Extrication of a Patient with a Pole Embedded in Car

A video of an extrication where a car was embedded around a metal traffic signal pole was post on YouTube a couple of years back.  The extrication was handled by the Santa Fe Spring Fire Department and LA County Fire Department. What is good about the video is how much of the extrication process that was recorded.  The video is a great training aid because it makes you think about having a plan A, B, and maybe even C and D.  This was an actual extrication.  So if in the video you would have done something different than please post a comment. I always like to hear the different approaches and techniques that other departments would have used.  A comment was posted on YouTube that there was some cutting and spreading done with the vehicle glass still in place.  However, what is the first thing you notice about the glass?  Tinted?  Aftermarket tint?  I would say definitely aftermarket tint because at 1:46 in the video you can see two firefighters handle the shattered rear glass in one piece.  It’s a great video, give it a look and let me know what you think?

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  1. My favorite part of this is always the stretcher strap over the neck.

  2. Hey Smitty
    These are my thoughts, some are a bit picky, but as we are here to learn, take them positively, and i mean no disrespect to the hard work done by this crew, side impacts such as these are always difficult extrications. So here goees:
    1, Crowded scene with members watching with no task, (wait at equipment area) to de deployed
    2, 26 secs Poor head control initially with one hand, and briefing other crew. This should be a dedicated task.
    3, 56 secs jerking down of the spreaders, is this really needed? especially as it was in close proximity to the casualty.
    4, No hard protection used throught, we should always be using some kind of casualty shielding.
    5, lack of rescuer eye protection during rescue, we must protect out eyes.
    6, tools left on the floor all around the incident, causing trip hazards etc try to keep a clinical scene as best as we can
    7, the door nearest the casualty was left on, why not remove it to gain better casualty access?
    8, The glass has already been mentioned, but why not remove it early on there where plenty of crew free for the task? simultaneouse activity at all times.
    9, None of the sharp edges left from cutting and the windshield etc where covered, no use of sharps protection throughtout, this should be done as the rescue progresses, again a lot of hazards left open there.
    10, there seemed to be no stability on the working side, but difficult to tell in the video if it was needed?
    11, a lot of casualty movement during removal onto the stretcher, again no one maintaining in line neutral c-cpine (side impacts carry a high percent of neck/ spine injuries) even with a collar we still need to control the head to prevent movement.

    Sorry this list seems to pull apart the rescue, please take these as learning points to look at. Its always difficult to comment on incidents when you are not there, and aslo without upsetting the crews with this type of feedback.


    • Hey John, Thanks for your comments. The poor C-Spine control is what really bugged me. They had enough people to dedicate one guy to a C-Spine! I would have sent someone in the vehicle to hold C-Spine, just my opinion. I always think it is important to have someone inside the vehicle whenever possible. Then C-Spine can be transferred to a responder outside the vehicle.
      No worries John, glad you listed everything out! I posted the video knowing it was not a perfect extrication hoping that people would make suggestions. You Tube is a great learning tool!

  3. It is a very good video. It would be interesting to know what were the injuries and how the patient was situated in the car. Was the pt wearing a seatbelt, did the door provide protection for the pt from the pole. One method that could have been deployed would have been to remove the seat on the passenger side to provide access to the pt. Very difficult extrication, good job!

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