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Is Re-Programming Our Thoughts on Extrication Necessary?

Increasingly over the past few years, I have had some interesting discussions on various vehicle rescue topics which have centered on why we do what we do.  By this I mean, it seems that we have been “programmed” to do or not do certain things.  Unfortunately, this “programming” may or may not be helping us at rescue scenes.  Maybe we need to “re-program” our rescue responses (or at least start thinking about it).

An example of something we need to think about today is windshield removal when doing a roof removal.  Why do we remove them?  And is it necessary to automatically remove windshield glass today?   When I was a beginning rescue, I learned that “you shall always remove windshield glass!”  Now when you are just starting out, you do what the old guys tell you.  Now I am getting to be an old guy (no, I am not there yet), and I realize that I drank the Kool-Aid.  So back to the question – do we need to automatically remove windshield glass?

In the modern vehicle, windshields are glued in and in many cases create some of the structural support of the occupant space.  We are no longer dealing with windshields set in rubber or mastic.  And years ago we had so many people at an extrication scene, we were looking for things to do.  Today we have fewer people responding, but in a lot of cases, we still take out a windshield before we take a roof off. 

We can extend this question today to include side windows that are laminated.  Is it necessary to take them out before taking a door off? 

Another example of questioning what we do is stabilization.  Yes, a car on its side or in some unusual position needs to be stabilized.  But is there a need to do multi-point stabilization to a damaged vehicle that is sitting upright on solid/level ground?  We have been taught that we must restrict even the slightest movement in a vehicle or the victim will be paralyzed for life.  What our medical community is telling us is that this is not the case.  I have seen many cases where crews take an inordinate amount of time to stabilize the vehicle, but they have no problem manhandling the victim during extrication.

If you think about it, why do we take so much time for stabilizing and glass removal, but do NOT take the time to properly assess the vehicles before we put tools to them?  Not properly assessing the vehicle for SRS, fuel/energy systems, etc. will have far more disastrous implications than moving the vehicle 1/16th of an inch during an extrication. 

These are examples of discussions we need to start about what, why, and/or how we operate at extrication scenes today.  Anybody can start these discussions (not just us soon-to-be-old guys) and everyone needs to contribute to them.  We may find that we need to change how we are doing things.  We may find that we need to go back to do things from back-in-the-day.  Either way, we need to think about what we do, discuss it, and if necessary re-program ourselves to insure the quickest and safest patient oriented extrication.

As always, you are welcome to translate (if necessary) and share with friends and fellow rescuers.  In other words:  “Get the discussion started!”

Keep it safe!  EJR

PS…  Summer is here!  I hope everyone has a chance to go on vacation/holiday with family and friends.  Please enjoy yourselves!