Chapter 39: Vehicle Extrication and Special Rescue

Introduction

• Role of EMTs: Primarily assist with extrication but not responsible for rescue.
• Rescue Situations: Can involve vehicle, water, and wilderness rescue, requiring specialized training.
• Importance of Understanding Extrication: To function effectively during rescue incidents.
• Initial Actions: Critical for the efficiency of the rescue.

Safety at Rescue Scenes

• Priority: Personal safety and team safety before patient care.
• Protective Equipment: Includes turnout gear, helmet, hearing protection, fire extinguisher, and permeable gloves.
• Vehicle Safety Systems: Shock-absorbing bumpers and airbags can be hazards post-crash.
• Airbags: Maintain clearance around undeployed airbags to avoid injury.

Fundamentals of Extrication

• Primary Concern: Safety and providing emergency medical care.
• Extrication: Removal from entrapment or dangerous situations.
• Roles:
  • EMS: Patient assessment, immediate care, triage, and transport.
  • Rescue Team: Securing vehicle, providing access, and extricating patients.
  • Law Enforcement: Traffic control and scene order.
  • Firefighters: Fire suppression and safety.

Phases of Extrication

1. Preparation: Involves pre-incident training and checking equipment.
2. En Route: Use dispatch information to prepare.
3. Arrival and Scene Size-Up: Position ambulance for safety, assess hazards, and determine additional resource needs.
4. Gaining Access: Ensure the vehicle is stable and hazards controlled before gaining access to patients.
5. Simple Access: Use minimal force; complex access requires special tools and training.
6. Emergency Care: Similar to standard care; address life-threatening injuries first.
7. Removal of the Patient: Requires coordination with the rescue team and careful planning to prevent further injury.
8. Termination: Clean and check equipment, decontaminate ambulance, and complete reports.

Specialized Rescue Situations

• Technical Rescues: Require specialized skills and teams.
• Search and Rescue: EMTs stand by at command post until the missing person is found.
• Trench Rescue: Requires precautions against secondary collapse.
• Tactical Emergency Medical Support: Specialized care during law enforcement incidents.
• Structure Fires: Ambulances dispatched to assist at fire scenes, stand by unless transporting a patient.

Conclusion

• Safety and coordination are paramount in all rescue and extrication operations.
• Effective communication and understanding of roles ensure successful rescue outcomes.
• Chapter 40 covers further incident management details, including hazardous material procedures.