Extrication / Rollovers

[Sizz]

Hey all

I'm curious from you more experienced Emt's and Medics how you handle removing a patient from a rollover with the vehicle upside down and the patient(s) still buckled in. Specifically safely removing them in a timely manner while maintaining C-spine up until they are boarded of course. I have not ran into this yet but I have been itching to find out how it should be preformed.

Scene is safe etc.

Thanks for the input

 

[usafmedic45]

Plenty of manpower (absolutely essential) and a KED (helpful).

 

[lightsandsirens5]

Plenty of manpower (absolutely essential) and a KED (helpful).

Agreed to the first. But to the second: If you don't have a KED you need a short spineboard. If you don't have one of those, you better have a sheet of plywood and a firefighter with a chainsaw to make one. If you don't have any of those, you just might be screwed.

Thank God I have never run across this scenario without having a KED or short spineboard.

 

[Code 20]

livechat and arranging assessments

How do i log on to the livechat on this website and whats the best way to ask a fellow class mate to arrange an assessment to go through scenarios to practice. get back to me:blush:

 

[mycrofft]

Most times I've found the victim extricated themselves, to be honest.

Theoretically, like USAF et al said. Remember make sure ABC's are working or that nice extrication will be on a dead pt.
Two hardest ones for me: car on it's side and slowly rolling over due to muddy soil, cribbing not working, pt severely obtunded; and, pt told to sit in the back seat of a '65 Mustang with a bloody nose after an accident, then began to experience neck pain.
Stupidest one was a rollover, end over end twice and ended up on its wheels with roof pushed down to jam doors. The EMT crawled into the '70 Beetle throujgh the shattered rear window then held manual traction while they got the FD handlines in play to disperse the gasoline all over the scene (!!) then pry the doors open. Pt would not leave without his CB radio.

 

[usafmedic45]

Agreed to the first. But to the second: If you don't have a KED you need a short spineboard.

True. I was just using the KED as an example because around here it's pretty much a "mandatory" item. I think I saw one short spineboard in actual use in my first ten years of full time involvement in EMS.

 

[lightsandsirens5]

True. I was just using the KED as an example because around here it's pretty much a "mandatory" item. I think I saw one short spineboard in actual use in my first ten years of full time involvement in EMS.

Yea, same here, we carry KEDs on the amb.

Unfortunately the fire engine does not have them. The department has some ancient shortboards, but the med. people will not put them on the rigs. :wacko:

Since my fire district is served by two different ambulance services, I have seen the shortboard in use several times as one of the services still uses them. I like them as well if not better than the KED. I know the KED is easier, but with bigger pts it just does not seem to immob the neck to well.

 

[Foxbat]

I recently read an article which described an interesting method.
You recline the patient's seat until it's almost horizontal. You put the patient face down on the backboard, cut the seat belt and remove him from the vehicle.

 

[mycrofft]

The Key Is PRACTICE!

..and where do you get a mannikin which is weighted articulated and cheap?
Seems you need a way to make 'em.

 

[akflightmedic]

..and where do you get a mannikin which is weighted articulated and cheap?
Seems you need a way to make 'em.

It is amazing what Urban Outdoorsmen will do for a few bucks...most realistic training aid you will ever get for such a low cost.

 

[Foxbat]

It is amazing what Urban Outdoorsmen will do for a few bucks...most realistic training aid you will ever get for such a low cost.

I don't know if I'd want to use a civilian for such a training. What if he gets hurt? He's not covered by your service's insurance and (since we're talking about a homeless guy) doesn't have his own...

 

[usafmedic45]

I recently read an article which described an interesting method.
You recline the patient's seat until it's almost horizontal. You put the patient face down on the backboard, cut the seat belt and remove him from the vehicle.

That doesn't work in an overturned vehicle, however that was the standard method of extrication we used the majority of the time I worked in fire/rescue and EMS in patient who were entrapped in upright vehicles. The roof comes off, the seat goes back, the background goes under the patient and the patient is laid back was how it went. Five minutes tops, not counting the time to pop the doors and roll the dash if necessary. It also allows you to recline the patient if you have concerns about their BP while extrication is still ongoing.

 

[Sizz]

Thanks for the feedback everyone, would anyone happen to have a link to a video of some sort that I could view or a link to a valuable website regarding the procedure(s)?