BLOCK 3: VEHICLE EXTRICATION/SPECIAL RESCUE Flashcards
3 levels of technical rescue
- awareness: scene size up and identifying hazards
- operation: apply LIMITED techniques
- technician: apply advanced techniques
8 steps of special rescue situations
- preparation
- response
- arrival/scene size up
- stabilization of scene
- access
- disentanglement
- removal
- transport
UCAN format for size up
Unit, Conditions, Actions, Needs
most common and dangerous hazard on rescue scenes
ongoing traffic
traffic incident management (TIM)
controlling flow of traffic to enhance safety and efficient rescue ops
what is the foundation of effective technical rescue incidents
incident command system
3 guidelines for rescue scene
approach scene cautiously
position apparatus properly
assist specialized team as needed
outer and inner circle surveys
outer: first, area surrounding scene
inner: heart of the TRI, 360 if possible
three control zones
hot zone: (red tape) entry/rescue teams, its size is proportional to its hazards
warm zone: (orange tape) trained/equipped personnel, decon
cold zone: (yellow) outer perimeter where vehicles/equipment is staged, command post
who publishes the Emergency Response Guidebook
US Dept of Transportation (DOT)
how far to park from electrical hazard
one full telephone pole span (50ft)
how far away must ground/aerial ladders be from electrical lines
at least 10ft
what two things increase risk of electrocution
increased air humidity and increased voltage in line
primary responsibility of paramedic at technical rescue incident
patient care
simple vs complex access
simple: hand tools
complex: special tools
unless there is an immediate threat, what should be performed before disentanglement
primary assessment and crucial interventions
disentanglement
freeing patients from area or object in which they are trapped
what device is used to stabilize a sitting patient
KED (Kendrick Extrication Device)
packaging
prepping patient for movement as a unit using backboard or similar device
carrying a standard basket stretcher involves a team of how many
6-8
who is in charge of coordinating movement of the stokes basket
person at the front of the left side
when is more than one carrying team needed
distance further than 15-20 minutes
leapfrogging
one team takes litter for a given distance while other team goes ahead to rest and plan for next stretch
what is the caterpillar/lap pass
when there’s an obstacle, all rescuers line up and sit down ahead of terrain/obstacle ALTERNATING
rescuers pass stretcher down between the two lines
posts of a car
A post: form sides of windshield
B post: between front and rear doors
C post: behind the rear doors
D posts: SUVs (also posts E, F, G, etc)
the hood covers ____
engine compartment
the bulkhead divides ___
engine compartment from passenger compartment
rocker panels are _____
metal below the doors between the front and rear wheel wells
most modern vehicles have what type of construction
unibody: body and frame of vehicle are fused together
what are crumple zones
on front and rear of car made to collapse on impact to absorb the force of a crash and prevent intrusion
what are alternative-power vehicles
vehicle that runs on anything other than gasoline or diesel fuel
types of electric vehicle power (3)
hydrogen fuel cells
all-electric batteries
hybrid (gas and electric)
high voltage wires in electric car are what color
orange
what type of fuel do power fleet vehicles use
liquefied petroleum gas (Autogas)
how does ethanol or methanol burn
bright blue “invisible” on clear day
methanol burns without smoke
how far should key fobs be from smart key ignition systems
30ft
what volt battery do electric vehicles have
12V
examples of striking tools
hammers, mallets
examples of leverage/prying/spreading tools
pry bar, halligan
example of cutting tools
trauma shears, glass hand saw
example of lifting/pushing/pulling tools
hooks, pike poles
most basic support for vehicle stabilization
cribbing
5 directional movements of a stabilized vehicle
horizontal, vertical, roll, bounce, yaw
what type of glass are side and rear windows
tempered glass, shatters into small pieces and easily
what type of glass are windshields made of
laminated glass, cracks but remains intact
glass sandwiched between layers of flexible plastic
what to place on outside of window before breaking if time permits
tape with “star of life” to minimize shattering
goal of disentanglement
remove sheet metal and plastic from around patient NOT cut patient out of vehicle
abbreviations on airbag systems
SRS (supplemental restraint system)
HPS (head protection system)
how long can airbag computer retain power after vehicle power is cut
10-30 mins
distance to maintain around airbags that have not deployed
side impact:
driver side:
passenger side:
side: 5 inches
drivers side: 10 inches
passenger side: 20 inches
how to move a dashboard crushing a patient
dash roll, lifts it up and forward
cutting both A posts (4 cuts) and using hydraulic ram
hydrogen sulfide
colorless, toxic, flammable, pungent odor
heavier than air
carbon monoxide
colorless, ordorless, tasteless
carbon dioxide
colorless, sour taste, stinging sensation
methane
will cause burns if ignited
ammonia
toxic, corrosive, pungent odor
lighter than air
nitrogen dioxide
toxic red-brown gas, sharp biting odor
what is used for stabilization during excavations
shoring
what increases probability of secondary collapse
vibrations or additional weight, water
what is the spoil pile
soil removed from excavation into a pile
most trench collapses occur in what size trench
12ft deep and 6ft wide
what side to approach a trench from
narrow side
what is the water self-rescue position
faceup, arched position
lower back higher than feet, feet together facing towards direction of travel, arms at sides, head down, chin tucked, toes above surface of water
how much faster does water cause heat loss than ambient air
25x
how fast will someone die of hypothermia in 35 degree water
15-20 mins
what is HELP
heat-escape-lessening position
floatation device - draw knees close to chest, arms close to sides of body, head and neck out of water
what is the diving reflex
slowing of heart rate caused by submersion in cold water
what is the cold-protective response
hypothermia protects vital organs from lack of oxygen
how to remove patient from cold water
horizontal and minimize patient activity to avoid orthostatic changes or heart dysrhymthmias
most common swift-water rescue scenarios
people attempting to drive through floodwaters
what are the dangers associated with low-head dams
recirculating currents called the “boil”
low-head dams also known as drowning machines
personal floatation devices are required for anyone working within how many feet of the water
10ft
model most commonly used in water rescue
reach-throw-row-go
what can be used to distribute weight of a rescuer on ice
ladder
low-angle rescue operations
less than 35 degrees
ground is primary sup[ort, rope system is secondary
steep-angle rescue operations
35 to 60 degrees
high-angle rescue operations
more than 60 degrees
depend on rope not fixed surface
search vs rescue
search: looking for lost person
rescue: removing person from hostile environment
EMS role in search and rescue
stand by at search base until person is found
particular hazard on farms
tractor power take-off shaft which can become entangled
typical machine hazards
pinch points, wrap points, shear points, crush points, pull-in points
what was the Hartford Consensus
THREAT mnemonic
Threat suppression
Hemorrhage control
Rapid Extrication to safety
Assessment by medical providers
Transport to definitive care
what is compartment syndrome
in chest, abdomen, or extremity when crushed over 4-6 hours
buildup of lactic acid and metabolic wastes
when patient is removed, BP tanks and toxic materials are released into the blood system
pronounced peaked T waves on ECG
how to treat compartment syndrome
PPV, sodium bicarb, calcium, fluid
nonpharmacologic pain management vs pharmacologic pain management
nonpharmacologic: position of comfort, splinting, padding
pharmocologic: meds
how much does water weigh per gallon
8.37lbs
two types of stokes baskets
rigid chicken wire mesh (better for water and air rescue)
rigid fiberglass or plastic (better for all other rescues)
what variables affect hydraulics of moving water
depth, velocity, obstruction of flow
