Tech Rescue

Dash-Displacement Tactics

Issue 2 and Volume 9.

Dash displacements allow responders to free victims from secondary entrapment created by the dash area and/or make additional space for the path of egress and victim removal. Given the damage pattern associated with frontal collisions, these tactics are traditionally associated with wheel-resting vehicles.

In previous years, responders have worked their way through several types of dash tactics, including pulling techniques, and tools, including spreaders vs. rams. We have debated the need for relief cuts to stop the movement of the entire vehicle. And we have explored alternative options, such as floor pan drops and seat displacements. Further, in recent years, responders have been called upon to complete a dash displacement or alternative tactic on a roof-resting vehicle. One often-overlooked scenario: a vehicle that was involved in a frontal collision and/or that received damage to the dash area, ultimately ending up in a side-resting position.

Side-Resting Vehicle Ops

Dash displacements involve some of the more intricate tactics at any motor vehicle collision (MVC). Operations on a side-resting vehicle aren’t necessarily more complicated than those on a wheel-resting vehicle, and they should follow almost the same procedures, but side-resting vehicles do present a unique set of challenges. As Holmatro Rescue Consultant Ian Dunbar stated, “View a vehicle as a vehicle, regardless of what orientation it is in. Of course, various factors will have to be taken into account.”

Vehicle stabilization is key because we’re changing the structure of the vehicle by displacing and pushing off of structural members. As such, we must have cribbing placed on the low side, as well as strut systems (whether they are opposing each other or placed against tension) against the high side. Give early consideration to the strut placement on the patient compartment side. The most common attachment point for the strut head is the high-side Alpha post, and the low-side Alpha post for the base restraint strap. One or both of these locations may be compromised during the dash displacement.

In training situations, we typically displace a dash much farther than we should and/or need to in a real situation. This is an important concept to remember when working with side-resting vehicles. We should create enough space to free the entrapped occupant, which is usually no more than a couple of inches, and then stop the displacement. All types of side-resting dash displacements have an increased potential to create vehicle movement, so we need to create sufficient relief to ensure the dash moves without creating a reaction in the remainder of the vehicle.

Low-Side Dash Displacement

Responders have limited options when it comes to these situations, especially where there’s significant entrapment. A controlled roll using options such as recovery vehicles, lifting struts, rope/cable/chain systems, or recovery vehicles will be necessary to create the needed space and access to the Alpha post and front frame rail. The movement of the patient vehicle has been the center of a lot of controversy over the years. It is important for responders to be open-minded to the effectiveness of these tactics under the right conditions.

The key to a successful operation is having an understanding of the resources available. The incident commander (IC) and disentanglement supervisor also need to know that the personnel have the training and skills to complete the movement in a controlled manner and avoid further patient injury.

Even when the roll is sufficient to create enough space between the ground and the side of the vehicle to remove the door, create the relief points, and displace the dash, the patient will literally be lying on top of the operation. They will need to be protected with hard and soft protection and a heightened sense of awareness of actions and reactions (for more on the controlled roll, see http://www.firefighternation.com/article/extrication/controlled-roll-extrications).

Without completing a controlled roll, responders will be limited to a center dash displacement or maybe even consideration of a dash pull. Although this technique has not been advocated recently due to collapsible steering columns, supplemental restraint systems, etc., it may provide a reasonable option when more traditional dash displacements are not practical.

Ensure power down procedures of the electrical system and maintain safe working distances.

High-Side Dash Displacement

The high side presents challenging factors, most of which are obvious. For one, completing tactics on the high side requires responders to work off the ground and in non-ergonomic positions. When possible, responders should use ladders, work platforms and the support of additional responders.

The steps needed to complete the dash displacement take place above the patient. Every action creates the potential for loose debris, glass, equipment, etc., to fall on or near the patient. As such, the patient should be protected with hard and soft protection. In certain cases, it may be necessary to tether tools with webbing to hold them in position and prevent them from dropping. Although a responder should maintain contact and support the tool prior to and during the displacement, they may not be able to fully hold or support it in the sometimes awkward body position.

Handling the material will also require more effort and coordination. Removal of the upper door may require as many as two or three responders. It’s not the most preferred method, but some responders still use spreaders to “spread” the door off the vehicle. The door removal should include exposing and cutting the hinges and pin to avoid the rapid movement and release associated with spreader operations.

Another concern: the position of the patient. The patient should be in one of two positions: (continued on p. 58)

1. If they were not seatbelted or if they tried to free themselves by releasing the seatbelt, they may be hanging from the high side by their lower extremities and the secondary entrapment of the dash. In these cases, the patient will need to be supported during the operations, and responders should anticipate supporting their full weight the moment the entrapment is relieved.
2. If the patient is still in the seat with the seatbelt holding them in position, responders should determine the location of the seatbelt connections and avoid negating its effect in holding the patient. If the roof is being removed prior to or during the dash displacement, ensure that the roof cuts are closer to the roof line than the seatbelt attachment point. Once the dash has been displaced, responders can support the patient, release the seatbelt and properly remove them.

Center Dash Displacement

Center dash displacements, regardless of vehicle position, have gained a lot of exposure in recent years. This tactic has been made easier with telescoping rams, and some people have even created center dash displacement ram attachments.

It’s important to remember that a center dash displacement requires either a blind push point at the ram ends or the time-consuming work of removing console and dash components. Just like cutting through areas that have not been exposed, ramming into areas that have not been exposed can create similar hazards. The time consideration for removing vehicle components to create center push points may exceed the needs of the patient. Also there are several variables-including the location of the lateral reinforcement, the ability to create a substantial push point, and the lack of training on this technique-that would make this tactic a last resort.

In Sum

Side-resting dash displacements can be one of the most technical tactics responders are required to complete at an MVC, and they necessitate a great deal of skill. The disentanglement supervisor, with the assistance of the technical personnel and the interior rescuer, will play a vital role in the evaluation of the available options as well as the patient needs. As always, a risk/gain analysis should be conducted to determine which tactic presents the most appropriate path of egress in relation to the time available for disentanglement. missing image file

A special thanks to Colleton County (S.C.) Fire and Rescue.