Chapter 8: Victim Disentanglement and Extrication Flashcards
Disentanglement
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.
Entrapment
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.
____ resting vehicles have a greater possibility of catching fire than ____ resting vehicles.
- Side and roof
* wheel
Point of entrapment (AKA disentanglement point)
The exact location in which the metal or other object prevents or limits the victim from movement.
Common points of entrapment:
- Pedals
- Seats
- Steering wheel and dashboard
- Doors
- Roof
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 ____
a roll over.
Override occurs
when a striking vehicle collides with another vehicle and comes to rest on top of the vehicle being struck.
Any trailer built after 1993 is required to have ____
reflective tape on its side.
Any trailer built after 1996 is required to have ____
a rear underride guard that is 22 inches above the ground or lower.
Special considerations for underrides and overrides include:
- 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
When sizing up MVI’s, rescuers should first ask:
Is there anything in the situation that would put rescue personnel or others at greater risk than any other vehicle incident?
Vehicular triage
A sorting of the vehicles into categories of damage
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.
- one vehicle at a time
* the condition of the victims and the vehicle
____ victims prior to any extrication activity.
Contact and communicate with
Before performing any glass management activity ____
provide victims with respiratory protection and cover them with fire retardant protective coverings.
The easiest way for rescuers to access passenger vehicles is to use ____
the existing entry points.
Compared to roof removal, cutting through the roof will Probably be ____
more time consuming
Flapping or removing the roof of a side resting passenger vehicle may ____
compromise the vehicles integrity
Rescuers typically extricate victims using four basic methods:
- Manipulative extrication
- Disassembly
- Cutting
- Forcing
What tools are available to remove laminated glass?
- Reciprocating saw
- Commercial glass removal tools
- Air chisel
- Axe
- Long-handled hook
In most modern vehicles, the windshield, the two A-posts, and the forward edge of the roof compose ____.
part of the structural integrity of the vehicle body and should remain in place unless they hinder rescue and extrication efforts.
If a windshield must be removed, rescuers should Leave ____ and ____ intact to maintain structural integrity.
- the A-posts
* roof edge
When breaking tempered glass, rescuers should strike the glass ____.
at a lower corner of the glass.
Always peek and peel the interior trim along ____ and ____ to expose ____, ____, and other devices that could cause injury.
- roof rails
- all pillars
- SRS compressed gas cylinders
- pretensioners
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 ____
cut and separate the wires one at a time with handheld cutters. Be aware that cutting the wires may deploy the SRS.
Fender crush technique
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.
What is the safest way to remove doors equipped with airbags?
- Disconnect the hinges by cutting or disconnecting and remove the door from the hinge side first.
Third door conversion
technique used to create a wider door opening on two door vehicles.
What tools are most often used for third door conversions?
- Reciprocating saw
- Spreaders
- Air chisels
Fourth door conversion
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.
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.
- roof flap, or removal
Considerations of vehicle stability during roof removal operations on unibody vehicles.
- 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.
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.
kick panel
Rescuers should avoid cutting ____ when performing kick panel removal.
the fuse panel
When gaining access through the floor of the vehicle, check ___ before cutting.
the interior of the vehicle to ensure victims are not in contact with the portion of the floor that is about to be cut.
Do not use ____ to make entry through the floor on a vehicle.
cutting torches
Trunk tunneling may be need in the following situations.
- rear or side underride incidents
* obstructions to both sides and top of the vehicle are encountered.
Alternative techniques to gain access and egress opening on passenger vehicles with advanced steel.
- Pie cut
- B-pillar lift
- Cross ramming
- Ramming the roof off
- Partial or total sunroof
Pie cut
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.
B-post lift
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.
Cross Ramming
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.
Ramming the roof off
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.
Partial or total sunroof
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).
Displacing a steering column
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.
Steering column displacement should not be done on ____.
Steering columns that contain a knuckle (tilt steering wheels). They can break and strike a victim.
Displacing a dashboard
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.
When displacing a dashboard, rescuers must protect themselves and entrapped victims from ____
undeployed front-impact or knee-bolster airbags.
Dropping the floor pan
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.
Displacing the B-post
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.
Interior spreading
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.
Before moving a seat, rescuers must properly ____
package any victims as dictated by their injuries.
If a victim cannot be packaged without moving a seat, rescuers must ____. In general, rescuers should try to ____
- 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.
To prevent a pedal from twisting and pinching a victim’s leg or foot, rescuers should ____
wrap a web strap around the pedal and place tension on the strap to pull the pedal away from the victims extremities.
Methods for displacing pedals:
- 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.
