Extrication: Do We Really Train Enough?
David Pease, Carolina Fire/Rescue/EMS Journal
The million-dollar question, do we really train enough in vehicle extrication? In our minds, most of us would say yes. In reality, the answer is probably no. Can we truly train enough? We could if extrication was the only responsibility we had in fire, rescue and EMS. But we know that most of us have many more responsibilities than just extrication.
Let us first take a look at our roles in public safety. If you are involved in vehicle extrication then you are probably a firefighter / rescue or EMS / rescue. You are either a volunteer, fulltime career, or part time person with the department you work with. I will take a moment here to stir the pot a bit. Some people will tell you that fulltime personnel are professional firefighters or professional EMS while others are just volunteers. This is not always the case. I have seen quite a few people during my career that were volunteers who were as professional as they come. I have also seen fulltime people that weren’t even close to being professional. But on the other side, there are volunteers that will never be professional, and will always be considered just volunteers. Your mindset and attitude will determine how your peers and others will judge you in the profession. This attitude should not only be there for response but should carry over to our training and daily activities.
As firefighters, your main function is going to be fire suppression and prevention. You will spend many hours training to be good at this. This is your main responsibility. You may also provide first responder coverage for your district. Then, finally, you may be responsible for the vehicle extrication in the area. There is a considerable amount of knowledge needed to meet this overall responsibility. If you are EMS and rescue then your primary responsibility is going to be patient care. At the paramedic level there is a tremendous amount of responsibility and liability with the advanced care given to patients. In EMS, you will have had many hours of class and field training to be at the level you are. You will also have to have many hours of continued training to stay at that level and stay proficient with your skills.
Now let us look at whether you are fulltime or a volunteer with your department. This will have some definite bearing on the amount of training you may be able to squeeze in during your career. Here, fulltime staff has the advantage. They can train while they are being paid to be at work. Of course, this is providing that their department does training during working hours. A lot of departments do provide training during shifts, while others offer only minimal training during shifts. The volunteers must get their training on weekends and nights. This does not leave much time for a personal or family life sometimes. The real point here is to make the most of your training time.
If you look at the overall number of calls you run, I bet you will find that only a small percent are motor vehicle crashes. If you break that down even more, you will probably find that only a very small percent of the vehicle crashes turn out to be extrications. So we can say with fairly good accuracy that vehicle extrications make up less than about five to ten percent of your overall calls. Now put into play that if you ran 24 hours and seven days a week, you would run that five to ten percent. But very few of us run every call so you probably only do a few extrications a year. So do you spend most of your time training for extrication, or training in EMS and fire? Probably the latter, which is what you spend the most time doing.
My philosophy is that those rescuers providing vehicle extrication, no matter how few, should be training a minimum of 40 to 60 hours a year in extrication techniques. Now ask yourself, do you or your department spend that much time on vehicle extrication training? If you do, then my hat goes off to you and your department for dedicating the time needed to be somewhat efficient at vehicle extrication. If not, maybe you should approach your department and discuss committing to more extrication training.
The next question to ask is what type of extrication training do you do. A lot of departments have a car or two pulled in and spend part of a day taking the doors off, removing the roof and pushing the dash. The tools used are primarily the hydraulics and the entire department participates. If that turns out to be only a handful of members then that might not be too bad. If that turns out to be ten to twenty, then ask yourself how much training did each member actually get. There are only so many doors and roofs to go around per vehicle. Did you also practice on a multitude of ways to stabilize the vehicle, did you practice using other tools or air bags? Did you practice with the vehicles in various positions? Time and vehicles probably did not allow for this. But this becomes the extrication training you have for the next six months.
Let me offer some tips on setting up and doing your extrication training. The first thing you need to do is make sure your equipment is in good working order. Take the time to check and service your extrication equipment. This even includes your large hammers, hacksaws, and other smaller hand tools. Seals will go bad over time and should be replaced. You should have your hydraulics serviced on a regular basis.
The next big issue is being able to get the vehicles you need for training. Contact your local salvage yards and rather than have the cars pulled to you, make arrangements to go there. This sometimes will get you more vehicles to tear up. The operators will even get into positioning the cars just to help you out. If you don’t have any salvage yards in your response district, then contact the ones that are closest to you. These places may also be willing to work with you even though you don’t respond in their district. Be willing to send your members or travel to other areas. I am fortunate that I have two resources for vehicles that will provide for ample extrication for everyone. Most of my students go home rather wore out. I set up classes on request and am more than happy to schedule classes in my area for outside departments.
Do not hesitate to start your training program with stabilization and hand tools. You can easily spend two weekends training on just these two topics. Practice stabilization techniques using your basic cribbing, and then use some hi-lift jacks if you have them. Your high-pressure air bags along with cribbing works well also. If you have other devices such as the ResQ jacks, Paratech struts, ART struts, The Crutch, and there are more, spend the time practicing with them in real life scenarios. Making the vehicle safe is as important as the actual extrication techniques you learn and practice. Students should also practice and learn how to extricate using basic hand tools. This not only teaches some very basic techniques that can be used during an extrication, but also gives the students a better understanding of the structural make up of the vehicles. With practice you can do a dash push utilizing the hi-lift jacks.
After you have gone back over the basics, work into some advanced techniques with your power tools. Once you have worked on the basic door removals, roof flaps, and dash rolls, try doing some modified roof flaps. Flap the roof from the side, from the back; even try it from the center. Remove the door hinge side first then try the Nader pin first. Practice a third door maneuver, then try a side roll down. Work on pushing the dash from the sides and the middle. Then it will be time to pull out the air tools and reciprocating saws. Use these tools to remove the doors, the roof and displace the dash.
Now it is time to place the vehicles in different positions for extrication. Have the vehicle placed on it’s roof, on it’s’side, and even on another vehicle. This allows for training with stabilization techniques as well as extrication and patient removal. We have covered some of the ways to train with basic extrication, but we have not even touched on bus and heavy truck extrication.
I think you can now see that training to become a good extrication technician takes many hours of dedication. The important thing is to lay out an outline and follow it, rather than just throwing your extrication training together haphazardly. Have a plan for your total extrication program and make it work. If you are having problems with your extrication program, give me a call and I’ll be glad to help you out. As always, train hard and stay safe.
David has over 27 years experience in the EMS and Rescue field. He is a NC certified ERT Instructor, confined space specialist Instructor, trench rescue specialist Instructor, Rope specialist Instructor, former NC Paramedic and Paramedic Instructor, NC Certified Law Enforcement Instructor, CPR Coordinator and Instructor for Wake Technical Community College, certified diver, teaches with over 7 community colleges, and is Chief of the Reds Team, a technical rescue operations team providing response and training to other agencies and industry. David also writes for Advanced Rescue Technologies magazine. David can be emailed at Reds100@aol.com or visit their website at www.RedsTeam.com.