extrication suecos

7/30/2019 Extrication Suecos

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Editor Dan Wargclou

Extrication romCars During RoadTrafc Accidents


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Dan Wargclou

Dan Wargclou has been working as an instructor

at the Swedish Rescue Services Agencys College

in Skvde since 1998. He teaches in the areas

o fre and rescue, with the emphasis on road

trafc accidents, and is a member o the Swedish

Rescue Services Agencys extrication team

which has compiled this book. Dan is also one

o the enthusiasts behind the Swedish extrica-

tion championships. He previously worked or

19 years as a frefghter and sub-ofcer in the

Mariestad fre brigade.


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Editor Dan Wargclou

E CD R T A

Swedish Rescue Services Agency


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E C D R T AOriginal Swedish title: Rddning vid trafkolycka -personbil

Authors: Dan Wargclou and the Swedish Rescue Services Agencys

Extrication Team

Project manager: Ingvar Hansson

Translation: Interverbum

Editor on English version: James Butler

Picture editor: Kristina Malmstedt-Svensson

Design and layout: Lena Mrtensson

Year o publication: 007Order number: U30-670/07

ISBN 978-9-753-366-0

007 Swedish Rescue Services Agency


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C

I 5Time is precious! 6

Arrangement o the manual 7

1 A 9Disconnect the battery! 10

Location o battery 11

Belt pretensioners 12

Airbags 12

How an airbag works

Fire 14

Volvo S80 airbag system 14

Identiying a vehicle with an airbag 15

Medical eects o airbags 16

Airbags and the fre brigade 18

Whiplash protection 20

Roll-over protection systems 20

Saety glass 21

Frequently asked questions and answers on airbags

2 T w 25Checklist daily inspection 7, Checklist regular inspection 7

3 O : Cw 1+4 29Scene o the accident 29

Incident commanders tasks 3, Trafc control ofcer/medic/extricator 3, Saety ofcer 3,

Medic/extricator 3, Vehicle driver/tool ofcer 33

R ! 37Read the situation 38

4 E w 41Non-deployed airbag 42

Summary 43

Quick removal 44

Removal when the casualtys condition is judged to be stable and there is no external hazard 45

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Upright car 45

Summary - extrication rom an upright car 54

Car on its side 55

Summary - extrication rom a car on its side 6

Car on its roo 62

Summary - extrication rom a car on its roo 67

5 P- w 69Follow-up and evaluation 71

S 73

L 74


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I

Every year around 70,000 road trac accidents happen inSweden. According to the Swedish Institute or ransportand Communications Analysis (SIKA)1 statistics (2005),480 people were killed on the roads in 2004.2 26,582 peoplewere injured, 4,022 o them seriously3.

A road trac accident in which one or more seriouslyinjured people are trapped is a demanding situation romboth the technical and medical points o view.

Te casualties condition must not be exacerbated by theextrication activity, and medical treatment must not be delay-ed.

Research suggests that damage to the cervical spine occursin most types o accident. According to the survey conduc-ted by the insurance company Folksam How sae are cars in2005 on serious injuries that have resulted in 10% or moreincapacity, neck injuries have shown the greatest increase.In the mid-seventies 30% o these injuries involved the neck.By the nineties the proportion had risen to 60%.

It must be possible to li a casualty out o the vehicle with-out his or her neck and back being twisted. We know thattwisting or incorrect liing can incapacitate the casualty orlie. Tis means that it may be necessary to li o the roo othe car, even i the casualties are not trapped.

It is important that we can attend to people involved inroad trac accidents quickly and as well as possible. TeSwedish Rescue Services Agency has thereore drawn up

routines or each person in the crew, zones around the acci-dent and an action plan or extrication that ollows the

action plan or medical assistance.

T !

1. SIKA is a government agency under the Ministry o Industry, Employ-ment and Communications.SIKAs responsibility is to help ensure that the public and the businesscommunity are oered good, environmentally riendly and sae transportthat is economically ecient and sustainable in the long term.

2. Te Swedish National Road Administration denes a atality in a roadtrac accident as a person who has died within 30 days ollowing theaccident. For this denition to be met, the person concerned has to have

died as a direct or indirect consequence o the accident.

3. Severe injuries in road trac accidents are dened as ractures, contu-sions, lacerations, severe cuts, concussion or internal injuries expected toresult in hospitalisation. Other injuries are termed minor.


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Smooth interactionbetween the rebrigade, emergencymedical services andpolice is essential i anaccident is to beproperly dealt with.

Time is precious!Te main message is that time is precious. Tere is a need to

coordinate the work o medical personnel and re brigadepersonnel and to make use o natural breaks in one anothersactivities. It is important that the re brigade, emergencymedical services and police interact well to ensure a goodoutcome. Te aim is to shorten the golden period andimprove care o the casualty so that he or she is in a better orno worse condition aer being extricated than when theunits arrived on the scene. Te concept o the golden periodmeans that a casualty is to receive hospital treatment withinone hour o the accident happening. Extrication has to ol-low medical attention. All parties involved have to work as

a team, in which everyone has to know about the variousoperations that take place. Fire brigade personnel have tocreate space or medical care according to the L-ABCDE

principle, pay close attention to the casualtys cervical spineand back during liing and be able to li in the longitudinaldirection o the spine and control extrication in a medicallyappropriate manner. All this necessitates joint exercises bet-ween the emergency medical services and re brigade.

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As everyone is aware, no two road trac accidents are thesame. Good knowledge is thereore needed both in pre-hos-pital emergency care according to the L-ABCDE principleand in extrication, so that the re brigade personnel can tail-or their response to the situation. It is important to be ableto read accident situations and keep track o developmentsso that cutting techniques can be adapted to vehicles on theroad. Vehicle design is constantly changing, and it isobviously not good to be le at the scene o an accident notknowing how to continue with extrication because yourown cutting technique is not working.

Arrangement o the bookExtrication techniques at the scene o an accident involvinga car are dealt with in this chapter. Some important actorsrelating to airbags and other saety systems are rst presen-ted. A description is then given o hydraulic tools, organisa-tion on the scene and extrication according to dierentaction plans depending on whether the car is on its wheels,lying on its side or lying on its roo. Finally post-emergency

work is discussed. Medical attention is only discussed ingeneral terms.


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Examples o driver, passenger and side airbags in Saab cars.


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Te technical progress taking place in the car industry isobviously o benet to road-users. But new materials and

new designs are also making ever greater demands on thoseo us who work on the scene o accidents. We have to keepabreast o the latest technology and constantly ask ourselveswhat the latest situation is. For example, can we cut in thesame way and at the same places as we used to? It may alsobe dicult to work on new cars with older tools. Te tool-makers too have to keep up with the latest developmentsand adapt their equipment to new car designs with regard tostrength, design, working pressure etc.

Car-makers aim to make sure that drivers and passengerscan travel in saety, and the impact protection system o amodern car is designed to provide the best protection pos-sible protection in an accident. Te interior is the part o the

vehicle that is being strengthened most. Various grades o

steel such as HSLA, which have been strengthened with

alloys such as aluminium and various boron steel admix-tures, are used. Te mechanical strength o dierent gradeso steel varies. HSLA steel has a strength o 700 N/mm2 andboron steel 1380 N/mm2.

Pure boron steel is, at present, the hardest and strongeststeel in use. It is dicult or us to cut into it, and in somecases it is so strong that it can damage our tools.

1 A


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Disconnect the battery!I they are to be able to carry out an emergency rescue ope-ration as well as possible, ambulance and re brigade per-sonnel need to know both how the saety systems in cars

work and how they are deactivated.It is important when attending the scene o a road trac

accident to make sure that the car battery is disconnected asquickly as possible. Disconnecting the battery reduces therisk o re and eliminates the risk o a saety device beingdeployed accidentally as a result o a short circuit. I it is notpossible to disconnect the battery, it must be ensured thatthe ignition is turned o.

Do not cut the cables, disconnect the cable terminals ins-tead. Start with the negative pole. It may happen that youneed power later to lower windows or move an electricallyoperated seat to assist with extrication. In these situations itis useul to be able to reconnect the battery easily.

Te re brigade has tokeep up to date with newtechnology and newdesigns. Te picturesshow how the B-pillarhas changed over aperiod o ten years.

Attempt at cutting intoB-pillar reinorced withboron steel.

B-pillar in Saab -1990 B-pillar in Saab -2000


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Mercedes Benz A-Class. Te battery islocated in the oor inront o the rontpassenger seat under acover and possibly amat.

Location o batteryA clear sign o the development taking place is that themanuacturers are putting more and more electrical equip-ment into their cars. In some models there may be more

than one car battery. Tere is still no marking to indicatehow many batteries a car is tted with. Instead you simplyhave to look to see how much electric power-consumingequipment there is in the car.

It can be dicult to locate the battery. And once a batteryhas been located, it is impossible to know or sure that it isthe only one. Tere is wide diversity between dierentmodels, and a battery may be located almost anywhere. Inthe good old days the battery could almost always be ound

under the bonnet. I it was not located there, it was becausethe car was a Beetle (Volkswagen) and then you knew thatthe battery was under the rear seat. Tat is no longer thecase.

Chrysler Cruiser. Tebattery is located on

the le-hand side o theengine compartmentunder part o an airintake.


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Belt pretensionerso eliminate slack in seat belts, modern cars have pretensio-ners, which mean that the belts tighten around the vehicleoccupants in the event o a collision. Tere are mechanical

pretensioners that work with a powerul spring and pyro-technic ones that tighten the belt around the occupant inthe event o a collision.Pyrotechnic pretensioners are themost common type today.

Older pretensioners may mean that the seatbelt is tightly

secured around the casualty aer a crash. More recentmodels release the pressure on the casualty aer activation.I the pretensioner has not been activated it is important notto cause any damage to it, to avoid activating it accidentally.

AirbagsMany vehicles on the road, particularly models dating rom1990 or later, are tted with airbags. Tere are airbags orthe drivers seat, passenger seats, side impact protectioncurtains and side airbags. Te latter may be in the side o the

seat, but also at other locations in the car. Common volu-

mes are 60 litres on the drivers side and 150 litres on thepassengers side. Te volume o side airbags and side impactprotection curtains is around 12 litres. Other airbag appli-cations are under development.

As well as cars and small and large vans, recent truckmodels are also usually tted with airbags.

Hw w

Sensors located in the interior o the car, at the ront or side,send an electric signal in response to a suciently powerulorce (or example a head-on collision with a barrier at aspeed o at least 15 kph) to a main sensor which in turnsends a signal to the saety equipment to be activated. Tesensors sense the deceleration but do not have a memory.Tis means that the system returns to its neutral positionaer a sharp braking manoeuvre or similar episode whenthe bag has come close to being deployed.

In almost all older vehicles (1997 year model and earlier),the sensors send an impulse to a gas generator, in which arapid chemical reaction generates nitrogen gas. Various


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substances are used or this reaction and some by-productsmay be highly corrosive and cause irritation to both pas-sengers and re brigade personnel. Some substances canhave an adverse eect on the healing o wounds. I they getinto open wounds, it will take longer or the wounds to heal.

One such substance is sodium hydroxide (caustic soda).According to the manuacturer no more than one gram osoda should emerge. But i it is known that caustic soda mayhave entered a casualtys open wound, the accident andemergency department o the hospital should be given thisinormation.

A kind o talc is also used on older airbags to reduce ric-tion. Tis talc could irritate the eyes and in some cases cause

a stinging pain in wounds.More recent systems have a pressure container that lls

the bag and is ree o the toxic substances produced by thechemical reaction. Nitrogen has also been to some extentreplaced by argon and helium.

In addition, there are hybrid systems where the steering-wheel bag is infated by a chemical reaction and the otherairbags by pressure containers.

Te airbag is lled with gas in a ew hundredths o asecond and is ully infated beore anyone hits it. It is thendischarged relatively quickly through holes that ace awayrom the occupants. Te bag expands quickly, and the speedo movement in the direction o the occupants can amount

to a ew hundred kph in a head-on collision. Heat is produ-ced in the reaction in the gas generator, and the steeringcolumn may become quite hot. Te sound level is also high.Te sound level may be up to 170 dB.4 Some driver airbags

are deployed in two stages, depending on vehicle speed anddriver weight.

4. Te sound level o a military jet is approximately 130 dB. Te decibelscale is logarithmic, and the step rom 8 to 10 dB is experienced as adoubling o sound level.


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T w :Driver airbag approx. 60 lPassenger-side airbag approx. 150 lSide airbags approx. 12 lInfatable curtains approx. 12 l

FireTe Swedish Rescue Services Agency has carried out trials

with Volvo and Saab in which cars are set on re to see howthe saety systems and gas containers and pyrotechnicdeployment devices in particular respond at high tempera-ture. Gas containers can ignite at temperatures in excess o200C. Tis means that an airbag might be deployed at highheat levels, or example in a vehicle re. At a temperatureabove 200C there will be a ully developed re in the pas-senger compartment.

Volvo S80 airbag systemTe airbag system o the Volvo S80 is a hybrid system.Te drivers airbag is lled with nitrogen gas, ormed in achemical process in a gas generator. Te passenger airbag,side airbags and side impact protection curtains (whichcome rom the roo as protection inside the side windows)are lled with argon gas. Tis gas is in pressure containersthat are opened by a pyrotechnic igniter controlled by anelectric signal rom the central sensor. Te pressure contai-

ners or the curtains may be in the A-, B-, C- or D pillars.Some pressure containers are located at the edge o the roobehind the passenger handles. Te pressure vessel o thepassenger airbag is in the dashboard. In cars with side air-bags there is a pressure vessel in the backrest o the rontseats which infates them.

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Side impact protectioncurtain or BMW.

Side impact protectioncurtain in Volvo.

Identiying a vehicle with an airbagAn airbag installation has to be identied in some way, butthe clarity o the identication varies. Te marking may beon a window, the dashboard or the steering wheel. Older

orms o identication may be S.I.R., P.R.S. or Airbag. Insome cases it may be very dicult to see whether the vehic-le has side airbags, or example. Agreement has now beenreached in the car industry to use the designation SRS(Supplementary Restraining System) or the system withairbag and pretensioner. Te hub o the steering wheel maylook bulky in a car with an airbag.


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An airbag installationhas to be identied, orexample on a window,the dashboard or thesteering wheel. Tepicture shows Volvosidentication o anairbag.

Volvo V50 with identi-cation o airbags on

interior trim.

Medical eects o airbagsA person who has crashed in a car tted with an airbag hasprobably been protected by the airbag, particularly i he or

she has also been wearing a seat belt. According to the Folk-sam surveyHow sae are cars in 2005, using a three-pointseat belt reduces the risk o atal or serious injuries by more

than 50%. A three-point belt together with an airbag redu-ces the risk o atal or serious injuries by over 60%, accor-ding to Folksam.

Te orce required to infate an airbag may, however, inju-re people who are very close to or in direct contact with thebag when it deploys. In the rst ew milliseconds o infationthe orce can seriously injure a person who is hit by theexpanding airbag. Anyone who is in contact with, or very

close to, the airbag when it starts to expand is in the dangerzone. It is important to understand that whether severeinjuries are caused by airbags usually depends on thepersons position when the airbag starts to expand - not the


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Volvo cars also have asticker showing whatairbags there are in thevehicle.

persons size or age. Most deaths involving airbags involvepeople who do not wear their seat belt, wear their seat beltincorrectly or do not sit correctly. People not wearing a seatbelt, particularly vehicle occupants on the passenger side,are in danger as they will probably be thrown orward

during the sharp braking manoeuvres or abrupt turns thatoen precede a collision. Tey may then come too close totheir airbags and be injured. Drivers who lean orward or sitless than 25 centimetres away rom the steering wheel arealso in the danger zone.

Babies should never travel in rearward-acing child car

seats on the passenger side i the car is tted with an airbagon that side.

As mentioned earlier, the occupant may get corrosive(alkaline) substances or substances that cause mechanicalirritation in his or her eyes and wounds i an airbag deploys.I the substances get into open wounds, it may take longeror these wounds to heal. It is mostly airbags in older vehic-les (1997 and earlier models) that release these substances.

Gases and particles can induce asthma attacks in asthmasuerers in a ew cases. Te sound level when the airbagdeploys (up to 170 dB) may cause temporary hearingimpairment.

In Sweden only a small number o injuries are known tohave been caused by airbags. Tere are more detailed statis-tics in the United States. More than 87 million (43.6 %) o

the 200 million cars and light trucks on the road in the Uni-ted States are tted with airbags on the drivers side (Insu-rance Institute or Highway Saety). American gures indi-cate that many people have been killed or injured as a result

o an airbag. Te reason may be that many car drivers seethe airbag as a substitute or a seat belt, and not as a comple-ment to it. Te car industry has thereore developed strong-er airbags that can withstand the orce o an adult who is notwearing a seat belt. Tis leads to increased risks or anyonewho sits incorrectly.


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Airbags and the fre brigadeTe Insurance Institute or Highway Saety does not knowo a single case in which re brigade personnel have beenseriously injured by an airbag during a rescue operation.However, two reghters in the United States were slightlyinjured by an airbag that deployed when they were working

to extricate a casualty rom a car. Te incident was descri-bed as ollows in the magazine Rescue:

A conclusion that can be drawn rom the incident is that rebrigade personnel should ollow these recommendations:

A car had le the road and collided with a tree.Te le side o the car was badly smashed.Te driver and a rear-seat passenger were trapped and hadsustained serious injuries. Both were conscious. Te crew

attempted to open the bonnet and disconnect the battery, butthe movements this produced in the car caused the trappedoccupants severe pain and the attempt was abandoned. Tereghters then re-prooed the car, but the circumstancescaused them to orget that the battery had not beendisconnected.

Te driver was removed on a rescue board through the rontright-side door. Te passenger, an adult man, was trappedwith his eet under the ront seat, and it was very dicult toextricate him. A reghter inserted a spreader between theseat sub-rame and a metal box located on the tunnel betweenthe ront seats. He was assisted by another reghter who layacross the steering wheel. Tis rst attempt to ree the casualtyailed, and another attempt was made. It was then that theairbags deployed. Both reghters were thrown rom the carby the orce.

Te reghter who had been lying across the steering wheelhimsel thinks that he lost consciousness or a while. Aer theaccident both reghters suered stomach and chest pain and

temporary hearing impairment. Fortunately it turned out thatneither o them had sustained any ractures. Both were backon duty soon aer the accident.

What happened was that one prong o the spreader peeled othe plastic cover on a positive cable (+). Te other prongcreated a hole in the metal box which contained equipmentor deployment o the airbags. Te spreader then conductedthe current to the deployment equipment, and that wasenough or the accident to occur. (Extract rom the magazine

Rescue, July/August 1996)


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REMEMBER! Always disconnect the battery. I this cannot be done, switch o the ignition.

Bear in mind that cars may have two batteries.

Avoid working in the risk zone o the airbag i the airbag has not deployed.

Bear in mind that the car may have more than one airbag.

Avoid placing the spreader guide against unknown parts o the car.

Note that there are some situations in which particular cau-tion must be exercised:

Most vehicles have airbags with a certain deactivationtime, so that they can also work in a protracted crash

sequence in which the battery has been disconnected. Tedeactivation time in modern cars is normally less than oneminute, usually a matter o seconds. But there are cars witha deactivation time o up to hal an hour. For example, some

Saab models rom 1994 and earlier have a deactivation timeo 20 minutes.

Tis means that an airbag that has not deployed in thecrash may deploy unexpectedly during the rescue opera-tion, even i the battery has been disconnected. Tis can

happen or example i the leads are cut. It is thereore advi-sable not to be in the airbag risk zone (i.e. less than 25 cmrom the steering-wheel hub) during a rescue operationwork or to hold an object between a trapped occupant and anon-deployed airbag. Nor should work be done on the ste-ering-wheel column or hub, as this can cause airbag deploy-ment.

Tere have been reports o airbags having been triggered

by radio communication equipment located in cars. Leadsrom sensor to gas generator could conceivably act as aerialsand in so doing contribute to accidental airbag deployment.Te instruction manuals o many modern cars contain awarning against using a mobile phone without an externalaerial in the car, as the phone can interere with the carselectronic systems, which include the saety system.

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Whiplash protectionMany car-makers are trying to nd answers to the problem

o whiplash injuries. Volvo and Saab have anti-whiplashprotection tted into their seats. Mercedes has protectionbuilt into the seats head restraint.

Roll-over protection systemsConvertibles have special saety systems to provide protec-

tion in the event o roll-over. Tese are known as roll-overprotection systems. o protect the driver and passengers ithe car rolls over, arches are deployed at the head restraint.I these arches have not been activated in a road trac acci-dent, they can pose a risk to re brigade personnel. As thesystem may be activated during the rescue operation, it isimportant not to lean across the arches.

Te car above showswhiplash protectiontted into the seatshead restraint


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Volvos symbol orsaety glass.

Saety glassIt is becoming increasingly common or cars to be tted

with saety glass (laminated glass). Tis is identied on allcars by a symbol on the window or by text stating that it issaety glass.

Activated saety systemor Saab 9-3 conver-tible. It is important toexercise caution iworking close to a non-

deployed rolloverprotection system.


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FREQUENTLY ASKED QUESTIONS ANDANSWERS ABOUT AIRBAGS

How to tell i a car is equipped with an airbag?Cars equipped with airbags have to be marked accordingly. Tis marking maybe located on a window, the dashboard and/or the steering wheel. Older termsused are S.I.R., P.R.S. or Airbag. Te car industry has now reached agreementon the designation SRS (Supplementary Restraining System). Te steeringwheel hub oen looks bulkier on a car that has an airbag. I you are uncertain,you should always treat the car as having an airbag.

Can toxic substances emerge rom a deployed airbag?

Yes, very small quantities o toxic substances may emerge rom a deployed air-bag. Many airbags are infated with nitrogen, which is ormed by a chemicalreaction in a gas generator. Residues are also ormed in the process, includingsome corrosive substances, such as sodium hydroxide (caustic soda). On olderairbags there is also a kind o talc that may cause irritation in the eyes and insome cases a stinging sensation in wounds. According to the manuacturer nomore than one gram will escape into the passenger compartment.In more recent cars with pressure containers, no toxic substances can leak outat all as dierent types o gases are used (or example argon and helium).

Can it be expected that all the airbags will have deployed i the car hasbeen involved in a head-on collision?

No, normally not all the airbags will deploy in a head-on collision. Te side-impact protection system will not have deployed in a head-on collision. I a carhas been hit rom the side, only the side-impact protection system will deploy.

Is it dangerous to approach a crashed car when the airbags have notdeployed?

Might the airbags be close to deploying? No, non-deployed airbags in a crashedcar are not close to deploying. Tere is thereore no risk o the airbags deploy-ing as a result o you taking hold o the vehicle, bouncing it etc. Te sensors thatsense the deceleration do not have any memory and always return to theirneutral position aer an abrupt manoeuvre. I this was not the case, the airbagsmight or example be triggered by a series o hard braking manoeuvres in suc-cession.


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Can airbags deploy accidentally?

An airbag normally does not deploy i the power supply is broken by discon-necting the battery. You should thereore always disconnect the battery and not cut the cables

to the airbag! Also avoid cutting the steering wheel hub and steering wheel column. urn o the ignition i it is not possible to disconnect the battery. Do not cut a gas container.


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Tis chapter describes the hydraulic tools used during therescue operation and how to handle and look aer them. I

the rescue operation on the scene is to work smoothly, weneed to be amiliar with the tools we have at our disposaland look aer these tools aer use.

Te three most common hydraulic tools used in road tra-c accidents are cutters, spreaders and rams (also known aspistons). Tere are also some other tools, or example a

2 T w

Cutter

Ram

Spreader


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combi-tool (cutter and spreader combined into one tool), apedal cutter, which is a smaller cutter used to cut pedals,steering wheel rims, head restraints etc. and manual toolsoperated by hand, so that they can be transported to andused in inaccessible places.

Te cutting orce o the cutter is 20-95 tonnes. But theorce is not what we are concerned with here. o achievegood results when cutting dierent types o steel, the blademust be suitably shaped. It is also important to cut as closeto the centre o the cutter as possible, because that is whereit is strongest.

Te spreading orce o a spreader is around 5-30 tonnesand the compressive orce o a hydraulic ram is 10-25 tonnes,

depending on model.A hydraulic pump is needed to operate these tools. Te

maximum operating pressure on the most commonly usedpumps is 600-800 bar. Te high operating pressure o thehydraulic oil means that there is a risk o injury i care is nottaken. Do not use hydraulic hoses more than 10 years old.Tis ten-year limit also applies to the shorter pieces o hosebuilt into the tools.

Check the hydraulic hoses at regular intervals. Do notpull on a hose i there are kinks or knots in it. Doing sowould make the hose more brittle and prone to damage,resulting in reduced power (pressure losses).

All tools should be le with their jaws/spreader arms/pis-

tons slightly apart so that the tool pressure is relieved.I the tool is le closed up, there continues to be pressure

in it, increasing the risk o an accident.

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checklist - regular inspection est tool and pump to detect any leaks. Open and close the tools so that the

pump builds up ull hydraulic pressure (check using pressure gauge). Check the dead mans handle. Te handle must return easily to the neutral

position. Dismantle, clean and grease all joints (pins) on the cutting tool, including the

blades. Make sure that there is no play in the blades and that they are notdamaged.

Check hoses to make sure there is no damage and no kinks. Bear in mind thatthe operating pressure is 600-800 bar. Avoid pulling on the hydraulic hose ithere are knots in it.

Check the level o hydraulic oil. Check the torque on the centre bolt. I the centre bolt is not properly tightened,

there is a risk o the blades separating and coming apart during cutting.

checklist - daily inspection Check the condition o hydraulic hoses. Inspect the blades and tips o cutting and spreading tools visually. Replace

blades and tips i metal chips have become detached or is there is a lot o

deormation on the cutting edge/tip. Visually inspect quick-release connectors. Clean away dirt. I there is a level gauge or the quantity o hydraulic oil in the pump, it should be

checked at regular intervals. Check the level o uel in uel-driven pumps and electric cables on electric

pumps. est the system.


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Orderliness on the scene allows rescue work to ow better


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O :Cw 1+4

In this chapter we make suggestions on how the rescueorganisation on the scene can be organised and what needs

to be borne in mind to ensure that the operation will pro-ceed saely and eciently. A standard routine is generallyollowed to make sure that work on the scene is done e-ciently. Tis means that each member o the re brigadecrew has particular tasks he or she has to carry out automa-tically without waiting or orders. It is also important thateveryone knows what everyone else is doing.

Scene o the accidentTe scene o the accident is divided into three zones: a hot

zone with a radius o 5 metres (inner zone) and a warm zonewith a radius o 10 metres (outer zone). Te emergency ser-

vice vehicles are parked in the cold zone (the third zone), sothat they protect the scene o the accident. Only persons

who have a specic task to perorm with the casualties andthe extrication stay in the hot zone. All personnel workingin the hot zone have to wear saety goggles and latex glovesunder their ordinary gloves, in addition to their personalprotective equipment. Te ground must be kept clear in thehot zone. Tere should be no reason or anyone to tread onor trip over anything. Medical equipment is placed on or inthe vehicle.

Car parts and similar items cut ree are placed at a specialdebris point in the warm zone. Te warm zone containspersonnel, tools and equipment not needed at the time.

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5 m.

10 m.

Toolpoint

Debriscollection

Hot zone

Warm zone

Cold zone

SDR

713

SDR50

2

SDR 951


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I Te incident commander guides, assesses, decides andissues commands. Te incident commander carries outcontinuous risk assessment, coordinates with the emergen-cy medical services and police and i necessary requests sal-

vage assistance.

Te incident commander

requests supplementary inormation rom the emer-gency services switchboard concerning people who areinjured/trapped

issues preparatory orders to the re brigade personneland is responsible or making the scene o the accidentsae (stabilising vehicles i necessary)

assesses access routes/separated lanes o trac decides whether to cordon o the road on arrival and

provides the emergency service switchboard with athrough-the-windscreen report

documents the incident, i appropriate by takingphotographs

makes sure that the vehicle is positioned so that it

provides protection looks out or special risks, or example hazardous

materials orders more ambulances and i necessary an emergency

medical services team and other resources needed on the

scene.

In addition, the incident commander assesses environmen-tal hazards and whether a clean-up operation is required.

T //Te trac control ocer/medic/extricator (right rear) ini-tially cordons o the road completely or partially on eitherside o the accident. He or she then proceeds to the scene othe accident and puts on his or her tool belt to work as amedic/extricator.

In some cases cordoning o the road may need to be givenlower priority, or example i a re or other high-priority

task arises or the police are already on the scene.


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S Te saety ocer (le rear) initially wears breathing appara-tus and a mask, and ensures that no re will break out by

deploying a pressurised oam extinguisher or powderextinguisher.

Always think rst o all about the saety o both re brigadepersonnel and casualties!

Injured re brigade personnel are o little benet at thescene o an accident and use up resources i they need to betreated.

Te saety ocer

makes sure that the vehicle is stabilised

makes sure that the car battery is disconnected and thenjudges the saety o the casualties and re brigadepersonnel on the scene by taking a ew steps back toobtain an overview

makes sure that personal protective equipment is used(saety goggles, gloves, helmet etc.)

is responsible or there being a clear area to work inaround the damaged vehicle (hot zone)

has to be prepared to step orward to help when neces-

sary and then step back to reduce the risk o tunnelvision.

Do not take of breathing apparatus until the scene is sae

and the command to do so has been given!

M/Te medic/extricator (centre rear) takes medical fuids andcervical collars to the scene o the accident and itemises and

prioritises together with the commander. Te medic/extri-cator is responsible or medical attention until ambulancepersonnel arrive. When ambulance personnel are on thescene, he/she changes role to that o extricator.

Medic/extricator

starts giving medical attention on the basis oL-ABCDE principleI re brigade personnel enter the damaged vehicle

beore it has been stabilised, great caution must be exer-cised so that the condition o the casualties is not madeworse

T

!


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keeps the casualties airways open stabilises the casualties necks using cervical collars

creates access or medical treatment. I the car doorscannot be opened, the windows are used. Windows thatmay break with the result that the casualties are hit by

glass ragments must be removed.

V / Te vehicle driver parks the emergency service vehicle sothat the scene o the accident is protected as much as pos-sible, leaves the blue fashing light on and turns on thehazard fashers. Te emergency service vehicle must notdazzle other trac with dipped headlights and should ins-

tead have its parking lights switched on.Te vehicle driver also makes sure that the accident is

documented by taking photographs early on.

Te driver

connects and lays out a oam line then acts as tool ocer

takes out stabilising material and assists with stabilising

i necessary.

ool ocer

Builds up a tool point in the warm zone by laying out theollowing equipment:tarpaulin,stabilising equipment,tool bag,

blanket,crowbar,protective plastic sheet or the casualties (to guardagainst glass ragments),hydraulic tools,glass saw,hard plastic disc (cutting protection),protective equipment or sharp edges etc.Te tool ocer serves the re brigade personnel with

equipment and is prepared to help or a short time in the hotzone i necessary.


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A A:Immediate action: aking stockLie-supporting measures andestablishment o a sae workplace

B E:Continued measures: First aidCreating space/extrication

A B

1. Driver akes out extinguishing equipment. ool ocer. Tat the rightFoam. tool is always available.

Assists with liing.

2. Commander Vehicle location, frst round. Orders. Leads the work at

Directs on Guidance, the scene o the accident.assessment, decision. Status reports.

3. Saety ofcer Protect and saeguard against fre. Continuously checks onDisconnects car battery and has a saety, e.g. glass ragments,oam extinguisher or powder in sharp edges, petrol leaks,readiness. Respiratory equipment cut-o parts, personal pro-to be used until commander orders tection, stability o vehicle,otherwise. protection o casualty/

casualties. Assist with liing.4. First aid Accompanies commander on Works with tools.

frst round, takes medical equip- Creates space or medicalment. Lie-supporting measures/ personnel.lie-threatening situation. Attendsto casualties until ambulancepersonnel take over.

5. Trafc saety Warns, cordons o road. Attends Works with tools.

to casualties until ambulance Creates space or medicalpersonnel take over. personnel.


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Sometimes the whole road has to be cordoned of.


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R !

It is important that rescue service personnel can read acci-dents so that they can set the right priorities, move casualt-ies who are in situations that pose a danger to lie, make surethat the casualties breathing, circulation and heart activityare working, prevent shock, stop haemorrhages etc.

Te re brigade personnels knowledge and understan-ding o the orces that cause physical injury speed withregard to suspecting various kinds o injuries and skill inassessing the situation are crucial actors.

Reading an accident means obtaining a picture rom what

can be seen at the scene o an accident o what has happe-ned, the sequence o events in the accident and what measu-res need to be taken. A picture is ormed o how and where

injuries may have been sustained: Have loose objects beenthrown around in the car? Have the passengers had theirseat belts on? I there is a bulls eye in the windscreen, orexample, neck and head injuries can be suspected or thedriver or passenger. It may also mean that there has been a

collision with someone or something.Te more you know about emergency medical care, extri-cation etc., the more you can read rom the situation you seein ront o you and the greater your readiness or action.

Reading the accident situation also means studying thescene: What is the speed limit or the section o road con-cerned? What are the road conditions like? What has the carcollided with? Fire hazard? Lie-threatening situation? Andso on.

One way o learning how to read accident situations is tolook at photographs rom the scenes o various accidentstogether with colleagues and thinking about what mighthave happened.


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read the situationOne way o reading an accident situation is to ask yoursel a number o questionsabout what you see. Te examples below are taken rom the book Pre-hospitalemergency care. According to the L-ABCDE principle (this book only available inSwedish)

the scene:Attempt to obtain an overall pictureo the accident, how does it look?What does the scene o the accidentlook like?How many vehicles are involved?Establish type and extent o damageto each vehicle.

What was the prevailing speed limiton that section o road?Road conditions?Is it a high-energy or low-energyimpact?

the situation:What has actually happened?

Why?What has collided with what and atwhat speed?How many vehicles are involved?How many persons are involved?How old are the persons involved?How has the body moved?Was the surace hard or so?Important details?

Was a seat belt being worn?I yes, was it correctly positioned?Were an airbag or side impact protec-tion curtains deployed?Is the windscreen intact?I it is damaged, has the damage beencaused by impact rom inside or out-side?

Could the casualtys head have struckthe steering wheel or the windscreen?Is there blood in the car?How has a person who has been fungrom the vehicle landed?Where is or are the person or personsoutside the vehicle?

What was the location o the casualtiesat the start?Is there anything under the vehicle?A child who has been hit can easily endup under the vehicle.How many persons are in each vehicle?Is anyone trapped?How much is the vehicle dented?Are there any brake or skid marks on

the road?Where on the vehicle did the collisiontake place?Are there are any signs that the vehiclehas rolled over?Are there are any marks inside thevehicle indicating that any part o thebody has struck anything?Must the vehicle be moved or it to be

possible or extrication to take place?Is there is a risk o the vehicle topplingover, sliding down a slope etc.?


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Questions can also be put to the casualties. Te replies you receive generally give anindication o the casualties condition, how severe the injuries are and where theinjuries are located. Te inormation obtained also makes it easier to commencethe right treatment.It is useul to start with a question that demands more than a yes or no, or example:

What happened? Where does it hurt? By asking questions o this kind you can gainan idea o the casualties breathing, circulation and general condition.


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Te saety ocer initially guards against the danger o re by using a oam or powderextinguisher.


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E

Te extrication ollows an action plan. When the incidentcommander, medic and saety ocer (with a oam or pow-der extinguisher) arrive, they walk around the vehicle toobtain a picture o the injuries and the damage to vehiclesand o the risks posed by the vehicle or vehicles. At this stagedecisions must be taken on whether the vehicle needs to bemoved to allow access.

Te medic/extricator takes the medical equipment, makessure that the emergency medical services have access so that

the casualties airways can be kept open and tries to openthe doors.

Te tool ocer unreels the hose and oam tube or oamspreading and lays out the tools. He or she starts with block-ing equipment, protective plastic sheet, rigid plastic andcrowbar, which are normally used rst.

During this time the trac control ocer/extricator hasbeen placing cordons on either side o the accident. Every-one wears saety goggles, saety vests and fexible workinggloves. Latex gloves are worn under the working gloves toprevent blood contamination.

A general description is rst given below o what re bri-gade personnel must watch out or and do in view o the actthat there may be non-deployed airbags and side impactprotection curtains in the vehicle. A brie description is then

given o what is known as quick removal, ollowed by moredetailed fow charts or extrication and removal when the

condition o the casualties is judged to be stable and thereare no external hazards that make quick removal essential.

Te descriptions are intended to provide readers with asbroad and structured a picture o extrication as possible.

4


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Check where the gascontainers are locatedand make sure you donot cut into these.

At the scene o a real accident many people will naturallybe working at the same time, and actions will be perormedin parallel wherever possible.

It is important to have the casualties under supervisionthe whole time, which is not repeated or every operation in

the account given below.o simpliy the account we have also chosen to write

about a casualty or the casualty in the singular.

Non-deployed airbagIdentiy whether the car is tted with an airbag, or withmore than one airbag! Tis is marked on a window, the

dashboard or the steering wheel. Te car industry has nowreached agreement on the designation SRS (Supplementary


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Restraining System). Tis marking also means that the caris tted with belt pretensioners. Older markings may beS.I.R., P.R.S. or Airbag. Te steering-wheel hub is slightlybulky in a car tted with an airbag.

reat the car as though it has airbags i you are unsure.

Do not hold any tools or other objects between the casu-alty and a suspected non-deployed airbag. Disconnect thebattery, detaching the negative terminal rst. Te airbagsensors may be located at the ront o the vehicle, in the pas-senger compartment or on the side depending on what air-bags there are in the car. Do not work on the steering-wheel

column. Doing so could cause tool damage. Also avoidexerting orce on the steering wheel hub as doing so may

trigger a non-deployed airbag. Do not cut the leads attachedto the saety system. Te leads are generally brightly colour-ed: orange, yellow or neon-green.

urn o the ignition and disconnect the battery to deac-tivate the system. Avoid cutting into pressure vessels. I a cutis made in a pressure vessel, it might conceivably fy o dueto the high pressure in the container (300 bar). Containerstoday are not just located on the C or D pillars, in somecases they can also be ound on A-pillars or on the edge othe roo. We recommend breaking away the inside o all thepillars and looking to see where the pressure containers arebeore cutting. It is a good idea to mark on the outside whereit is appropriate to make the cut. Also take account o the

width o the pillar so that you cut not at its widest point butat the narrowest point possible.

summary Always disconnect the battery beore commencing extrication. Note that some car models may have two batteries. I possible do not work in the airbag risk zone i the bag has not deployed. Remember that the car may have more than one airbag. Do not place the spreader guide against unknown parts o the car. Do not cut into the brightly coloured cables as there is a risk o accidental

deployment. Prise o the panel and look to see where gas containers are located beore

cutting.


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1. O ()

2. H ,

3. O w

4. Lw

5. I

Quick removalA quick removal may be necessary due to a deterioration inthe casualtys condition or an external threat, such as re,hazardous materials etc. which mean that the casualty mustbe removed rom the vehicle quickly. Te basic principle is

to remove the casualty in the longitudinal direction throughthe rear windscreen on some kind o aid such as a rescueboard or spine board or equivalent device. Tis preventstwisting o the casualtys back and neck, which can aect thepattern o injuries.

Action plan or quickremoval.


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Upright car

Removal when the casualtyscondition is judged to be stable andthere are no external hazardsTe ollowing action plan should be ollowed when the

external situation and the casualtys condition give the rebrigade personnel a little more time than in the case o quickremoval.

1. S First stabilise the vehicle at our dierent places: behind each

o the ront wheels and in ront o the rear wheels. Placeblocks/wedges/steps under the door sills and remove thewheel valves. Te vehicle will then settle on the blocks andbecome stable.

Stabilise the vehicle.

Remove the wheelvalves.


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2. D w urn o the ignition, gain access to the battery and dis-

connect the negative cable rst.NB First unlock the doors i the vehicle has central lock-

ing. Tere are vehicles today on which the central locking

locks automatically at speeds above 20 kph. Electric win-dows may need to be lowered in the door. Tis should bedone i possible beore the battery is disconnected. Other-wise the necessary actions can be done rst and then thebattery can be reconnected. It is partly or this reason thatthe power supply has to be disconnected by detaching thecable terminals and not by cutting o the cables.

3. A Common seats have a number o manual adjustments thatcan be used to relieve the pressure on the casualty.

Alter the position o the steering wheel to reduce the pres-sure on the casualty i there is steering wheel adjustment.

I the car has been hit rom the side and there is pressureon the casualty, use the hydraulic ram to orce the bodyworkapart so that the pressure on the casualty is eased.

Prevent cooling by putting a blanket and cap on the casualty.

Cover the casualty and medic with transparent bubble-wrap plastic and put saety goggles and a cap on the casualtyi necessary.

Disconnect the cablesrom the battery, nega-tive terminal rst.


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4. R ww wWind or run down the windows and crush them in the door(i possible). Te glass ragment will then be le in the door.

I you leave the windows intact it is possible that they willdisintegrate in an uncontrolled manner later in the opera-tion, leading to an increased risk o injury. Another optionis to place sticky lm on the windows to avoid problemswith glass ragments when they are broken.

Tere are cars that have unbreakable laminated glass orsaety glass in the side windows. Windows o this kind mustbe run down into the door or sawn away. Te usual practice

Attend to the casualty.

Crush or saw sidewindows and rearwindow.


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is to saw them away as the battery has been disconnectedpreviously. Work on the rear window in the same way i it ismade o laminated glass.

Bear in mind that sabre saws and glass saws generate highsound levels that may be very distressing or the casualty. It

is thereore advisable to put some orm o hearing protec-tion on the casualty and the medic.

Finely divided glass dust is also ormed in the sawing ope-ration, and has a tendency to whirl around in the car. Somake sure that the protective plastic sheets provide a propercover. Occupants remaining in the car can be given masks i

necessary.

5. C Cut o the saety belts where necessary to ease the pressureon the casualty.

6. C Break away a little o the trim lining the pillars and look orgas containers so that you do not cut into them. Use a sharpobject to mark a line on the outside to indicate a suitable

point at which to cut. (See photo on next page.)

Cut of the seat belt.

B w

w

.


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Start cutting the A-pillar urthest away rom the casualtyand saw rom the hole at an angle across the windscreen.

Continue by cutting the B-, C-, (D-, D-,) C-, B-, A-pil-lars.

Break away the trimand look or where gas

containers are located.

Exposed gas container.

Marking o cuttingpoint.


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7. Sw wSaw the windscreen with a glass saw or battery-operatedsaw. Wear a mouth guard. Start sawing rom the cut made inthe A-pillar just above the windscreen. Saw to the intendedcutting point on the other A-pillar.

Cut of the A-pillar.

Saw the ront wind-screen.

Te pillars are namedrom the ront:A-pillar, then B-pillarand at the rear the C-pillar. I the car is anestate or an SUV thereis also a D-pillar. Notethe cars crumple zonesand the door sill. Crumple zones

A-pillar

B-pillar

C-pillar

Door sill


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Cover sharp edges withedge protectors.

8. L Bear in mind that the roo becomes unstable when the pil-lars are cut on one side. Secure by asking someone to holdup the roo on the cut side.

9. C w Use edge protectors. Tis prevents personnel and the casu-alty rom cutting themselves on sharp edges.

Li of the roo.


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10. L When the casualty is ready to be lied out, lower the rescueboard/spine board down behind his or her back.

Hold the stretcher/board still, lower the backrest, pull thecasualty and board backwards, slide the body up onto the

board, li out in the lengthways direction and place on avacuum mattress and ambulance stretcher, or example.(See photo or point 14).

In most cases these measures are sucient or it to bepossible to perorm controlled and sae extrication, asdescribed in point 14. I the casualty is trapped, proceed asollows:

11. R I the door is wedged shut, it must be prised o. Start on thehinged side between the A-pillar and the window rame.

Force open with a crowbar. Continue with the spreader.Make the opening wider and work downwards.

Hold the spreader at an angle o around 45 degrees romabove. Tis eliminates the risk o a smashed door being bentinwards.

Work gently in small steps towards the hinge.Tere is a large amount o metal to be gripped when ope-ning the hinge. It may happen that the inner panel o thedoor bends inwards. Use the spreader to clamp the panelstogether and bend the door outwards.Remove the door.


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Continue down towards the lower hinge until both hingeshave been released.

When this has been done, try to get the door back to its star-ting position. Press the door handle in and li the door away.

I this proves not to be possible, bend the door backwards

and then orwards. A crack will then appear, making iteasier to break the lock away.

When the ront door has been removed, it will be possibleon some models to unscrew the hinges on the rear door.Bear in mind that the rear door may be needed as a counter-hold.

12. P w

I the dashboard needs to be pressed orward, place ahydraulic ram horizontally in the door space. Press with theram. (I necessary make a cut in the bottom edge o the A-pillar.)

Press the dashboard orwards with the ram and ollow

Cut the backrest inecessary.

Press the dashboardorwards.


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with the blocks. Te rear door must be le in position toserve as a counterhold.

I the casualty is trapped, the actions described can besupplemented by a middle ram that is run parallel. It mayalso be necessary to cut the backrest o the seat to be able to

li the casualty out saely.

13. C w It is very dicult to cut pedals with pedal cutters i someoneseet are trapped in them. Either the pedal moves or the cut-ter does, and this can exacerbate the injury to the oot. Oneoption is to tie a saety harness around the pedal, or example,and connect it to the spreader. Ten use the spreader to put

weight on the outside o the A-pillar in the door openingand pull in the direction in which the pedal is to be pulled.Another option is to cut the rim o the steering wheel owith the pedal cutter.

14. L When the casualty is ready to be lied out, lower the rescueboard/spine board down behind his or her back.

Hold still. Lower the backrest and pull the casualty andboard backwards.Slide the body up onto the board, li out and place on a

vacuum mattress or ambulance stretcher, or example.

summary o extrication or upright car Stabilise the vehicle

Disconnect the battery

Attend to the casualty

Remove side windows and rear windscreen

Cut o the seat belt

Cut the pillars

Saw the ront windscreen

Li o the roo

Cover sharp edges with edge protectors

Li the casualty out

Remove the door

Press the dashboard orwards

Cut pedals and rim o steering wheel i necessary

Li the casualty out

Te steering-wheel rimcan also be cut with apedal cutter.

Li the casualty out.


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Car on its sideI the vehicle is on its side and the casualty has to be lied out,ollow a special action plan. Only the extrication is describedhere. See the introductory section, page 29 , or assessmentand reproong.

1. A Te casualty may still be attached to the seat belt or be downat the door (not secured by belt). ry to keep the airwaysopen.

2. S Stabilise the vehicle i possible underneath or example with

scaling ladders against each axle and then secure the emer-gency service vehicles winch cables or equivalent (e.g.straps) at a suitable point on the car underbody to obtainpurchase against the ladders. I this method is applied, thereis no stabilisation on the other side to obstruct extrication.Tis makes it easier to work.

A good way o stabili-sing a car on its side isto use ladders, asshown in the picture,or supports.


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It is also possible to use various types o supports positio-ned so that the car becomes stable. It is advantageous toposition the supports on either side o the car and try toposition them directly opposite each other.

3. A Make sure that the casualty does not become cold. Use ablanket or something similar and a cap.

Crawl into the car and attend to the casualty as soon asthe vehicle is considered to be stable. I possible send some-one in to relieve the strain on the casualty i he or she is stillheld in the seat belt.

Stabilise the casualty asquickly as possible.

Cover the casualty andmedic with transparentplastic.


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4. D urn o the ignition, gain access to the battery and discon-nect the negative cable rst. (See point 2 in the section on anupright vehicle.)

5. R ww wCover the casualty and medic with a protective plastic sheet.

Remove the windows. Remove the lower windows rst,so that they do not break later, or example i someonestands on them. One way o reducing the risk o glass rag-

ments when the window is removed above the casualtyshead is to stick adhesive lm or tape on it beore punch-marking it.

Reduce the risk o glassragments by usingtape or adhesive lmwhen punch-markingand removing thewindow.


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6. C Break away the trim and see what is underneath.

Cut o A-, B-, C- and where applicable D-pillars acing

up.Cut the pillars high up at the edge o the roo. Te casu-

alty will be le attached to the seat belt.

Cut above the beltattachments.

Break the trim awayand check where anygas containers arelocated beore cutting.


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7. Sw wSaw the ront windscreen. Te more you saw out, the morespace there will be or liing out. I possible, saw so that a spineboard can be inserted to relieve the strain on the casualty.

8. M w Make notches in the the lower edge o the roo to weaken itat the A- and C-pillars, or the D-pillar where there is one, sothat it is easier to bend the roo down.

Saw away as much aspossible o the rontwindscreen.

Make notches whereyou want the roo tobend, or cut away the

whole roo.


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9. B wBend the roo down. ake care to cover sharp edges duringthe work. Te whole roo can be cut away i necessary.

10. C w -w Te rim o the steering wheel oen needs to be cut away tomake extrication easier.

Bend the roo down.

Cut the steering-wheel rimaway i necessary.


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11. L Make sure the casualtys eet are not trapped in the pedals.

I the casualty is attached to the seat belt, insert the rescueboard/spine board underneath him or her.

Support yoursel against the transmission tunnel, handbrake or the other seat.

Li the casualty up and relieve the strain on him or her.Cut o the belt.ake hold o suitable points on the casualtys body and

pull him or her out. Guide the casualtys legs.

I the casualty is lying on the door, insert the rescue boardbetween him or her and the door.

Li out.

Li the casualty out asgently as possible.


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summary, extrication rom a car on its side Attend to the casualty

Stabilise the vehicle

Attend to the casualty

Disconnect the battery Remove side windows and rear windscreen

Cut the pillars

Saw the ront windscreen

Make notches in the edge o the roo to weaken it

Bend the roo down

Cut away the steering-wheel rim

Li the casualty out

Car on its rooI the vehicle is on its roo, the casualty may be attached tothe belt or be lying against the roo. Only the actual extrica-tion is described here. See previous section (page 29 ) orassessment and reproong.

1. A ry to open the door where the casualty is located.

Attempt to establishaccess to the casualtyby opening a door.


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2. S

Stabilise the vehicle with wedges under the A- and C-pillarsand supports.

It may be dicult to obtain a good counter-hold with thesupports as there may not be much to secure them against.

3. D Switch o the ignition. ry to disconnect the battery. It cansometimes be reached rom underneath.

4. R ww wCover the casualty and medic, i present, with a plastic sheet

and remove the windows (i there are any le).

5. P wPrise away the door where the casualty is seated. Start on the

hinge side and continue with the lock side. On vehicles withour doors the rear door can oen be screwed o. Tis maybe sucient to get the casualty out.

Always take care tostabilise the car.


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6. L A large amount o space can be created by adjusting thebackrest, making it easier to work.

Relieve the strain on the casualty (either by one o the rebrigade personnel taking the strain or by using a rescueboard).

Cut o the seat belt. Insert the rescue board i it is notalready in position, and li the casualty out.

I this does not prove sucient, proceed as ollows:

Relieve the strain onthe casualty i he or sheis caught in the seatbelt.

Li out gently, using a

rescue board orexample.


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Alternative A: Open up the car rom the side

7A. C Position the hydraulic ram between the edge o the roo andthe door sill or foor. Apply pressure to the ram.

8A. C Cut o the B- and C-pillars or the A-, B- and C-pillars onone side o the car depending on how much space is needed.Cut above the belt attachment i the casualty is caught in thebelt. Note that the other side must not be moved as it isneeded or stabilisation. It is also possible to cut o and

remove the whole B-pillar i the casualty is caught in it whenthe ront door has been removed.

9A. W w fApply pressure to the ram and part the vehicle rom its roo.Ten support with blocks so that stability is maintained.

10A. L Pull back the backrest.

Cut the backrest o i it is electrically operated and thepower supply has been disconnected. NB. Cut the uphol-stery where it needs to be cut and check that there is no

Make sure that the caris stable and sae thewhole time.


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hardened steel or side airbags at that particular point.Insert the rescue board under the casualty. Relieve the

strain. I necessary, the steering-wheel rim can be cut o togain easier access to the casualtys legs.

Cut o the belt.

Li the casualty out straight back through the rear wind-screen, diagonally through the rear door, or rstly into therear seat so that the eet come ree in the ront door spaceand then out. Create space i the casualty is lying against theroo.

Alternative B: Open the car rom the rear

Make sure that the car is stabilised on both sides.

7B. C Position hydraulic rams in the edge o the roo and up intothe foor.

8B. C Cut the pillars rom the rear, but never cut either o the A-

pillars, as doing so would make the car highly unstable.

9B. W w fApply pressure to the ram and part the vehicle rom its roo.Ten support with blocks so that stability is maintained.

10B. L Pull back the backrest. Cut the backrest o i it is electri-

cally operated and the power supply has been disconnected.NB. Cut the upholstery where it needs to be cut and checkthat there is no hardened steel or side airbags at that parti-cular point.

Insert the rescue board under the casualty. Relieve thestrain. I necessary, the steering-wheel rim can be cut o togain easier access to the casualtys legs. Cut o the belt.

Li the casualty out straight back through the rear wind-screen, diagonally through the rear door, or rstly into therear seat so that the eet come ree in the ront door spaceand then out. Create space i the casualty is lying against theroo.


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summary, extrication rom a car on its roo

Attend to the casualty Stabilise the vehicle Disconnect the battery Remove side windows and rear windscreen Prise away the door Li the casualty out

alternative a: open up the car rom the side Create space Cut the pillars Widen the opening between the roo and foor Li the casualty out

alternative b: open the car rom the rear Create space Cut the pillars Widen the opening between the roo and foor

Li the casualty out

Always cover sharpedges.


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P- w

Every reghter is likely to have been taught at some time to

bear salvage value in mind when responding to variousemergency calls. For example, not to use more water thannecessary so that water damage is not caused in an apart-ment or house re, to remove combustion gases rom anaected room or to pressurise adjacent rooms beore thecombustion gases reach them. It is also necessary to bearsalvage value in mind in road trac accidents. Even i a carhas been involved in a road trac accident and cannot berepaired, there is considerable salvage value to bear in mind.I the car has been involved in a head-on collision, part o

the vehicle interior, wheels, panels orm the rear o thevehicle, lamp glass, rear axle etc. may be usable.

Instead o buying new parts, insurance companies andcar dealers may, or example, use these parts to repair partsthat have been hit rom behind. We can help here, orexample by not slitting the tyre with a knie when stabilisinga vehicle and pulling the valve instead. Tere is a price di-

erence o around SEK 1500 per tyre.Follow the recommendations below when starting to

clear up at the scene. Tis is an easy way o helping to pre-serve salvage value. Tese recommendations have been pre-pared by the Swedish Rescue Services Agency together withthe car industry and insurance companies.

W w w ?

Metal parts. But make sure that they do not damagethe vehicle interior. Plastic parts Rubber

5


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W w w ? Glass ragments Road surace materials, gravel etc. Clean-up materials Wet, sticky parts that spoil the vehicle interior General debrisMake sure you have some kind o container to take itemsthat cannot be thrown back into the car.


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Follow-up and evaluationUnder Chapter 3 Section 10 o the Civil Protection Act weare also obliged to document the accident:

When a rescue operation has been completed, the munici-

pality shall ensure that the accident is investigated in order toclariy to a reasonable accident the causes o the accident, thesequence o events in the accident and how the emergencyresponse operation has been conducted.

Whosoever carries out an investigation in accordancewith the rst paragraph o this section is also entitled to gainaccess to the scene o the accident. Te police authority shallprovide the assistance required.

Follow up the accident at the station using photographs

taken on arrival and aer the accident.Discuss questions such as:

What went well? What went less well? What do we need to do better next time?

Also ollow up the accident together with others whowere at the scene o the accident, or example the police,ambulance crew, emergency medical services etc.

Did the cooperation work well?I not:

Why did the cooperation not work? What do we need to do better next time?

E Te ollowing items should be considered and be includedin the emergency response operation report:

Te sequence o events in the accident and implementationo the emergency response operation Course o the accident prior to arrival o the re brigade,

behaviour o the public, evacuation Course o events aer the re brigade arrives, de-

ciencies in protection, implementation o the emergencyresponse operation, risks o spreading.

Evaluation

Measures to prevent similar accidents occurring Measures to improve protection against similar accidents

Measures to make similar emergency response opera-

tions more eective.


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I re brigade operations in road trac accidents are con-cerned, include also:

ypes o road trac involved

For example pedestrian, animal, car, bus, truck, rail-mounted vehicle etc.

Fire brigade measures

Extrication - simple tools, hydraulic tools, air jacks etc. Securing o the scene o the accident - spreading o oam,

stabilisation, battery disconnection etc. Other aspects - trac control, vehicle recovery, clearing

o road surace etc.


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Sources:http://www.olksam.sehttp://www.iihs.org

http://www.bmw.comhttp://www.saab.comhttp://www.volvo.comJande-Waldau, C. & Winarve, B. (2004): Prehospitalt akutomhndertagande.Enligt principen L-ABCDE.Rescue (a periodical) July-August 1996SIKA Statistics 2005:14 - Road rac Injuries 2004


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PhotographsPages 24,28: Christian Svan

Pages 15, 50: VolvoPages 8,21: SaabPage 15:BMWPage 6:Christoer TessmanPage 11:Ingvar Hansson, SRSAOther photographs:Dan Wargclou, Stean Andrasson, Ola Johansson,SRSA Skvde


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ExtricationromCarsDuringRoadTrafc

Accidents

A

round 70,000 road trac accidents happen every year

in Sweden. Many people are injured. Attending to the

casualties o road trac accidents is a responsible and

demanding task. It is important to ocus the whole time

on those who need help and to base the emergencyrescue operation on their condition. Knowledge, practical skills,

patience and common sense are needed to ensure that this is done in

a medically correct way. Te fre brigade, police, emergency medical

services and others involved have to be able to cooperate so that a

satisactory result is achieved. Joint exercises and dialogue are required

so that the various parties involved will learn about and understand

one anothers methods o working and approaches.

Extrication rom Cars During Road Trafc Accidents emphasisesextrication as an important element in this work. Te book describes

airbags and other saety systems, tools and tool use, organisation

on the scene with a 1+4 crew and extrication according to an action

plan or an upright car, a car on its side and a car on its roo. Finally

attention is also given to post-emergency work.

Extrication rom Cars During Road Trafc Accidents supplements

literature and training in other areas, such as emergency medical

treatment, and is intended to provide fre brigade personnel with afrm oundation in attending to casualties o road trac accidents.

extrication suecos

Documents