Chapter 8: Victim Disentanglement and Extrication

Question 1

Disentanglement

Answer 1

Aspect of vehicle extrication relating to the removal and/ or manipulation of vehicle components to allow a properly packaged patient to be removed from a vehicle. The vehicle must be removed from around the victim.

Question 2

Entrapment

Answer 2

When the victim or part of the victim is being mechanically restrained, or has restricted means of egress, by a damaged vehicle or machinery component.

Question 3

____ resting vehicles have a greater possibility of catching fire than ____ resting vehicles.

Answer 3

• Side and roof

* wheel

Question 4

Point of entrapment (AKA disentanglement point)

Answer 4

The exact location in which the metal or other object prevents or limits the victim from movement.

Question 5

Common points of entrapment:

Answer 5

• Pedals
• Seats
• Steering wheel and dashboard
• Doors
• Roof

Question 6

The rear of most passenger vehicles is lighter than the front, a rear end collision can raise the rear of the vehicle off the ground while pushing the vehicle forward causing ____

Answer 6

a roll over.

Question 7

Override occurs

Answer 7

when a striking vehicle collides with another vehicle and comes to rest on top of the vehicle being struck.

Question 8

Any trailer built after 1993 is required to have ____

Answer 8

reflective tape on its side.

Question 9

Any trailer built after 1996 is required to have ____

Answer 9

a rear underride guard that is 22 inches above the ground or lower.

Question 10

Special considerations for underrides and overrides include:

Answer 10

• Capturing the suspension of the underride vehicle
• Stabilizing the override vehicle
• Identifying lifting points
• Mitigating fuel and other fluid leaks
• Monitoring fuel tanks for leaks
• Accounting for victims who may have been ejected between the vehicles
• Maintaining control of air and hydraulic systems so that there is movement in the system

Question 11

When sizing up MVI’s, rescuers should first ask:

Answer 11

Is there anything in the situation that would put rescue personnel or others at greater risk than any other vehicle incident?

Question 12

Vehicular triage

Answer 12

A sorting of the vehicles into categories of damage

Question 13

Each extrication team must focus on ____. Based on ____, the team must determine the best way to remove the vehicle from around the victims and to remove the victims from the wreckage.

Answer 13

• one vehicle at a time

* the condition of the victims and the vehicle

Question 14

____ victims prior to any extrication activity.

Answer 14

Contact and communicate with

Question 15

Before performing any glass management activity ____

Answer 15

provide victims with respiratory protection and cover them with fire retardant protective coverings.

Question 16

The easiest way for rescuers to access passenger vehicles is to use ____

Answer 16

the existing entry points.

Question 17

Compared to roof removal, cutting through the roof will Probably be ____

Answer 17

more time consuming

Question 18

Flapping or removing the roof of a side resting passenger vehicle may ____

Answer 18

compromise the vehicles integrity

Question 19

Rescuers typically extricate victims using four basic methods:

Answer 19

• Manipulative extrication
• Disassembly
• Cutting
• Forcing

Question 20

What tools are available to remove laminated glass?

Answer 20

• Reciprocating saw
• Commercial glass removal tools
• Air chisel
• Axe
• Long-handled hook

Question 21

In most modern vehicles, the windshield, the two A-posts, and the forward edge of the roof compose ____.

Answer 21

part of the structural integrity of the vehicle body and should remain in place unless they hinder rescue and extrication efforts.

Question 22

If a windshield must be removed, rescuers should Leave ____ and ____ intact to maintain structural integrity.

Answer 22

• the A-posts

* roof edge

Question 23

When breaking tempered glass, rescuers should strike the glass ____.

Answer 23

at a lower corner of the glass.

Question 24

Always peek and peel the interior trim along ____ and ____ to expose ____, ____, and other devices that could cause injury.

Answer 24

• roof rails
• all pillars
• SRS compressed gas cylinders
• pretensioners

Question 25

If a vehicle door contains an airbag, and must be removed, rescuers will expose a cable between the door and A-post. If the wires must be cut, rescuers should ____

Answer 25

cut and separate the wires one at a time with handheld cutters. Be aware that cutting the wires may deploy the SRS.

Question 26

Fender crush technique

Answer 26

crushing the fender with hydraulic spreaders to gain access to the door hinges for cutting or spreading, and door removal. Completing this technique requires one arm of the spreaders to be placed in the wheel well behind the shock/ strut tower, and the other on top of the fender. Fitting the spreader tip edge into the space between the fender and the hood, as well as raising the back end of the spreader slightly above 90 degrees will help prevent the tool from slipping.

Question 27

What is the safest way to remove doors equipped with airbags?

Answer 27

• Disconnect the hinges by cutting or disconnecting and remove the door from the hinge side first.

Question 28

Third door conversion

Answer 28

technique used to create a wider door opening on two door vehicles.

Question 29

What tools are most often used for third door conversions?

Answer 29

• Reciprocating saw
• Spreaders
• Air chisels

Question 30

Fourth door conversion

Answer 30

A technique that creates an alternate opening on a panel van or work van that only has one operating door for cargo loading and off-loading. Cuts are made between the B and C posts in the side panel, creating a large opening for rescue access and victims removal.

Question 31

If a vehicle is side resting a ____ or ____ will probably provide the best option for creating a clear opening through which rescuers can extricate the victims.

Answer 31

• roof flap, or removal

Question 32

Considerations of vehicle stability during roof removal operations on unibody vehicles.

Answer 32

• rescuers should place a step chock or other support under the B post prior to roof removal.
• The windshields, A-post, and forward edge of the roof compose the structural integrity of the vehicle so they should remain intact, and the roof should be cut just behind the A posts.

Question 33

When the pedals pin a vehicle driver’s feet and legs, rescuers often need to move the ____ out of the way to allow access to the victims feet.

Answer 33

kick panel

Question 34

Rescuers should avoid cutting ____ when performing kick panel removal.

Answer 34

the fuse panel

Question 35

When gaining access through the floor of the vehicle, check ___ before cutting.

Answer 35

the interior of the vehicle to ensure victims are not in contact with the portion of the floor that is about to be cut.

Question 36

Do not use ____ to make entry through the floor on a vehicle.

Answer 36

cutting torches

Question 37

Trunk tunneling may be need in the following situations.

Answer 37

• rear or side underride incidents

* obstructions to both sides and top of the vehicle are encountered.

Question 38

Alternative techniques to gain access and egress opening on passenger vehicles with advanced steel.

Answer 38

• Pie cut
• B-pillar lift
• Cross ramming
• Ramming the roof off
• Partial or total sunroof

Question 39

Pie cut

Answer 39

Often, only the B-posts contain advanced steel and not the roof rail. In these situations a ____ can be made in the roof rail at the top of the B post allowing the B-post to be laid down.

Question 40

B-post lift

Answer 40

If advanced steel is in the roof rail, and pie cut attempts fail, often cuts can be made near the bottom of the B-post near the rocker panel allowing the B-post to be lifted out of the way.

Question 41

Cross Ramming

Answer 41

If the B-post cannot be cut at the top or bottom, rescuers can push the B-post away from the vehicle using a hydraulic ram placed on the transmission tunnel/hump and extending to the vehicles B-post. If the ram is long enough B-post to B-post ramming can also be attempted.

Question 42

Ramming the roof off

Answer 42

A powerful ram may be used to push the roof rail up until it begins to tear at the spot welds. After an initial push behind the B-post, a second push along the front side may completely tear the B-post from the roof rail. Cribbing will need to be placed beneath the rocker panel to support the push of the ram.

Question 43

Partial or total sunroof

Answer 43

If advanced steel is located in key locations of the roof pillars, roof rail, and rocker panel, a partial or total sunroof may be the best option. This is accomplished by cutting inside the roof rail and flapping or removing the roof panel up and away from the victim(s).

Question 44

Displacing a steering column

Answer 44

A technique that involves piercing the windshield and wrapping a chain or rescue hook around the steering column. The chain or hook should be placed as close to the dashboard as possible to prevent the steering wheel from flying into the victim. The chain is then used to lift the steering column freeing the victim.

Question 45

Steering column displacement should not be done on ____.

Answer 45

Steering columns that contain a knuckle (tilt steering wheels). They can break and strike a victim.

Question 46

Displacing a dashboard

Answer 46

Dashboards can be displaced using a ram in the door jamb along with appropriate relief cuts to push/ roll the dashboard. Or using spreaders in the kick board with appropriate relief cuts to perform a dashboard lift. Jacks can also be used to perform the dash push/ rolll.

Question 47

When displacing a dashboard, rescuers must protect themselves and entrapped victims from ____

Answer 47

undeployed front-impact or knee-bolster airbags.

Question 48

Dropping the floor pan

Answer 48

Cuts are made that greatly resemble a dashboard lift but with cuts made in the lower A-post and rocker panel rather than the upper A-post and fender rail. This allows the floor pan to be lowered away from the victim. Identify power cables (hybrid vehicle), brake lines, fuel lines, and other cables that extend along the inner side of the rocker panel under the vehicle prior to beginning this technique.

Question 49

Displacing the B-post

Answer 49

Cross ramming and interior spreading allow rescuers to alleviate intrusion and displace the impacted side outward. This provides access for rescuers to remove the doors and B-post without further injuring victims.

Question 50

Interior spreading

Answer 50

Involves positioning the spreaders behind the driver victim, usually from the rear floorboard to the lower B-post. Cribbing should be used on the floorboard to provide an adequate base for the spreader arm.

Question 51

Before moving a seat, rescuers must properly ____

Answer 51

package any victims as dictated by their injuries.

Question 52

If a victim cannot be packaged without moving a seat, rescuers must ____. In general, rescuers should try to ____

Answer 52

• leave the seat in position and remove the vehicle from around the victim.
• displace or roll the dashboard to disentangle victims instead of moving the seat.

Question 53

To prevent a pedal from twisting and pinching a victim’s leg or foot, rescuers should ____

Answer 53

wrap a web strap around the pedal and place tension on the strap to pull the pedal away from the victims extremities.

Question 54

Methods for displacing pedals:

Answer 54

• Cut the pedals
• Bending the pedals with a hydraulic spreader
• Attaching a chain, wed strap, or rope around the pedal arm near the foot pad and pulling laterally, either manually, or with spreaders.
• Strapping the pedal to a functioning door, and opening the door to move the pedal
• Strapping the pedal to the steering wheel and turning the steering wheel
• Using a jack, spreaders or ram to lift the pedals in the same manner as a steering column lift.