MVA- What’s your action plan?

The photo illustrates significant vehicle body damage. Consequently, emergency responders should expect decesased occupants or serious occupant injuries and a potentially lengthy extrication time. This car was involved in a high speed accident; the car hit two trees and came to rest against a third tree. This photo was taken in a salvage yard.

Photo by author

1. How will you use your resources?

2. What is your plan to make the scene safe?

3. Access the patient(s)?

4. Extricate the patient(s)?

5. Can you think of additional resources requiring “special call”?

Post your response in the Comments section. Let’s hear what you, and others, think about this extrication challenge!

A few of my thoughts:

1. My resources will be devoted to controlling hazards and determining if there are any survivors.

2. Expect hazardous fluids (gasoline, antifreeze, etc.) to be released in this accident. Are power lines involved? Control the hazards and increase responder safety.

3. Accessing portions of the vehicle to determine if anyone survived (back seat passengers) may be difficult. Tearing and/or cutting away portions of the vehicle may be necessary for access. Also, consider the need to remove the bodies of those not surviving the accident to allow access and/or extrication of survivors.

4. Expect a longer than normal extrication time and more paramedic and patient interaction. The vehicle has extreme body and frame damage. An advanced extrication consideration would be to make selective cuts to the vehicle and allow the frame and body to move, opening up the passenger compartment and allowing for more rapid patient extrication.

5. Special resources I would consider may include persons with advanced extrication knowledge and skills and a tow truck to assist with extrication operations.

4 Comments

  • RickyBobby says:

    EMAGUY, extrication is a challenge, for sure. My immediate thoughts were patient access to the survivors, if any, and how to reach them to start a line. All of my concerns were addressed. I also like how you addressed the need for specialized skilled support personnel (SSPs), and also immediately addressing the need for possible subject matter experts (SMEs).

    I was always told that most departments never carry enough cribbing. Is the vehicle stabilized enough to begin the extrication? Once the tow truck arrives on scene, can he help stabilize the vehicle if needed? Can he help mitigate any spilled substances that don’t require a HazMat response for the responders safety?

    This was just off the top of my head. Let me think about it for a minute and see what else I can think of. My wheels are already turning…

  • Timothy Bullard says:

    Rescue or Recovery, we will be here awhile. Get Law Enforcement buy-in early to shut down and re-route traffic. This creates a much larger working envelope and easy LZ for the helo we probably called. Good Post

  • RickyBobby:

    During my travels around the country providing training programs to emergency services, I’ve noticed a trend: a lack of advanced extrication training at many departments. Many organizations require minimal auto extrication training for most, if not all, staff; some organizations require only the auto extrication skills necessary to pass a Firefighter II program!

    A few things from your comments: 1)Cribbing- I would always love to have more; however, there may be limited quanitities available due to storage limitations, etc. One reason I like Rescue so much? The subject allows for great “thinking outside of the box” opportunities. Need more cribbing and none is available? Make your own. Pull the chainsaw off the truck and cut some roadside timber. Cut the desired cribbing lengths and notch the logs so the logs interlock. Pull the wheel knocked from the car out of the ditch and use the wheel as cribbing. Desperate times may call for desperate measures. Will the unorthodox method work? Will the method be safe to rescuers and patients? If so, use it!

    I like the idea of having the tow truck operator assist with making hazardous liquids safe for responders, although I’d prefer to use his/her skills to help with my extrication problem. I’m not opposed to using soil scooped from the roadside to absorb antifreeze, brake fluid, etc.

    Thank you for your comments and opportunity to expand the discussion.

    Yours in safety,
    ~EMAGUY

  • emaguy says:

    Timothy:

    Thank you for commenting on the article. You are correct; if there are survivors, expect to be on the scene for some time. Glad to see you’re thinking ahead and forecasting the need for an air ambulance. After the extended extrication time, the rapid transport time offered by the air ambulance is welcome.

    Also, since you noted the great possibility for victim recovery, I think consideration should be given to moving the vehicle to another location prior to body removal.

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