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    Basic Concepts and Techniques

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    Carlos Diaz Diaz
    This document outlines the objectives and key concepts covered in a vehicle extrication course. The course aims to provide insights on safety, teamwork and technology as well as teach the skills needed for assessing patients trapped in vehicles, disentangling patients safely, understanding safety features of extraction tools, and demonstrating various extraction techniques while maintaining patient protection. It emphasizes rapid extrication in unsafe situations, initiating advanced life support procedures during long extractions, and the benefits of pre-hospital care to improve outcomes for critically injured patients. Proper preparation, hazard control, and focus on rescuer and scene safety are also highlighted.

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    © All Rights Reserved
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    Basic Concepts and Techniques

    Uploaded by

    Carlos Diaz Diaz
    47 views43 pages
    This document outlines the objectives and key concepts covered in a vehicle extrication course. The course aims to provide insights on safety, teamwork and technology as well as teach the skills needed for assessing patients trapped in vehicles, disentangling patients safely, understanding safety features of extraction tools, and demonstrating various extraction techniques while maintaining patient protection. It emphasizes rapid extrication in unsafe situations, initiating advanced life support procedures during long extractions, and the benefits of pre-hospital care to improve outcomes for critically injured patients. Proper preparation, hazard control, and focus on rescuer and scene safety are also highlighted.

    Original Title

    Rescate Vehicular

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    This document outlines the objectives and key concepts covered in a vehicle extrication course. The course aims to provide insights on safety, teamwork and technology as well as teach the skills needed for assessing patients trapped in vehicles, disentangling patients safely, understanding safety features of extraction tools, and demonstrating various extraction techniques while maintaining patient protection. It emphasizes rapid extrication in unsafe situations, initiating advanced life support procedures during long extractions, and the benefits of pre-hospital care to improve outcomes for critically injured patients. Proper preparation, hazard control, and focus on rescuer and scene safety are also highlighted.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    47 views43 pages

    Basic Concepts and Techniques

    Uploaded by

    Carlos Diaz Diaz
    This document outlines the objectives and key concepts covered in a vehicle extrication course. The course aims to provide insights on safety, teamwork and technology as well as teach the skills needed for assessing patients trapped in vehicles, disentangling patients safely, understanding safety features of extraction tools, and demonstrating various extraction techniques while maintaining patient protection. It emphasizes rapid extrication in unsafe situations, initiating advanced life support procedures during long extractions, and the benefits of pre-hospital care to improve outcomes for critically injured patients. Proper preparation, hazard control, and focus on rescuer and scene safety are also highlighted.

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    Basic Concepts and

    Techniques

    Course Objectives
    Provide insight on Safety,
    Teamwork and Technology when
    dealing with Modern Vehicle
    Extrication

    Course Objectives
    Understand and Practice:
    the skills needed for the
    disentanglement of a patient
    entrapped in the wreckage of a
    vehicle crash.

    Course Objectives
    Understand and Practice:
    The skills related to the Assessment
    and Packaging of a patient
    entrapped in the wreckage of a
    vehicle crash.

    Course Objectives
    Understand and Practice:
    Safety features
    Precautions
    Capabilities
    Of the extrication tools used by this
    department

    Course Objectives
    Understand:
    The psychological considerations of
    patient care.

    Course Objectives
    Understand:
    Rapid Extrication/Protocol

    Course Objectives
    Demonstrate:
    Proper glass removal techniques
    Tempered
    Laminated

    Course Objectives
    Demonstrate:
    Patient access
    Interior rescuer duties
    Proper protection of patient(s) during
    extrication

    Course Objectives
    Demonstrate:
    Making a purchase point
    The forced opening of a door using
    hand tools
    Proper vehicle stabilization with
    cribbing

    Course Objectives
    Demonstrate:
    Roof displacement procedures using
    hydraulic cutters
    Door displacement and removal using
    powered hydraulic tools
    Procedure for dash lift using rams and
    spreaders

    1999 TOP FIVE CALLS


    80.00%
    70.00%
    60.00%
    Rescue
    Service Call
    False Call
    Good Intent
    Fire/Explosion

    50.00%
    40.00%
    30.00%
    20.00%
    10.00%
    0.00%

    1999

    Signal 4s vs all calls


    10.00%

    All others
    Signal 4's

    70.30%

    The ability to quickly extricate a


    critically injured patient and
    transport to a trauma center may
    help determine his/her outcome.

    The Golden Hour


    From the time of injury to Bright
    Lights and Cold Steel

    Rapid Extrication
    Shall ONLY be employed in the
    following situations:
    When the scene is unsafe and clear
    danger to the rescuer and/or patient
    exists, necessitating rapid removal to
    a safe location.

    Rapid Extrication
    Shall ONLY be employed in the
    following situations:
    When the patients condition is so
    unstable that he needs immediate
    intervention which can only be
    provided in a supine position and/or
    out of the vehicle or when his
    condition requires immediate
    transport to a hospital without delay.

    Rapid Extrication
    Shall ONLY be employed in the
    following situations:
    When the patient blocks the
    rescuers access to other more
    seriously injured patients in the
    vehicle

    Study of Effectiveness
    of ALS for MVAs

    Trauma review committee of ER physicians, trauma surgeons,


    neurosurgeons

    The committee felt that ALS was helpful


    or essential in 85% of cases
    Pre-hospital care improved survival of
    pts suffering major blunt trauma
    Penetrating thoracic/abdominal trauma
    mandates rapid transport
    The added time of transport to a trauma
    center, even if it bypasses another
    hospital is justified

    If extended extrication
    time:
    Initiate ALS procedures while pt. is
    still inside vehicle
    Intubation
    IV fluids
    O2 via NRB or BVM

    Time Studies

    Mean scene time studies for all Trauma Alerts

    Tuscon
    8.1 minutes
    Denver
    9.8 minutes
    Lee County
    12.0 minutes
    Australia 13.0 minutes
    Sacramento
    14.5 minutes
    New York 17.3 minutes
    Milwaukee
    21.0 minutes
    Washington D.C.
    24.9 minutes

    Preparation & Response

    Preparation & Response


    Proper training
    This class
    Specialties
    Trucks, busses, heavy equipment, etc.
    Every six months

    Preparation & Response


    Response considerations

    Time of day
    Weather conditions
    Response routes
    Multiple calls reporting
    Reports of entrapment

    Preparation & Response


    Possible entrapment or vehicle
    rollover?
    Respond with engine and 510

    Teamwork
    Common Terminology

    Anatomy

    Right side
    Left side
    Top
    Bottom

    Drivers side
    Passengers side
    Roof
    A-post, B-post

    C-Post

    Roof

    A-Post

    The Scene Survey

    Scene size-up
    Look for immediate hazards
    Is it safe to exit the vehicle? (traffic)
    Call for additional resources (if
    needed)

    Power company (downed electric lines)


    Extrication needs (obvious entanglement)
    Additional ambulances (multiple patients)
    Hazmat team (vehicle carrying hazmats?)

    Outer Circle Survey


    Look for patients no longer in cars
    Locate other vehicles involved in
    accident
    Obvious hazards

    Inner Circle Survey


    Determine number of patients in
    vehicles
    Conditions of patients
    Degree of entrapment

    Hazard Control
    Control potential fires with hose
    line
    Cover spilled vehicle fluids
    Stabilize vehicles
    Chock tires
    Make sure motor is off

    Action Circle
    10-15 feet around crash

    Keep clear of trip hazards


    Stage unused tools outside of zone
    Exclude non-essential personnel
    Must be protected if in zone

    Tool Staging
    Locate just inside
    the action circle
    Ideally have a tarp
    or marked area
    Allows rescuers to
    see what is
    available
    Keeps tools clean
    and protected from
    damage

    Safety Issues
    Identify existing hazards
    Anticipate potential hazards
    Eliminate hazards that can be
    eliminated
    Avoid creating additional hazards

    Safety Issues
    Stabilization
    Disconnect electrical system
    Negative side first (< sparks)
    Air-bags
    Fuel pumps

    Safety Issues

    Bent and torn metal


    Broken glass
    Fumes (gas, battery acid, oils)
    Fuel leaks
    Unstable vehicle
    Vehicle cargo (unstable, hazmats)
    Power lines
    Loaded bumper

    Safety Issues

    Head protection
    Eye protection
    Hand protection
    Foot protection
    Coat & pants
    Bloodborne pathogen protection
    Hearing protection
    Respiratory protection

    Scene Safety
    Verbalize all activities
    Use the term FREEZE to stop all
    operations/activities

    Safety Priorities

    Yourself
    Other rescuers
    Bystanders
    Victim

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