Extrication at a Glance: Rollovers
David Pease, Advanced Rescue Technology Magazine
In order to cover all the details involved in any specific type of extrication, one must first realize it would take more than a single article, perhaps a chapter would be in order. There are several factors that must be considered when discussing any type of vehicle extrication. We are dealing with a wide degree of expertise, that ranges from the rookie to the seasoned veteran, so many opinions abound. We must understand that vehicle extrication is an ever-changing technology. We, as rescue technicians, must be able to change with that technology. Another consideration is that we sometimes differ in our approach on how we feel things should be done, and most of the time this can be a positive and learning experience for all of us. The old saying, " there is more than one way to skin a cat " definitely applies in vehicle extrication. Every extrication is different with different challenges and obstacles to overcome. We learn a multitude of techniques and strategies to better our application during the rescue. We also keep an open mind and do not allow for tunnel vision during complex operations. There are almost as many personalities performing vehicle extrications, as there are extrications to be done. Patients that we extricate are usually found to be in two types of situations. They are either trapped or pinned. When a patient is trapped, they can exit the vehicle once an opening or exit is made. This can be of their own accord or they may have to be stabilized and removed on a long board. If the patient is pinned, they are being physically held by some part of the vehicle itself. This can be the steering wheel, firewall, dash, roof, or any other part of the vehicle. These patients can not be removed until that part of the vehicle is displaced. These obviously prove to be the most challenging types of extrications. Frontal collisions and T-bones account for a higher number of pin-ins. These will be discussed in more detail in my next article on multi-car collisions.
We are going to take a look at some considerations when dealing with rollover type crashes. We will, by no means, cover every consideration or technique in this article. We will be looking at some of the basic considerations for this type of vehicular crash. If you think back to that very first extrication class you attended, you probably were on an adrenal rush and could not wait to put your hands on the power tools and rip that door off or remove that roof, only to have the instructor subdue your expectations with talk of hazards and vehicle construction. As you sit in class you find the instructor talking about vehicular hazards, scene hazards and basic vehicular construction. At that time you may have felt this was a lot of fill in information and would be of little use. But later in class you came to realize how helpful it would be to understand this information. It could even save your life.
One should consider all vehicle hazards when dealing with rollover crashes. This may include fuel leaks, vehicular air bags, heat from the exhaust system, battery acid, vehicle contents such as bottled gas, chemicals used in cleaners and pesticides that may be in the trunk, power lines, traffic, or weather, just to name a few. One very important hazard that must be considered is vehicle stabilization. Vehicles that roll come to rest in a variety of positions. Some come to rest back on the wheels or rims, some on their sides, while others may come to rest on the roof. They may even be resting on another vehicle or an object such as a tree or a concrete highway barricade. It is easy to see why stabilizing the vehicle prior to extrication or entry is very important. We will assume that any scene hazards have already been considered and handled by the Safety Officer. There are a multitude of ways to stabilize a vehicle that has rolled and is not resting on it’s wheels or rims. However, do not assume that a vehicle on “all fours” does not need to be cribbed or stabilized, because it does. Vehicles on “all fours” are much easier to crib and stabilize, and should also be chocked from rolling,
Vehicles that come to rest on the roof pose a slightly different situation. There are a multitude of ways to stabilize a vehicle on it’s side or roof. Using cribbing is one of the most standard and reliable ways. If the distance to crib is very high, you will soon find out it can take an enormous amount of cribbing to get the job done. However, there are now other accepted methods for vehicle stabilization. The use of high lift jacks is one good and relatively inexpensive way to achieve good stabilization. These jacks cost less than fifty dollars and can support loads up to 15,000 pounds. They come in several heights and can be used for lifting, prying, and even pulling. For the dollar, placing several of these on the rescue truck is a good investment. Air struts are another good tool for stabilization. Although a little more expensive, they can eliminate the use of large amounts of cribbing and take up a lot less space on the rescue truck. These come with a selection of bases and tips for various situations that might arise. When using either high lift jacks or air struts for stabilization, remember to anchor the base of the jack or strut back to the vehicle to eliminate the possibility of the jack kicking out. Air struts have bases that come with grooves or holes where a picket can be driven into the ground and help eliminate kick out. You can also use low-pressure air bags. These will inflate to heights up to four feet and support weights up to 20,000 pounds depending on the brand. I think one can easily see that there are many tools that can be used to stabilize a vehicle, depending on your budget and space allotted. I think that stabilization is an important part of the extrication process, and time spent in the salvage yard practicing these techniques is time well spent.
Once the vehicle(s) are stable, it is now time to consider what types of extrication techniques might be needed. Several factors play in the equation on rollover type crashes. The speed of the vehicle, the ground conditions, and any objects that may have been struck during the rollover. We will see structural damage to the roof and doors of the vehicle. Seldom will we see any dash or firewall intrusion. The roof post will be crushed and the doors may also be crushed or damaged. The crushing of the roof can be as subtle as some slight post deformity, to the roof being crushed to the tops of the doorframe. Doors can be pushed either inward or outward depending on the circumstances of the roll. Most of the time the windows are broken, so side and rear glass removal will not be necessary. Front windshield removal may have to be done. The structural integrity of the doors will prevent the crushing of the vehicle any further than the top of the door frames in most cases. The victims in the majority of these types of crashes will be trapped rather than pinned.
The two most primary techniques for rollovers are roof removal and door displacement. The techniques for these two operations are taught several ways and all methods should be considered. Whenever I teach an extrication class, the first thing I tell my students is that there are different techniques taught to accomplish the same results. There is no one way to extricate. All techniques should be considered, as all extrications are different. Lets look at the process of removing the roof. Some prefer to cut the post low, as this presents less of a hazard with the post protruding up. Some prefer to cut the post higher and place a piece of fire hose for protection. You might want to consider a complete roof removal or just a roof flap. When performing a roof removal, the windshield is removed and then all the posts are cut. You may choose to use hydraulic cutters, a hydraulic combination tool, a reciprocating saw or even a hacksaw if necessary. Remember there may be wires running in the post for dome lights and accessories. Some sports cars, such as the Jaguar, the fuel line runs through the post. Once the post are cut, the roof can then be set aside and access gained to the patient. There are several ways to “flap” a roof depending on the situation at hand. You may prefer to remove the windshield and then cut the front “A” post on each side. You will then need to make a relief cut into the roof in front of the “B” or rear post on each side. Using a pike pole, or pinch bar, a crease needs to be made across the roof at the relief cuts. The roof can then be folded back and secured for patient access. This technique can be modified to flap the roof from the rear to the front, or from either side. You may also choose to cut across the bottom of the windshield and flap the roof back with the windshield intact. This is also an acceptable method. You must decide which method will work for the given call you are on.
Door displacement, or removal, is the other technique that may be required to access or extricate your patient. Most door displacements take place in several fashions. You may choose to displace the door using the hydraulic spreaders as we did. Depending on the damage to the door, you may want to start your prying at the hinges or the nader pin. When prying at either the hinges or door handle, you must create a purchase point. This can be done by inserting a pry bar or haligan tool into the space between the door and the fender. You need to then widen the space at the handle or hinges to insert the tips of the spreader. Door hinges are made of cast steel, so they will not bend, but rather break abruptly. They can also send the rivets or bolt heads flying when the hinge breaks free from the doorframe. I had a student struck by a bolt head during an extrication class who was standing a good forty feet from the vehicle. The proper protective gear should be worn at all times by anyone that is in close proximity to the extrication. Always spread as close to the hinges as you can, otherwise you may find yourself pushing sheet metal and the hinges remain intact. When spreading at the nader pin, again a purchase point needs to be created. The prying technique works good or you may also try squeezing the fender vertically just over the tire. This may also create a purchase point for spreading. The minimum holding requirement for a nader pin is 2500 pounds of longitutal force, and some vehicles exceed 5000 pounds, so if the door lock can be released it will help in the separation from the nader pin. You should pry as close to the nader pin as possible to avoid pushing sheet metal. The areas immediately around the hinge and nader pin are the strongest points for spreading. The hydraulic spreaders, or combination tool, works well for this type of displacement. A porta-power can also be used for this, but is going to be much slower. Another method for door removal or displacement is utilizing the combination tool or hydraulic cutters. After making an access point at the hinges you can then cut through the top and bottom hinges, you can then move to the door handle, create an access, and cut the nader pin. Before trying this technique, please make sure that the power tool you are using is capable of cutting cast hinges and nader pins. Not all hydraulic power tools are capable of performing this task and may not warranty their equipment if this procedure is done.
It makes you wonder how on earth you can arrive on the scene of a rollover, the roof is pressed flat as a pancake, and the driver is no where to be found, go figure. I have touched on several considerations when dealing with rollover crashes. There are many techniques to be considered when planning your extrication. Remember there is no substitute for practice, and you should schedule training sessions and practice scenarios at your local salvage yard whenever possible. We all get a little rusty sometimes and even us old dogs learn from our inspiring rookies.