Chapter 38: Vehicle Extrication and Special Rescue

structure fire

A fire in a house, apartment building, office, school, plant, warehouse, or other building.

tactical situation

A hostage, robbery, or other situation in which armed conflict is threatened or shots have been fired and the threat of violence remains.

technical rescue situation

A rescue that requires special technical skills and equipment in one of many specialized rescue areas, such as technical rope rescue, cave rescue, and dive rescue.

special weapons and tactics team (SWAT)

A specialized law enforcement tactical unit.

technical rescue group

A team of emergency responders from one or more departments in a region who are trained and on call for certain types of technical rescue.

Common duties and responsibilities of EMS personnel at the scene of a motor vehicle crash include all of the following, EXCEPT: A. keeping bystanders at a safe distance. B. assigning all patients a triage category. C. preparing all patients for transportation. D. continual assessment of critical patients.

A. keeping bystanders at a safe distance.

_____________ is defined as the ability to reach the patient.

Access

simple access

Access that is easily achieved without the use of tools or force.

safe zone

An area of protection providing safety from the danger zone (hot zone).

danger zone (hot zone)

An area where people can be exposed to hazards such as electric wires, sharp metal edges, broken glass, toxic substances, radiation, or fire.

hazardous materials

Any substances that are toxic, poisonous, radioactive, flammable, or explosive and cause injury or death with exposure.

Which of the following is the BEST example of gaining simple access to a patient? A. Using a pry bar to open a damaged door B. Entering a vehicle through an open window C. Breaking glass to gain access to the patient D. Removing the roof to access a critical patient

B. Entering a vehicle through an open window

Which of the following is the most important in protecting EMS providers during an extrication operation? A. The dispatch information B. The scene size-up C. The number of patients D. The availability of special operations personnel

B. The scene size-up

Proper protective equipment will vary depending on the hazards encountered. Which piece of equipment should be utilized during all patient contacts?

Blood- and fluid-impermeable gloves

You respond to a wooded area to help search for a child who has been missing for approximately 24 hours. Which of the following equipment should you leave in the ambulance? A. Radio B. Flashlight C. Jump kit D. Backboard

D. Backboard

A man has been sucked inside the bin of a grain silo and is trapped. Which of the following rescue teams is the MOST appropriate to request? A. Trench rescue B. High-angle rescue C. Local fire department D. Confined space rescue

D. Confined space rescue

What should be done for any type of alternative-fuel vehicle that is involved in an accident?

Disconnect the battery.

complex access

Entry that requires special tools and training and includes the use of force.

access

Gaining entry to an enclosed area and reaching a patient.

Who has overall command of an emergency incident?

Incident Commander

extrication

Removal of a patient from entrapment or a dangerous situation or position, such as removal from a wrecked vehicle, industrial incident, or collapsed building.

self-contained breathing apparatus (SCBA)

Respirator with independent air supply used by fire fighters to enter toxic and otherwise dangerous atmospheres.

Incident Commander

The individual who has overall command of the incident in the field.

command post

The location of the incident commander at the scene of an emergency and where command, coordination, control, and communication are centralized.

size-up

The ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics to manage an emergency.

entrapment

To be caught (trapped) within a vehicle, room, or container with no way out or to have a limb or other body part trapped.

Rescuers have brought you a patient rescued from a structural collapse. You should immediately _________.

begin a rapid assessment

A two-door passenger car struck a tree while driving approximately 50 mph. The doors are badly damaged and jammed, and the driver appears to be unconscious inside the vehicle. Entering the vehicle by breaking the back window is an example of:

complex access.

Tactical EMS providers are specially trained to function during _________.

dangerous law enforcement operations

To evaluate the scene for hazards and identify the number of patients, the EMT should first _________.

do a 360-degree walk-around

A hiker was injured when he fell approximately 20 feet from a cliff. When you arrive at the scene, a member of the technical rescue group escorts you to the patient, who is positioned on a steep incline. The MOST appropriate method of immobilizing and moving the patient to the ambulance is to:

immobilize his spine with a long backboard and place him in a basket stretcher.

In contrast to simple access, complex access:

involves forcible entry into a vehicle.

A 50-year-old female is entrapped in her passenger car after it struck a tree. As the rescue team is preparing to extricate her, you quickly assess her and determine that she is breathing shallowly and that her radial pulse is absent. You should:

maintain spinal stabilization as she is extricated.

Proper removal of a critically injured patient from an automobile involves:

moving the patient in smooth, slow, controlled steps.

Upon arrival at an active law enforcement incident, the EMT should _________.

notify the incident commander

The EMT's primary responsibility during a rescue or extrication situation is _________.

patient care

A 30-year-old semiconscious man is pinned by the steering wheel of his badly wrecked vehicle. Once access has been gained to the patient, the EMT should:

perform a primary assessment and provide any needed emergency care prior to extrication.

What is the first phase of extrication?

preparation

You and your partner are standing by at the scene of a residential fire when you hear the incident commander state, "We have located a victim" over the radio. You should:

remain with the ambulance and wait for fire personnel to bring the victim to you.

Disentanglement involves:

removing a patient from a dangerous position.

As you approach an unconscious patient who is still in her wrecked vehicle, you note that there is a power line entangled in the wreckage of the vehicle. You should:

retreat until the power line has been removed or the power is shut off.

As you and your team are removing an unresponsive patient from her wrecked car, you note that she has closed deformities to both of her legs and a deformity to her left humerus. You should:

support the injured extremities and continue removal.

A unique consideration when dealing with a hybrid vehicle is that:

the battery has higher voltage than a traditional vehicle battery.

The reasons for rescue failure can be referred to by the mnemonic FAILURE. In this mnemonic the "U" stands for:

underestimating the logistics of the incident.

Your unit has been dispatched to stand by at the scene of a structure fire. There are no injuries of which you are aware. Upon arriving at the scene, you should:

ask the incident commander where the ambulance should be staged.

While the EMT is in a vehicle assessing the patient, the rescue team should be:

assessing exactly how the patient is trapped and determining the safest way to extricate.

You are dispatched to the scene of a trench collapse. Upon arriving at the scene, your ambulance should be parked at least _____ feet from the incident.

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