School Bus Extrication - Part 1: Our Precious Cargo
David Pease, Carolina Fire/Rescue/EMS Journal
Your first task at hand is to assess scene safety and determine any and all hazards that may be present. Next you need to control or eliminate those hazards. An example of your worse nightmare would be the collision of a loaded school bus and a chemical transport truck with product leaking. First you would have to overcome the natural instinct to go in and help the injured children. Next you need to render the scene safe for all the responders, which may mean standing back until a trained hazmat team arrives. To stand back and watch children suffer until someone else arrives to make the scene safe, can be an extremely stressful, emotional ordeal. Let us hope this never happens. After handling any fuels, electrical lines, traffic, etc. the scene can then be considered safe. Your next step is to determine the number of victims involved, is extrication going to be required, are the injuries going to be serious, and what additional resources are you now going to need.
If the bus is loaded, then additional EMS units might be needed. Based on your rapid determination of the injuries, you will have to decide the number required. If the injuries are relatively minor, then the EMS units can transport more children per unit than if there are a lot of serious injuries. You will also need to determine where the children are going to be transported. Can one hospital handle all the causalities or are you going to have to transport the patients to several hospitals. Parents will soon be finding out about the crash and may even arrive on scene before all the children are transported. I have been involved in several bus crashes where some of the parents arrived on scene before we were able to transport all the kids. This can be a good thing or it can be a bad thing. It will be another factor in the overall management of the scene. Should the children need to be transported to different hospitals, the Staging or Transportation Officer will need to track and record where each child went. This will help to eliminate a lot of confusion when the parents, the school system, and law enforcement get involved in the crash scene.