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Basic Concepts and Techniques

Basic Concepts and Techniques. Course Objectives. Provide insight on Safety , Teamwork and Technology when dealing with Modern Vehicle Extrication . Course Objectives. Understand and Practice:

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Basic Concepts and Techniques

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  1. Basic Concepts and Techniques

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

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

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

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

  6. Course Objectives • Understand: • The psychological considerations of patient care.

  7. Course Objectives • Understand: • Rapid Extrication/Protocol

  8. Course Objectives • Demonstrate: • Proper glass removal techniques • Tempered • Laminated

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

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

  11. 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

  12. 1999 TOP FIVE CALLS

  13. Signal 4’s vs all calls

  14. The ability to quickly extricate a critically injured patient and transport to a trauma center may help determine his/her outcome.

  15. The Golden Hour • From the time of injury to “Bright Lights and Cold Steel”

  16. 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.

  17. 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.

  18. Rapid Extrication • Shall ONLY be employed in the following situations: • When the patient blocks the rescuer’s access to other more seriously injured patients in the vehicle

  19. Study of Effectiveness of ALS for MVA’sTrauma 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 pt’s 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

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

  21. Time StudiesMean scene time studies for all Trauma Alerts • Tuscon 8.1 minutes • Denver 9.8 minutes • Lee County12.0 minutes • Australia 13.0 minutes • Sacramento 14.5 minutes • New York 17.3 minutes • Milwaukee 21.0 minutes • Washington D.C. 24.9 minutes

  22. Preparation & Response

  23. Preparation & Response • Proper training • This class • Specialties • Trucks, busses, heavy equipment, etc. • Every six months

  24. Preparation & Response • Response considerations • Time of day • Weather conditions • Response routes • Multiple calls reporting • Reports of entrapment

  25. Preparation & Response • Possible entrapment or vehicle rollover? • Respond with engine and 510

  26. Teamwork Common Terminology

  27. Right side Left side Top Bottom Drivers side Passengers side Roof A-post, B-post Anatomy

  28. C-Post Roof A-Post

  29. The Scene Survey

  30. 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?)

  31. Outer Circle Survey • Look for patients no longer in cars • Locate other vehicles involved in accident • Obvious hazards

  32. Inner Circle Survey • Determine number of patients in vehicles • Conditions of patients • Degree of entrapment

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

  34. 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

  35. 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

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

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

  38. 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

  39. Safety Issues • Head protection • Eye protection • Hand protection • Foot protection • Coat & pants • Bloodborne pathogen protection • Hearing protection • Respiratory protection

  40. Scene Safety • Verbalize all activities • Use the term “FREEZE” to stop all operations/activities

  41. Safety Priorities • Yourself • Other rescuers • Bystanders • Victim

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