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Post by canton1 on Nov 14, 2004 16:39:12 GMT -5
Windhield----Axe/Glassmaster/Glass remover/Recip saw?
Roof----------Recip saw (18 or 24 Volt) (cordless or Corded)/Combi Tool/O-Cutter/Hack Saw/File
DO you always let the air from the tires??
How many EMS people need to be with a Pt. (inside the car or outside the car)
Should EMS be in PPE
Why do we, EMS and FIRE, not ALWAYS set up COMMAND, for all calls??
DO you use cribbing on EVERY rescue?? as taught
Do you cut the POWER everytime to the vehicle???
If the vehicle is on its side---shoud we have people in it?
How to you properly support a vehicle on its side (in your department) not in the PERFECT world?
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Post by FIREFIGHTER16 on Nov 14, 2004 17:34:22 GMT -5
IF YOU HAVE THE VEHICLE SUPPORTED FROM THE UJNDERCARRIGE TO THE GROUND, I THINK YOU MIGHT BE ABLE TO LET THE MEDIC IN AND THATS IT. IN OUR DEPARTMENT WE USUALLY USE HIGH LIFT JACKS WITH SOME STEEL BRACING
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Post by CMTMedic on Nov 14, 2004 18:46:54 GMT -5
First of all, there is no one way to accomplish any of these tasks. Each situation is different and requires an open mind. It is too easy to get locked into a specific tool or technique and miss the obvious. (we have all done it)
Windshield-Any tool already mentioned will do the job, the specific selection will depend mostly on vehicle and patient postion.
Roof-see above
Tires-not my preferance, the car can be stabilized without deflating the tires and the whole point of stabilization is to keep the vehicle from moving.
EMS-Most patients in a vehicle do not require a medic to be in the vehicle with them. ALS skills are difficult to impossible to perform in the vehicle. (there are times when it is necessary, however) As for assessment, the EMT should have the same ability as the Medic to identify and initally manage injuries. This does not mean that the Medic sits in the ambulance and does nothing. There needs to be communication between EMS providers. Many times the Medic does not have appropriate PPE to enter the vehicle anyway.
PPE-EMS operating within the "hot" zone around the vehicle should have PPE. Does it always happen, No.
Command-Command should be set up for all calls. Several things can hinder this process, including manpower and training. On a recent call I was on command was not established by the fire department because they only had a small handful of personel. The senior rescuers were forced to preform extrication tasks instead of overseeing them. (I do have to say that the incident was managed quite well given the factors that came into play.)
Cribbing-generally when there are disentanglement tasks being performed the vehicel gets stabilized. Is the vehicle stabilized every time personel are operating in it (for example applying a KED on a patient involved in a minor accident)? No. Should it be, probably.
Power-The electric system in the vehicle needs to be controlled (no necessarily cut). Electric seats, windows, and other items may be utilized to assist with pt removal. Care has to be taken when there may be fire hazards present. This may require disabling the electrical system.
If the vehicle is on its side, after it has been properly stabilized, rescue personel may make access to the patient. This is a situation where it is necessary to limit the number operating in the vehicle but it is important to get an "inside rescuer" on the inside.
My preference for stabilizing a vehicle on its side is to use long shoring. (or a similar commercial device) High lift jacks work but I just feel better with the wider footprint that shoring offers.
Ok, im done for a while, but you asked for it canton1. ;D
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Post by Firemedic on Nov 15, 2004 15:10:47 GMT -5
PPE-EMS operating within the "hot" zone around the vehicle should have PPE. Does it always happen, No. This IS an issue, but is most certianly NOT limited to EMS people. Personel from many seperate agencies including EMS, Fire, Law Enforcement and even Tow Truck operators have all been in the "HOT" zone without proper PPE. Define proper PPE for Vehicle Extrication! Proper PPE for vehicle extrication in my book is head and eye protection, all skin should be covered with some type of garment whether it be turnout gear or just a regular jacket of some sort that covers your arms with a pair of gloves.
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Post by 911wacker on Nov 15, 2004 22:18:14 GMT -5
DO you use cribbing on EVERY rescue?? as taught Do you??? Just kidding Chief, but I couldn't resist. Why do we, EMS and FIRE, not ALWAYS set up COMMAND, for all calls?? - Just because we don't say it on the radio, doesn't mean it ain't happening. How many EMS people need to be with a Pt. (inside the car or outside the car)
- Depends on the patient condition and needs Should EMS be in PPE - should is the key word here, but yes. If the vehicle is on its side---shoud we have people in it?
- Only if its secured, secured is probobly a debatable term. How to you properly support a vehicle on its side (in your department) not in the PERFECT world? - we use large cribbing to construct an "A" frame with ratchet binders, also we may use a winch, chains and come-a-long or whatever else we may have to do and get the job done. This is where good ol fashion american engineering comes in, we have all done it once or twice.
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Post by canton1 on Nov 15, 2004 22:23:20 GMT -5
Hey Stermer you loser/trader/fence jumper/on and on No I dont, That is why I asked..... Do you use PPE befoer entering a car as you were taught!!! ;D
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Post by charlotte_ff on Nov 19, 2004 0:32:29 GMT -5
I rember running MVA calls in Bradford County and must say that for the most part cribbing is used and used effectively. Congratulations to you guys. In my 2 years here in charlotte I have not seen cribbing used one time.
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Post by flash97 on Nov 21, 2004 14:05:14 GMT -5
how many medics in ONE vehicle, not any more than absolutley needed, as for the reponse of "depends on patient condition", if the patient is in that serious trouble, wouldn't you do a rapid extrication? just asking, seemed obviuos to me.
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