Chapter 39: Vehicle Extrication and Special Rescue

Overview

• Focus on EMS rescue operations including vehicle extrication and specialized components of EMS operations.
• Includes tactical EMS, trench rescue, high angle rescue, and EMT roles.
• Emphasis on safety in these operations.

Key Concepts

EMS Rescue Operations

• Extrication: Involves removal from entrapment or dangerous situations.
• Safety Priority: Ensure personal and team safety before providing patient care.
  • Consider mental and physical preparation.
  • Use appropriate equipment based on scene hazards.

Vehicle Safety Systems

• Can become hazards post-collision.
  • Shock Absorbing Bumpers: Approach from the side to avoid injury.
  • Airbags: Maintain clearance if not deployed, they can inflate spontaneously.
  • Use protective gear to reduce risk from airbag substances (cornstarch, talc).

Phases of Extrication

1. Preparation: Pre-event training and equipment checks.
2. Enroute to Scene: Safety precautions similar to ambulance responses.
3. Arrival and Scene Size Up:
   • Position ambulance safely.
   • Use PPE and evaluate the scene for hazards.
   • Perform 360-degree walk around to assess.
4. Hazard Control: Manage risks like downed power lines or vehicle instability.
5. Alternative Fuel Vehicles: Disconnect batteries; high-voltage cables (orange) should be avoided.
6. Support Operations: Include scene lighting and establishing equipment zones.
7. Gaining Access: Determine the best method based on the situation.
8. Rapid Vehicle Extrication: Quick removal when required for patient safety.
9. Emergency Care: Provide primary assessment and necessary medical care.
10. Patient Removal: Coordinate safe removal with rescue personnel.

Specialized Rescue Situations

• Technical Rescue Situations:
  • Require special skills (e.g., cave rescue, confined space, ice climbing).
  • Search and Rescue: Standby role until person is found.
  • Trench Rescue: Prevent secondary collapses, stabilize before entry.

Tactical EMS Support

• Law Enforcement: Coordinate with SWAT during tactical situations.
• Structure Fires: Work with firefighters; follow IC’s direction.

Important Details

• Communication: Essential among team members for efficiency and safety.
• Patient Care: Always prioritize stabilization and safe removal.

Quiz Review

• PPE in Patient Contact: Blood and fluid impermeable gloves.
• First Phase of Extrication: Preparation.
• Power Line Hazard: Retreat until safe.
• Access Techniques:
  • Simple: No tools.
  • Complex: Requires tools.
• Patient Handling: Use slow, controlled steps to ensure safety.
• Rescue Team Coordination: Vital for safe extrication.

Conclusion

• Always prioritize safety and communication.
• Proper training and equipment use are crucial.
• Be prepared for various rescue scenarios and work closely with specialized teams.