LO12 Extrication Flashcards
The following factors also contribute to serious injury on the farm
Very few safety regulations exist
When a farmer becomes entangled in equipment, lengthy extrications are often required, which aggravates and increases the severity of injury.
Since many farmers work alone in remote areas, they may not be missed for hours.
Long transport times contribute to the severity of injuries
Pinch points
two objects meet to cause a pinching or pulling action. Example: Chain driven parts
Wrap points
an aggressive component of machinery moves in a circular motion. Example: Power take off
Shear points
two objects move close enough together to cause a cutting action. Example: Auger
Crush points:
two large objects come together to cause a crushing action. Example: Feed roller
Stored energy
hazards remain after the machinery is shut down. Example: Spring loaded equipment
Once the vehicle has been stabilized, it may be shut down using the following procedures:
Enter the cab or climb onto the operator’s platform. Locate the ignition switch or the key and throttle
Slow the engine down with the throttle and then switch or turn off the key or ignition.
If you cannot shut down the engine from the cab or operator’s platform, try the shut-off valve at the bottom of the fuel tank.
If this does not work, try clamping the fuel line (rubber or metal hose) with a pair of pliers or vice-grips.
If the patient is in a life-threatening situation and all other attempts to shut down the engine have failed, discharge a CO2 fire extinguisher into the air intake.
Power Takeoff Shafts (PTO)
is a specially designed shaft that connects the tractor’s engine to other agricultural implements such as augers, mowers, and corn pickers.
PTO–related accidents occur when clothing gets caught in the spinning shaft and pulls the worker in. Arms and legs may be amputated. The worker’s body may also be wrapped around the shaft.
Combines
A common source of injury is the auger. The auger is the rotating part of a screw conveyor. It can pull in victims with extreme force, often causing complete amputations of extremities.
Other sources of injury are the heads, which have oscillating cutting bars; reels with hardened steel tines that can impale the patient; and snapping rollers, which cause severe crush injuries.
Never use the self-reversing feature on a combine to remove a trapped patient.
Hay Balers
A worker can be picked up and pulled into the header assembly. He can be entrapped up to the shoulders, and the tines can cause penetrating wounds in the chest and abdomen.
Avulsions of various degrees can be caused by the cross auger.
grain bins
Usually loaded by augers, grain bins come in a variety of sizes. Workers who enter one to get grain flowing can be buried with grain in seconds.
Because most bins unload from the centre, most patients are found in the middle of the bin.
The temperature of stored grains is low, even in the summer. The patient could become hypothermic, possibly prolonging survival.
General guidelines for grain bin extrication include the following:
Keep fans working until the
actual extrication begins—this may provide more air to the patient.
Ensure the fire department is on-scene with a charged water line.
Cut two 18-inch triangles in the side of the wall on opposite sides of the bin.
The holes should be as high as possible, but remain below the grain level.
Open the holes at the same time to allow the grain to flow out of the bin evenly.
You may have to cut additional holes as the grain level drops.
Once you have exposed the patient, secure him with a lifeline.
Try to shore the grain away from the patient. You could use spine boards, plywood, metal sheets, etc
Remove as much grain from around the patient as possible before extrication. Pulling against the force of the grain can cause further injury.
Airway management and spinal immobilization are management priorities.
Silos
used to store chopped grain or hay as feed for livestock. They may be constructed of clay blocks, concrete blocks, steel sheets, poured concrete, or steel glass-lined sheets.
When crops are stored in silos, gases are formed by natural chemical fermentation.
Fermenting crops can release high levels of carbon monoxide, methane, and oxides of nitrogen (“silo gas”).
silo gas
Red-brown to yellow-green in colour, silo gas smells like household bleach and will kill within minutes in high concentrations. Because silo gas is heavier than air, it flows down the side chute and out the open silo door.
People working around the base of the silo, in the feed room, or adjacent barn can be exposed to dangerous levels of silo gas. Low levels of silo gas can irritate the nose, throat, and lower airway.
The presence of silo gas may be recognized by the following signs:
Bleach-like odour
Yellowish or reddish vapour hovering over the product
Stains of red, yellow, or brown on the product or other surfaces contacted by the gas
Dead birds or insects near the silo
Nearby livestock with signs of illness
When rescuing a patient exposed to silo gas, follow these guidelines:
All rescuers entering the silo or contaminated structures must use a self-contained breathing apparatus (SCBA) and appropriate protective clothing and eyewear.
All rescuers coming into contact with the patient must use appropriate protective clothing, eyewear, and gloves
Follow decontamination procedures.
All patients must be transported to a health care facility.
Manure Storage
There are two potential injuries from liquid manure
drowning and inhaling toxic fumes.
The liquid manure releases ammonia, carbon monoxide, carbon dioxide, methane, and hydrogen sulfide.
Agitation of the manure pit can cause the sudden release of hydrogen sulfide.
Signs and symptoms of hydrogen sulfide intoxication
cough,
irritation of mucus membranes,
nausea
pulmonary edema.
High concentrations can cause respiratory paralysis respiratory arrest and sudden collapse.
Agricultural Chemicals
Poisoning from these agents are often overlooked because the signs and symptoms resemble other common medical conditions including heat exhaustion, food poisoning, asthma, allergies, congestive heart failure, smoke inhalation, and influenza to name a few.
Rescue
needs to deliver for danger or imprisonment’
Technical rescue incident
complex rescue incident involving
vehicle extrication,
rescue from water, ice or confined spaces,
rescuing following trench, structural collapse,
high angle rescue,
response to hazardous materials incident
wilderness search and rescue in specifically trained personnel in special equipment
Three levels of training and technical rescue
Awareness: emphasis on recognizing the hazards, securing the scene and calling for appropriate assistance
Operations: operations training will allow you to assist directly into the rescue operation and take a limited part in rescue incidents
Technician: directly involved in the rescue operation itself
Steps of Special Rescue
Preparation Response Arrival and assessment Stabilization Access Disentanglement Removal Transport
Preparation
Does the service have the personnel and equipment needed to handle a TRI from start to finish
Which equipment and personnel will be first on scene
what resources will be available on call
Do members of the service know the hazards in the response area
Response
A dispatch protocol should be established
Respond with resources including a rescue squad, a fire engine, fire supervisory staff, an ambulance and a paramedic supervisor
Might need to notify utility companies
Arrival and assessment
Immediately on arrival incident commander will assume command
A rapid an accurate seen assessment is needed to see what additional resources might be needed and to determine danger
Assess the extent of injuries and number of patients
Stabilization
Establish an outer perimeter to keep public and media out of staging area and maintain a smaller perimeter directly around the rescue
The size of the rescue area is proportional to the hazards are exist
Hot zone
Area for entry teams and rescue teams this zone immediately surrounds the site of incident
Warm zone
the warm zone is only for properly trained and equipped personnel this is where personnel and equipment decontamination and hot zone support take place
Cold zone
outer perimeter in which vehicles and equipment are staged and the command post is located
Access
Gain access to the patient how is he or she trapped
Identify the actual reason for the rescue and work toward freeing the patient safely
Communicate with patients at all times during the rescue to make sure they are not injured further by the rescue operation
Disentanglement
involves free and patient from area or object in which they are trapped
Unless there’s an immediate threat you should perform an initial assessment and any necessary interventions before disentanglement such as intravenous, spinal motion restriction, securing the airway, administering oxygen, providing ventilation or controlling significant bleeding
Removal
What’s the patient has been disentangled and life hazards treated begin removing patient
Quick removal may occur if hazards are present such as spilled gas or other materials that could endanger patient or rescue personnel
The only time the patient should be moved prior to completion of initial care, assessment, stabilization and treatment is when the patients or emergency responders life is in immediate danger
Scene assessment begins with info from dispatch and bystanders
Information collected should include the following:
Location of incident
Nature of incident
Number of patients trapped or injured
Condition and position of patients
Nature and estimated severity of specific injuries
Condition and position of vehicles
Hazards at the scene or specific hazard information
Name of person calling in a number where person can be reached
Identify in life-threatening hazards, take corrective measures to mitigate them
determine whether situation is a search, rescue or recovery
A scene assessment should include the initial ongoing evaluation of the following issues:
Scope and magnitude of the incident
Risk and benefit analysis
Potential number and severity of patients
Hazards
Access an exit from the scene
Environmental factors
Available and necessary resources
Publishment of a control perimeter
Outer circle survey
involves evaluating the area surrounding the technical rescue incident
Identifies any life threatening hazards and taking measures to avoid or mitigate them
Inner circle survey
might help responders notice downed wires on top of a behicle or additional victims beneath it
Incident command
First arriving officer
Utility hazards
Can be above ground and below ground
Park 15m away from downed power lines
Motor Vehicle Collisions
Parker emergency vehicles in a manner that will ensure safety and not distract trafficked
On limited access highways keep vehicles in apparatus not directly involved in the rescue off the roadway
Use only essential warning lights and do not assume that motorist will heed them
Energy absorbing bumpers can explode when subjected to heat and can spring out when loaded
Airbags can deploy at any time after collision and must be deactivated even if the power supply to the vehicle has been disconnected
Conventional fuel systems with highly flammable vapours may ignite if they come in contact with hot converters or heated engine components
The A post
The B posts
The C posts
The D posts
The A posts are located closest to the front of the vehicle they form the sides of the windshield
The B posts in four-door vehicles are located between the front and the rear doors of a vehicle
The C posts in four-door vehicles if present or located behind the rear doors
The D posts can be found on large vehicles such as sport utility vehicles and vans that have windows behind the rear doors
Platform frame construction on vehicles
uses beams to fabricate the loadbearing frame of a vehicle
found primarily in trucks and SUVs
Provides a structurally sound base for stabilizing the vehicle and an anchor point for attaching cables or extrication tools
Unibody construction on vehicles
is used for the most modern cars combines the vehicle body in the frame into a single component
Allows auto manufacturers to produce light weight vehicles
When Extricating a person from such a vehicle remember that unibody vehicles do not have the frame rails that are present in platform frame constructed vehicles
Alternative Power Vehicles
Encompass vehicles powered by electricity, gas, ethanol, bio diesel fuels and other less common alternative power sources
Electric and hybrid power
Electric vehicles are powered by hydrogen fuel cells all electric batteries are a combination of gasoline and electric power most common types of alternative power vehicles rescuers are likely to encounter
The less commonly encountered but more hazardous is leakage of chemicals from damaged battery packs releasing toxic gels liquids or gases
Liquified petroleum Gas (LPG)
similar to traditionally fuel vehicles but use compressed propane gas or a mixture of propane and butane sometimes referred to as auto gas
Hazard after a crash if large amounts of highly flammable or reactive gases leak from vehicle
Ethanol and flex fuel
vehicles powered by ethanol and flex fuel are almost identical to traditional gasoline powered vehicles in appearance and operation
Biodiesel and dimethyl ether
almost identical to traditional diesel counterparts in appearance in operation
Fire fuelled by ethanol or methanol
burns bright blue and gives off a little to no smoke hard to see during clear day
Tips for managing alternative power vehicle hazards
Look for marking specific to alternative power vehicles and call early for assistance
Do not use flares to mark off the incident scene is nonsparking markers
Stabilize the vehicle by engaging the break setting the parking brake putting the transmission in park turning off the ignition and stabilizing the scene applicable
Quiet hybrid or electric vehicle is not necessarily turn off or power down
Be aware of the possibility of toxic vapours gases and fumes even if no fires present
Avoid contact with any fluids leaking from the vehicle
Call for hazardous materials team
Cribbing
short lengths of timber used to stabilize a vehicle prevents it from moving
Step blocks
stairstep shaped blocks that are placed under the side of the vehicle
Wedges
used to snug loose cribbing under the load or when using lift airbags to fill the void between the crib and the object as it is raised
Confined space
a structure that is not designed for continuous occupancy and that usually has limited openings for entry and exit
Ventilation may be too limited to provide adequate air circulation and exchange
Inadequate ventilation may trap flammable mixtures, presenting the risk of fire and explosion
Hydrogen sulphide
is a colourless, toxic, flammable gas released by bacteria break down organic matter in the absence of oxygen
Can be found in swamps
Heavier than air and has a pungent odour at first but quickly deadens a person’s sense of smell
Carbon monoxide
is a colourless, odorless, tasteless gas that cannot be detected by a persons senses
Inhaling this can cause severe poisoning because the CO binds to hemoglobin in red blood cells preventing oxygen from binding
Carbon monoxide signs and symptoms
headache, nausea, disorientations and unresponsiveness
Carbon dioxide
colourless gas associated with asphyxiation
End product of metabolism
Produces sour taste in mouth and a stinging sensation in nose and mouth
Methane
the principal component of natural gas
Not toxic but will cause burns if ignited
Used as a fuel from natural gas but can be generated from fermentation of organic matter
Ammonia
is a toxic, corrosive chemical with a characteristic pungent odour
Lighter than air and rises to top of any confined space
Nitrogen dioxidered-
red-brown gas that has a characteristic sharp, biting odour
Water
Self rescue position
roll faceup, arched position, lower back higher than feet
cold water incidents
Water causes heat loss at a rate 25 times greater than ambient air temperature
In extremely cold water 4 degrees a person is likely to die after 15-20mins
Heat escaping lessening position
draw knees close to the chest, pressing the arms close to the sides of the body and keeping the head and neck out of the water
Cold protective response
when the body is submerged in cold water heat is conducted from body to water resulting in hypothermia which can protect vital organs from lack of oxygen
Reach, throw, row, go
Reach: first attempt to reach out using any object
Throw: if you cannot reach the person throw something
Row: if you cant reach by throwing row out to person
Go: last resort go into water only if safe for you
Spinal incidents in submersion incidents
Assume spinal injury exists with the following conditions:
Submersion has resulted from a diving mishap or fall
The patient is unresponsive and no info is available to rule out c spine injury
Patient is responsive but reports weakness, paralysis or numbness in the arms or legs
You suspect the possibility of spinal injury despite what witnesses say
rope rescue
Low angle operations
situations where the slope of the ground over which the rescuers are working is less than 45 degrees
Rescuers depend on the ground for their primary support and the rope as a secondary support
Used when ropes are needed to haul up a patient or rescuer
Belay
is a technique of controlling the rope as it fed out to the climbers to protect them in the event of a fall
Scrambling
a method used to ascend rocky face and ridges can be described as a cross between hill climbing and rock climbing
Hasty rope slide
self escape procedure when there is no other means of egress
rope rescue
High angle operations
situations in which the slope of the ground is greater than a 45 angle and rescuer or patients are dependent on a life safety rope and not a fixed surface of support such as the ground
