. There are, however, a few elements I want to cover.

Apparatus positioning is critical to the safety of firefighters and the efficiency of the operation. You don’t want to park too close or too far from the scene, and it’s important to use the apparatus to block on-coming traffic. This provides a barrier and protects the scene for firefighters to work without the fear of being hit by an oncoming car. It also protects the patient.

The trick is, however, the driver must park the apparatus far enough away to give the crews room to work and to have the ability to lay a hose line without a spaghetti pile. Parking too far away can waste valuable time if you need additional equipment from the apparatus.

If you come upon an MVA with leaking fuel, position the apparatus uphill and upwind from the scene. Use traffic cones to protect the scene from oncoming traffic rather than flares, for obvious reasons. Once police officers arrive on scene, have them use their vehicles, well beyond the spill, to divert oncoming traffic. You may also want to consider laying down a blanket of foam, before extrication begins, as a precaution to help control flammable vapors from the fuel spill.

A charged hose line needs to be deployed along with a dry chemical portable extinguisher. Keep the nozzle and the extinguisher close to the immediate operation.

Look for other scene hazards that can make the situation worse, like other sources of ignition and downed power lines.

In addition to determining the stability of a vehicle, an important part of size-up is determining the number of victims involved. It’s easy to get tunnel vision when you come upon a spectacular wreck. A person trapped in the wreckage may be an obvious observation, but there have been incidents where victims have been thrown clear of the accident, in need of advanced life support (ALS) medical assistance and weren’t discovered until well into the incident.

The first-in company officer needs to determine how many victims are part of the incident. They may not all need to be extricated, but they may all be in need of ALS or basic life support (BLS) medical treatment. Don’t hesitate to call for additional resources.

It’s important to keep crew members safe too. Make sure your crew members are dressed with their structural firefighting ensemble (SCBA excluded unless there’s an obvious reason to have them on, like the presence of fire). Not only does it protect firefighters from sharp metal and glass, it’s their best protection from a flash fire and explosion. Crews need to prepare not only for what the incident is, but also for what it may become.

Should a fire start, crews are not going to have time to run back to the apparatus to don their turnout gear. This is also the reason why the deployed hose line needs to be charged and not simply laid out. It takes time to charge a line, remove the kinks and bleed out the air. I can see no reason, other than laziness – not wanting to drain, pick up and reload hose – for not deploying a charged hose line at an auto extrication.

A pickhead axe will quickly deflate tires to help stabilize wrecks for extrication. However, flattening tires prematurely might make it difficult to move vehicles if necessary.

Consider using a tarp to cover and protect the victim. If the victim is conscious, no doubt a firefighter will be inside the vehicle holding C-spine traction. Cover the firefighter with the tarp as well and have him/her talk with the patient to keep the patient calm. The noise of the operation and the inability to see what’s going on can be frightening in a situation that’s already distressing.

There are many methods and tools that can be used to stabilize a vehicle. Probably the quickest (and most fun) way to stabilize a vehicle is to take a pickhead axe and drive the pick right through the sidewall of the tires. The tires will quickly deflate creating increased friction with the road and the vehicle will be difficult to roll.

On the flip side, this method can work against you. If vehicles need to be pulled apart or moved for better patient access, an over zealous firefighter can needlessly complicate the task with a few quick swings of an axe. You can always decide to flatten the tires later, after further size-up, but you can’t re-inflate them because you’ve changed your mind.

Perhaps a better solution is to quickly deploy a wheel block (chock). All fire apparatus carry them, and they are religiously used to chock the tires of the apparatus at an emergency scene. However, this is an excellent use of equipment by first-in units to quickly stabilize a car. Once additional units arrive on scene, the wheel blocks can be exchanged for cribbing blocks and returned to the first-in apparatus for proper placement against the apparatus wheels.

Depending on the make and models, spreading and cutting tools can deliver a range from 60,000 to 200,000 pounds of cutting force. Once that metal gives way, those forces need to go somewhere.

Doors and vehicle posts have been known to shoot out like missiles for several feet from the scene. One way to control these projectiles is by tying a rope or webbing to the part of the vehicle being cut.

For example when cutting a car door, I have a member tie a 1-inch body loop (webbing) to the handle or window frame. As the door is being cut, the firefighter pulls on the webbing in the direction he/she wants the door to fall. This is usually away from the firefighters operating the spreaders. Once the door falls off, that firefighter can quickly drag the door away from the scene.

There are two special, underutilized resources that are found in every community that often get overlooked until the scene has been cleared. In fact, some of these resources are close by and can often be deployed before additional fire department units arrive on scene. They are tow trucks, or wreckers, and forklifts.

If you’ve noticed how vehicles are moved and stacked at wrecking yards, you’ll see it’s often done with forklifts. Many operators simply insert the forks through the open windows of the car and lift it by its roof. It almost looks like they’re flipping pancakes. You’ll want the operators to use a little more finesse than they might employ in wrecking yards, but the point is forklifts are very powerful tools that are often readily available, at least in urban areas.

Depending on your community, you may also have access to super heavy-duty forklifts capable of moving and lifting semi trucks, tractor- trailers, buses and other large commercial vehicles.

During vehicle extrications, it’s important to keep the occupants safe. Covering occupants with tarpaulins will protect them from glass and debris that may dislodge. It’s also a good idea to include a firefighter or rescuer under the tarp to provide a modicum of comfort. (Seattle Fire Department Photo)

Tow trucks are usually used after the incident is over to remove the crashed vehicles from the roadway. However, a skilled tow truck operator is most often willing and ready to help out in the initial stages of the incident. The incident commander only needs to ask, and they’ll usually respond immediately. Tow trucks can be quickly deployed to help stabilize, lift and move vehicles when necessary. Skilled tow truck operators are taught to cause no further damage to the vehicle, so most should be able to provide the kind of controlled power needed to execute a successful extrication.

Firefighters love using their specialized rescue equipment like airbags, but unless crews are well trained, this can be a time consuming evolution. Airbags need to be set, the compressed air system needs to be hooked up, and cribbing blocks need to be set out. “Lift an inch, crib an inch” is a safety motto and rule of thumb for rescue air bag/lift operations, but with some auto extrications, time is of the essence if we are to save a life.

Don’t get me wrong, airbags absolutely have their place in the rescue arsenal, especially when a wrecker is available or advisable for a variety of reasons.

As well trained as my guys are, I would certainly consider the use of a tow truck if I had to quickly lift a vehicle off a patient who was being crushed to death. Attaching a tow truck cable is a pretty quick and safe evolution. Think about it.

So, that’s a quick look at some of the different tools you might want to think about next time you’re at an auto extrication scene. Help and resources might be a lot closer than you think.

Editor’s Note: Raul A. Angulo is a 28-year veteran of the Seattle Fire Department and captain of Ladder Company 6. He is on the Educational Advisory Board for the Fire Department Instructors Conference and is on the Board of Directors for the Fellowship of Christian Firefighters. He lectures on fire service leadership, company officer development and fireground strategy and accountability throughout the U.S., Canada and Mexico.