Section 6-1

Vehicle and Machinery

Vehicle extrication and machinery rescue can occur any where in the United States. We can have entrapment of arms or hands in punch presses in rural manufacture plants. Or we can have multiple car accidents with entangled bodies on any expressway in any major city. A great majority of these incidents will be handled by fire fighters whether they are volunteer, paid on call, or full time.

When rescue personnel arrive on the scene of these accidents, they must perceive the site for a safe and workable condition. Rescuer safety is first priority .The first item to look at is the size up of the scene. There are many ideas that can encompass size up but we will be looking at three major areas -environmental conditions, patient injuries and scene conditions.

Environmental conditions deal with the weather. We can have extreme heat and cold situations that may affect the rescue operation and our personnel. These conditions can also create added problems for the patients we are trying to disentangle. Rain, sleet and snow are other dilemmas that we may face. The ability for us to respond and work at the scene is dependent upon traction of the work surface. In several conditions, the patient's state may deteriorate at a faster pace. The last concern is darkness. The rescuer acknowledges the problems and will react in a faster manner. Whereas, in a low light or dark condition, rescuers are restricted or handicapped to the amount of lighting provided.

The patient's injuries will occur from the mechanism that will come in contact with the body. The mechanism of injury can come from a windshield, air bag, steering wheel, dashboard, " A " or "B" posts, rear view mirror, door, roof, auger, conveyor belt, etc. The injury of the patient could be external and/ or internal. The possible external injuries that the EMS personnel may see are injuries to the head, neck, shoulder, arm, hand, back, hip, leg, foot, etc.. Internal injuries can involve the organs, spine, brain, blood vessels, etc.. The damage to these body parts can be bruises, lacerations, fractures, amputation, etc.

Scene conditions are the last subject of size up that will be explored. The major areas are listed below:

1. Stabilization is the first priority to any accident of a machine or vehicle. Stabilization will maximize the contact surface between the car and the ground or provide support the key points in the machinery .It should also prevent further injury to the patient and safety for the rescue personnel.
2. Hazardous materials is another area that should be addressed for rescuer's safety. Hazardous materials should be identified, addressed or removed before any rescue personnel is allowed to continue the rescue.
3. Electrical problems can exist in many ways:

   a. Utilities -if the power lines are down, they could be in the immediate area or could

   spread to electrify metal fences, guard rails, downed phone lines or cable lines. If anyone comes in contact with these lines, it could be fatal. So let the power company handle the problem.

   b. Vehicle battery -the location of the batteries in cars could be under the hood (high or low -hidden), under the back seat, or in the trunk. The power cable will run along or in the rocker panel. On trucks, the batteries will be in the battery box, under the hood or in the wheel wells.

   c. Machinery power -should be turned off at the main electrical panel with a lock out! tag out equipment applied.

4. Fire is a large concern in vehicle accidents because of the fuel that is being used. The use of a charged hose line at the scene of an extrication should be used to protect the rescue personnel. Crowd control should be addressed by the police department. The crowds could restrict or hamper the rescuer's activities thus needing a longer time to extricate the patient(s).
5. The police should also control the traffic around an accident. Consider using the fire apparatus for blocking traffic.
6. Hydraulic shocks, absorbing bumpers, hatch back, hood pistons and hydraulic suspension systems that are found on cars, vans and trucks can be very explosive under a fire condition. Bumpers have been known to be launched as far as 100 feet or could wrap around the vehicle.
7. Scene survey will be an eight sided approach to an accident: inside, outside, top, bottom, front, back, left side and right side.

Depending of the type of emergency system that can be found in the region, there could be as many as four agencies that may responding to the incident. In some systems, all of the following could be under one department. But, all of the following must be addressed at any accident.

1. The police are responsible for maintaining crowd control, traffic control and preserving the scene for reconstruction and investigation.

2. The fire department has the responsibility for:

   a. Maintaining scene safety by extinguishing fires, preventing any fires from starting and handling any spills or leaks of hazardous materials.

   b. Maintaining vehicle safety by checking the fuel system and handling any fuel spills or leaks, checking the electrical system and removing the power to the vehicle or machinery, and assist the EMS and /or the rescue personnel.

3. The emergency medical services has the responsibility for:

   a. Patient assessment of medical problems

   b. Patient packaging for removal

   c. Assess the patient's disentanglement and extrication needs

   d. Patient removal and handling

   e. Transportation of the patient

4. The extrication rescue personnel are responsible for:

   a. Vehicle or machinery stabilization

   b. Create a safe access for the EMS personnel

   c. Initiate safe disentanglement procedures/guidelines as necessary for all patients

   d. Assist the EMS personnel with removal of the patient

There are many possible hazards that are found at the scene of vehicle or machinery accidents. The following are the most pronounced risks.

1. Air bag systems are found in most vehicles. These systems are marked with the following logos: SRS, SIR, Air Bags, Side Air Bags, Knee Impact Bag, Head Impact Bag, Head Curtain Bag, etc.

   a. Electrical drain time after the battery power has been disconnected could range from 30 seconds to 25 minutes.

   b. For safety of the rescue personnel and the patient, the distance of 5" for side air bag, 10" for driver's air bag and 18" for passenger air bag should be maintained away form the bags.

2. There are four major types of fuels used in vehicles.

   a. Gasoline is the most used fuel found in most vehicles. Gasoline is a flammable fuel.

   b. Diesel fuel systems is very popular in the trucking and fanning industry .Diesel is a combustible fuel and will often have a large quantity on board the vehicle.

   c. Compressed natural gas or liquefied petroleum gas systems are not too widely used. These systems may be found in forklift trucks and natural gas company vehicles. The trucks and cars will be marked to indicate that it is powered by that gas. This type of system will have heavy , high pressure tanks on the vehicle.

   d. Electrical cars are not common but maybe seen in industrial areas. The largest concern for electrical cars is the presence of batteries and acid.

3. Hydraulic shocks, absorbing bumpers, hatch back, hood pistons and hydraulic suspension systems that are found on cars, vans and trucks can be very explosive under a fire condition. Bumpers have been known to be launched as far as 100 feet or could wrap around the vehicle.
4. Vehicle battery -the location of the batteries in cars could be under the hood (high or low - hidden), under the back seat, or in the trunk. The power cable will run along or in the rocker panel. On trucks, the batteries will be in the battery box, under the hood or in the wheel wells.
5. The seat belt pretensioner is a device that will draw the person back into the seat on a frontal accident. The location of the pretensioners ( if equipped) will be in one of the following places:

   a. B post (low or mid point)

   b. C post (low)

6. c. Inner front or rear seat buckler area
7. In the machinery rescue area, the use of gears, chains, pulleys, augers and conveyor belts are very extensive. The use of these items in manufacturing, farming, material movement, etc. are quite common. There are some basic items to be aware of:

   a. The power source could be electrical, motor, air driven or hydraulic.

   b. This equipment is very rugged in its construction.

   c. There could be a chemical hazard because of the equipment's usage.

   d. The accident could be in a remote area.

   e. There could be a time delay getting to the scene.

   f. Great caution should be used because of stored potential energy or full cycle machinery .

   g. When shutting down machinery , the lock out! tag out procedure should be used.

   h. When disassembling of equipment is needed, the assistance of the maintenance man would be of great help.

Initial Company Actions

1. The scene protection at an auto accident can be achieved by utilizing the apparatus in controlling the traffic. It may also be achieved by using traffic cones, flares and other devices. When a machinery accident occurs, the rescuer can control the movement of personnel by traffic cones, caution tape, locking doors, etc.

2. The access to the vehicle involved in an accident can be as simple as opening the door with the car's handle. More entailed equipment should be used by trained personnel. Access into machinery can be as simple as unscrewing an access panel.

3. Stabilization of a vehicle can be achieved by the rescuers by putting the vehicle in park or apply the parking brake. The use of basic cribbing can also achieve stabilization. When dealing with machinery , just shutting off the power may not stabilize the equipment.

Scene Control at an Incident

1. Traffic needs to be controlled for the safety of the rescue personnel. Crowds could restrict the rescuers' activities at the scene

2. Machine can be controlled in two ways: Electrical power can be shut down and locked out at the main electrical box and mechanical power (hydraulic, pneumatic or motor) can be shut down and locked out.

CAUTION: Beware of stored potential energy or full cycle machinery . EXAMPLE: Machinery that continues to move after power is removed.

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