Vehicle on side
Extraction

 

The following technique offers one of numerous options for a vehicle on it's side.

 

 

 

 SCENE SETUP

 

Overcrowding and poor placement of equipment at the scene of an accident by Rescue and Ambulance Officers can cause delays in the extraction, scene cluttering & trip hazards requiring multiple movements of equipment. 

With the patient in this scenario being extracted out the roof, the following general principles should be applied whenever feasible:

  • Ambulance equipment staging area should be setup at the extraction side of the vehicle on the 5 m outer circle.

  • Rescue equipment staging area should be setup at the side opposite to the extraction of the vehicle on the 5 m outer circle..

  • Fire protection with a live hose is again placed on the 5 m outer circle at the front of the vehicle so as not to interfere with the Ambulance or Rescue staging area.

 

 

  PREPARE THE PATIENT

 

Once the vehicle has been stabilised, Officers can enter the vehicle and perform Manual In-Line Stabilisation of the patient’s head and apply a Cervical Collar.

The use of a jacket style Cervical Extrication Device (CED) is very limited in these cases unless the patient is found in an upright sitting position.

 

 

 MAKING AN OPENING

 

 

To allow for the removal of a patient, a number of  options are available.

Complete roof removal offers the greatest access to the patient and the safest work area for Officers.

Roof removal is undertaken by:

1. Cutting the upper side A, B & C pillars, removing or cutting the windscreen, making two relief cuts in the roof and then folding the roof down. 

2. A can opener is then used to remove the roof at the crease, with the remaining sharp edgescovered with sharps protection.

 ThThis roof removal technique has the advantage of the side of the vehicle in which the patient is lying on  (including door and window) remains intact.

 

 

  INSERT THE LONG SPINE BOARD

 

Place the LSB on top of the sharps protection. The addition of a blanket over the sharps protection will further allow the LSB to slide easily  in and out of the vehicle. Failure to do this may result in severe LSB vibration during extraction.  

The patient will usually be found on their back or side, however LSB insertion is similar in either situation. To insert the LSB under the patient, the  patient will need to be lifted using a modified Side Straddle Lift:

Officer 1 places the LSB at the patient’s head.

Officer 2 positions at the patient’s head and stabilises the patient's head for the LSB’s insertion.

Officers 3 & 4 are positioned on either side of the   patient at the patient’s torso, placing their hands    under the patients shoulders and pelvis.

Officer 5 positions at the patients feet and will assist the legs onto the LSB.

When ready, Officers 2, 3 & 4 raise the patient  3-5 cm whilst Officer 1 slides the LSB under the patient.

 

 

 

 

 

 

  SLIDE PATIENT ONTO THE LONG SPINE BOARD

 

Officers begin the slide out of the vehicle onto a LSB by:

Officer 1  continues to support the LSB.

Officer 2 continues to stabilise the patient’s head during the slide out of the vehicle onto the LSB.

Officer 3 & 4  positioned on the either side of the LSB assist in the sliding of the patient out of the vehicle by grasping the patient’s clothing at the   shoulders and waist.

Officer 5 positioned at the patients feet assist the patient’s legs onto the LSB.

The patient is slid up the LSB in 30 cm movements until the patient’s shoulders are level with the shoulder markings on LSB in preparation for immobilisation.

 

 

 

 

IMMOBILISE PATIENT TO THE LONG SPINE BOARD

 

If the patient was extracted on their back, immobilise the patient to the LSB.1

However if the patient was extracted on their side (as depicted here),  carry the patient to a safe place and log-roll the patient onto their back , then immobilise to the LSB.1

The patient can now be safely carried to the  Ambulance stretcher.

 

 
Additional Notes:

  • The photos presented above are staged with pre-prepared vehicles.  Protective coverings have been left off the patient for photographic purposes so as to clearly demonstrate the techniques being used.

  • All Ambulance, Rescue and Fire staff are referred to as 'Officers' in this presentation.

  • In all road accidents, Officers should undertake scene protection from oncoming traffic, perform outer & inner circle checks, control hazards including fuel leaks, establish fire protection of the scene, ensure vehicle stabilisation before entry of the vehicle or any cutting, disconnect batteries, be aware of the dangers of undeployed airbags & ROPS  maintaining a safe working distances from the deployment path as recommended by your agency.

  • Officers should wear Personal Protection Equipment (PPE) as recommended by your agency.

  • Officers work gloves should be removed when in direct contact with the patient's skin due to fuel and other contaminants that may have impregnated the gloves.  Only personal protective barrier gloves should be allowed to come in contact with the patient.

 

 

Bibliography 

1.    Victorian Ministerial Task Force on Trauma 
 Review Of Trauma And Emergency Services     Report 1999 

 

 

 

 

This training manual has been produced with the assistance of

 

Ford Australia Pty Ltd

Holmatro Rescue Equipment

NEANN Emergency Products

 

 

 

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