Vehicle extrication

Vehicle extrication is the process of removing a vehicle from around a person who has been involved in a motor vehicle accident, when conventional means of exit are impossible or inadvisable. A delicate approach is needed to minimize injury to the victim during the extrication. This operation is typically accomplished by using chocks and bracing for stabilization and hydraulic tools, including the Jaws of Life. Standards and regulations can be found in NFPA 1670 and 1006.

The basic extrication process consists of, but is not limited to, six steps:

In less complicated cases, it is possible to extricate the casualty without actually cutting the vehicle, such as removing a person from the side door or another part of the vehicle.

As soon as possible, best before beginning the mechanical operation, a medically trained person enters the cabin to perform first aid on the casualty: mid-level assessment, stopping the bleeding, putting a cervical collar on the patient (extrication operations are likely to provoke vibrations), providing oxygen first aid. In France, this rescuer is called the "squirrel" (écureuil). NFPA regulation 1006 and 1670 state that all "rescuers" must have medical training to perform any technical rescue operation, including cutting the vehicle itself. Therefore, in almost all rescue environments, whether it is an EMS Department or Fire Department that runs the rescue, the actual rescuers who cut the vehicle and run the extrication scene are Medical First Responders, Emergency Medical Technicians, or Paramedics, as a motor vehicle accident has a patient involved.

After the vehicle has been secured and access gained to the patient, the EMS team then enters to perform more detailed medical care. Continued protection of the patient from extrication itself, using hard and soft protection, should be done at all times. The deformation of the structure and the section of the roof take several minutes; this pre-extrication time can be used for medical or paramedical acts such as intubation or placing an intravenous drip. When the casualty is in cardiac arrest, cardiopulmonary resuscitation can be performed during the freeing, the casualty being seated. The use of this incompressible duration is sometimes called play and run, as a compromise between scoop and run (fast evacuation to a trauma center) and stay and play (maximum medical care onsite).

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