Standing Order #2 - Vehicle Extrication
Issue Date: January 1991
PURPOSE
The purpose of this Standing Order is to state the PCSAR procedures for stabilizing the scene of a motor vehicle accident and properly and safely extricating patients from the scene.
SCOPE/POLICY
It is the policy of PCSAR to respond to motor vehicle accidents and safely and efficiently remove patients entrapped in the wreckage.
RESPONSIBILITY
The on-scene commander of rescue operations is responsible for implementing this standing order.
PROCEDURE
In all cases of vehicle entrapment, the primary concern is safety of responders. The secondary concern is safety of the patient; patient condition, his/her situation, hazards (real and potential), and available resources will influence the methods and speed at which the operation will be accomplished.
With this in mind, the on-scene commander and personnel called to these incidents must use careful, efficient means to accomplish the following in a timely manner;
Establish command and/or rescue operations.
Survey the scene, mitigate immediate hazards, and triage patients.
As soon as the need for extrication procedures has been established, command shall ensure proper rescue tools are on scene or en route, he/she must also determine what additional resources may be needed and request through the IC.
Establish a tool staging area and action circle.
Check for control hazards.
Ensure stabilization of the vehicle.
Gain access to the patient.
Perform primary patient survey and implement immediate care of life-threatening injuries if not established.
Perform controlled movement and/or removal of all metal and/or obstructions in order to properly package and remove the without further aggravating the patient’s injuries.
Prepare patient for removal.
Carefully remove the patient with due care to injuries.
Prepare the patient for transport without further delay.
Secure any equipment used and secure the scene.
COMMAND PROCEDURES
Command procedures may include establishment, transfer, divisions, and staging. Command should strictly control access to the action circle to those persons working on the extrication. All personnel located inside the action circle should be in full protective gear whenever possible.
On scene, overall command is under the Incident Commander (IC), with patient care under control of medical personnel. Ultimate responsibility lies with the IC and decisions should be made with help of medical control.