Recapping last weeks daily training we have been dispatched to a reported vehicle accident. After boarding the engine we have reviewed the dispatch information, figured out the best route to get to the scene and have begun considering the resources that will be needed to safely and efficiently control the incident.
Now as you are approaching the incident a more detailed size-up process begins. Your size up should parallel your perspective of the scene. As you approach the scene from a distance you have a wide view…Think big picture (ie apparatus placement, roadway and overhead hazards). As you get get closer to the incident your view narrows and the details of the scene become more apparent (Number of vehicle, vehicle placement and vehicle damage). Combining all of this information will provide all of the data needed for an accurate initial scene size up report and influence your initial incident action plan.
Reading the wreck and understanding how energy is transferred is critical in the scene size up process. When two vehicles collide the energy that was once movement, is transferred first to the other vehicle and then to the occupants inside. Understanding which of the body systems are affected by that energy transfer can help us predict patient injury and determine patient priority.
Triage is the act of categorizing each patient according to severity of injury and transport priority. Triage is vitally important but it is NOT static. Patients must be continuously evaluated for changes in their condition. Adjustments to your IAP may be necessary if a patient’s condition deteriorates.
Inner Circle and Outer Circle must be completed at the accident scene to ensure that all occupants of the vehicles are accounted for and that there are no hidden dangers that might put your crew in harms way.
Vehicle Stabilization- Stabilize the vehicle using the resources and equipment on scene to ensure that there is no movement of the vehicle during the extrication process that might endanger the crew or further injure the occupants of the vehicle.
Access Patient- Once the vehicle is stabilized, access to the patient can be made and patient care can begin. C-spine precautions should be taken if the mechanism of injury dictates. This is also when a initial patient assessment should be made to establish a baseline from which future patent evaluations can be measured.
*** Next week we will be detailing patient assessment skills and how the patients vitals and appearance reflect their condition
Prepare to Extricate / Extricate- Extrication is no longer the simple act of grabbing a set of hydraulic tools off the engine and starting to cut. Modern extrication involves and understanding of the vehicles construction, safety systems and power systems i.e. gas, electric, or hybrid. Before you begin the actual extrication, the power should be isolated and the interior trim removed near all cut points to ensure that no pressure cylinders or seatbelt tensioners are cut during extrication.
As a crew, watch the link below
