During the extrication process it is vitally important to create as much space as possible. The space you create ensures that your extrication route is sympathetic to the casualty’s injuries and also allows adequate space for personnel to work safely and effectively.
We can look at space creating in two areas:
External space creating – the removal of the vehicle structures allowing access for rescuers and medics and a final extrication space for your casualty.
Internal space creating – the manipulation of the interior of the vehicle to ensure maximum access for medical intervention and to allow crews to work effectively during the physical extrication phase.
Below demonstrate methods for internal space creating for vehicles on their side and on their roof.
Vehicle on its side
If your primary access is through the hatch, this if often restricted due to the rear seat construction and head restraints. Firstly remove the head restraints, either manually or by using a mini cutter (see below). You will now see that your access space is already increasing.
Now use your spreaders; spread between the roof rail and the seat back. If the seats are 60/40 splitting, you will need to repeat this for both sides of the rear seat.
Vehicle on its roof
A vehicle on its roof can offer ideal access through the hatch once it has been opened and removed, however the rear seats will impede progress.
Remove the rear head restraints manually or using a mini cutter.
Release the rear seat backs and push them forward.
Hold the rear seat backs in position by reclining the front seats.Your final space now allows access for medic and equipment. Creation of internal space also improves visibility.
Conclusion
The creation of internal space is fundamental to a safe and successful rescue. It allows us to work in a more comfortable environment, ensures greater casualty access and allows a more thorough assessment to be carried out. Ultimately, it makes the physical extrication of the patient less stressful for all concerned. Crews should have a more structured approach and always seek to identify ways to create space using manual and hydraulic methods.