Tech Rescue

Perfecting Basic Extrication Skills

Issue 12 and Volume 8.

I was recently making a presentation to a group of city and fire department administrators about some of our rescue capabilities, including auto extrication. As we discussed the cost of rescue tools and how many sets of tools that we had in service throughout our city, an important point was made: With all the tools and equipment that our department currently has—hose, nozzles, SCBA, aerial ladders and all the other things that make a large fire department run—we may save more people’s lives with our extrication equipment than with any other one tool.

Now, don’t get me wrong—I’m not advocating going around with empty hosebeds and apparatus compartments with just rescue tools in them, but I do think that day to day, we may save more lives with rescue tools than we do with anything else we own. Just about every day somewhere in our city, we will extricate someone—or several someones—from a vehicle using our tools.

Why has extrication become so much of our call load? First, there are a lot more cars on the road today than there were 30 or 40 years ago. Second, we’ve learned, as a fire service, that taking the time to perform extrication is the right thing to do. Popping doors and removing roofs allows much better access to the patients and minimizes the dangers of causing secondary injuries during their removal from the wreck.

Classroom & Hands-On
Just because I have a set of expensive rescue tools on my apparatus doesn’t necessarily make me or my crew expert rescue technicians. The truth is, most of us just don’t get the “tool time” that we need to be as good as we should. And working on wrecked cars at 0200 HRS is a difficult place to learn due to the serious of the situation. That’s why, as company officers or department training officers, we must recognize the importance of getting a balance of classroom and hands-on extrication training for our members.

The classroom part of the training is currently outstanding and easily obtainable because there’s so much information available to us in print and online articles and in videos.

The more difficult part of extrication training is getting your hands on high-quality cars and trucks. A lot depends on where you’re at and who you know. Developing a good relationship with your local auto salvage yard or car crusher will really pay off. Also reach out to local law enforcement agencies that operate impound yards. Many of them will allow you to train on their vehicles before selling them to wrecking yards as scrap.

Although any make or model will help develop your skills, later-model cars are more relevant to our operations due the fact that technology in the auto industry has advanced so quickly during the last 30 years, especially with regard to occupant safety. You just don’t see many 1978 Ford LTDs out on the roads these days, so focus on obtaining training opportunities with new cars if at all possible. Yes, newer model cars are harder to get due to their resale/salvage value, but it is possible to get them.

The Big 5
So what should we as company officers or training officers focus on when it’s time to do some extrication training?

First and foremost, you must know and have confidence with the rescue tool and associated equipment, such as rescue struts and cribbing. Work through scenarios, such as power plants not starting and hydraulic hose with stuck couplings. Nothing makes you look as bad as having mechanical problems or not looking smooth and professional when deploying rescue equipment on an incident scene. Spend some time talking about things as simple as having fresh fuel in the power plant and the importance of starting those tools daily. Note: Many departments are making the move to ethanol-free fuel in their rescue tools due the damage ethanol causes to small engines and the associated starting issues.

In addition to equipment, focus on the Big 5 basics of extrication: stabilization, glass removal, taking doors, roof removal and dash displacement.

  • Stabilization. After a good scene size-up, stabilization is the first hands-on operation to be done at an accident scene. This operation is much more advanced than just a few years ago because of the many new products on the market developed to stabilize vehicles.
  • Glass removal. Getting the glass out of the way makes the scene safer for the responder and the patient, and it provides better access to the patient. By removing the glass in a controlled manner, we don’t have any unexpected surprises, such as glass shattering and spraying the patients and responders. Just like with the new stabilization equipment, there are many new glass-handling products on the market that make this job easier.
  • Taking doors. If there is one extrication skill that you really need to make sure you’re great at, it’s popping or removing doors. Doors are our go-to point of entry on most accidents and the quickest way to remove patients. But don’t take them for granted because it’s what you do most often; they still can present some challenges. The design of vehicle doors has changed a great deal over the years, and so must our tactics. We used to use a lot more brute force, basically just ripping and tearing the metal; today, we use finesse and technique to get the job done. Going old-school on a late-model car door by using the brute force of the rescue tool will more than likely create a problem. Be sure to teach your crew not to get tunnel vision when popping doors; they should be able to pop the door from the pin or the hinge side.
  • Roof removal. Nothing gives you better patient access than total roof removal. Crews that know this move can really make impressive progress at an extrication. When training on roof removal, focus on the coordination and teamwork required to remove a roof; it’s not a one-person operation. Talk about the sequence of the cuts needed to completely remove the roof.
  • Dash displacement. Although we don’t use it as often as roof removal or popping doors, dash displacement is still an extrication basic. Many accident victims have the dash and/or steering wheel pushed down on them; dash displacement is one of the best methods to get it up and off of them. Take the time to drill with your company on the many different ways of getting the job done—jacking with the spreaders, rolling using rams or whatever technique you may use in your department based on the equipment and tools you have available.

Make the Most of It
Extrication has grown into one of our most important, life-saving operations. As a result, our tools, techniques and training are getting better each day. As training officers and at the company level, we must focus on finding training opportunities to hone our extrication skills, and making the most of them—because it’s very likely our training will make a life or death difference.